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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 4978 U. S. DEPARTMENT OF LABOR NOT TO BE FILLED IN BY ALIEN FOR USE OF OFFICIALS SEARCHING IMMI- NATURALIZATION SERVICE 29216 GRATION RECORDS CLERK OF COURT: RECORDS EXAMINED terminatory SERVICE Place number in CARD INDEX upper left-hand corner of all copies of JAN12 1925 declaration, immediately under your INDEX BOOKS declaration number. NEW OF DISTRICT DIRECTOR OF NATURALIZATION. MANIFESTS travin (NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements in the regular order as they are to appear on the Declaration of Intention.) I desire to file my Declaration of Intention (first paper) to become a citizen. Mr. My name is Mrs. Willy (Alien/should Tokab print or typewrite here Eggert true, origiat, and correct 24 ; age, years. Miss name) (Give age last birthday) Also known as (If alien has used any other name in this country, that name should be shown here) I used that name because The full name of the person shown on my steamship ticket was Willy aggert My mother's maiden name was Emma Wiedumitt My maiden name was (if woman) My present occcupation is millhand Familight 5-14 My personal description is: Color, white ; complexion, strong ; height, 5 feet the inches; weight, 156 pounds; color of hair, brown Fair light ; color of eyes, plue ; other visible distinctive marks: none I was born in Chemnity (City town) Sachsen or (Country) Germany on the 26, day of July , GORNATURALLY TIGN : My present residence is 73 River Street Baltic (County) (State) (Number and street) (City or town) office address is Baltic Conn. P.V. Bux 98 AN 13 My post 927 ADD M The place where I took the ship or train which landed me in the United States was Bremen Hermany , on Secember 19. 1926 (Month) (Day) (Year) The ticket on which I came to this country was bought at Weida (City) Germany (Country) The name of the ship or railroad on which I came was SS Bremen CA Issued (OVER) IAN 21 1927

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4978\nU. S. DEPARTMENT OF LABOR\nNOT TO BE FILLED IN BY ALIEN\nFOR USE OF OFFICIALS SEARCHING IMMI-\nNATURALIZATION SERVICE\n29216\nGRATION RECORDS\nCLERK OF COURT:\nRECORDS EXAMINED\nterminatory\nSERVICE\nPlace number\nin\nCARD INDEX\nupper left-hand corner of all copies of\nJAN12 1925\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nNEW\nOF\nDISTRICT DIRECTOR OF NATURALIZATION.\nMANIFESTS\ntravin\n(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain\nstatements\nin the regular order as they are to appear on the Declaration of Intention.)\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nWilly (Alien/should Tokab print or typewrite here Eggert true, origiat, and correct\n24\n; age,\nyears.\nMiss\nname)\n(Give age last birthday)\nAlso known as\n(If alien has used any other name in this country, that name should be shown here)\nI used that name because\nThe full name of the person shown on my steamship ticket was Willy aggert\nMy\nmother's maiden name was Emma Wiedumitt\nMy maiden name was (if woman)\nMy present occcupation is\nmillhand\nFamilight\n5-14\nMy personal description is: Color, white\n; complexion,\nstrong\n; height,\n5 feet\nthe\ninches;\nweight, 156 pounds; color of hair,\nbrown Fair light ; color of eyes, plue\n;\nother visible distinctive marks:\nnone\nI was born in\nChemnity\n(City town) Sachsen\nor\n(Country) Germany\non the\n26, day of\nJuly\n, GORNATURALLY TIGN :\nMy present residence is 73 River Street Baltic (County) (State)\n(Number and street)\n(City or town)\noffice address is Baltic Conn. P.V. Bux 98\nAN\n13\nMy post\n927\nADD\nM\nThe place where I took the ship or train which landed me in the United States was\nBremen\nHermany\n,\non\nSecember\n19.\n1926\n(Month)\n(Day)\n(Year)\nThe ticket on which I came to this country was bought at\nWeida\n(City)\nGermany\n(Country)\nThe name of the ship or railroad on which I came was\nSS Bremen\nCA Issued\n(OVER)\nIAN 21 1927"
}