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If by ship Name of steamship line was
2d 1st cabin cabin
3d cabin
I arrived as (passenger, stowaway, seaman, member of crew, or otherwise)
(State which)
I traveled on (an immigration visa, a passport, a permit)
(State which)
I paid
head tax at
, on
(State amount)
(City)
(State or country)
(Month)
(Day)
(Year)
I was examined by immigration officers at
At that time I intended to remain (permanently temporarily, for visit, in transit)
(State which)
The person in the United States I was coming to was
(Give name in full)
The place in the United States I was going to was
The names of some of the persons or passengers I traveled with were
My last place of foreign residence was
Chester
England
(City or town)
(Country)
a
I am
married. The name of my
is
Hendrik Verkade
was born at
husband
He
Leiden. Holland
and now resides at
New London. Conn, said
I am now a subject of and intend to renounce allegiance to Queen Wilhelmina, of Holland queen
98 4ardner Avenue
(Write name and title of sovereign and country of which now a subject;
or, of if citizen the of Republic, Metherlands write of Republic only)
a name
I arrived at the United States Immigration port of
New York.
(City or town)
N Y.
,
on August 7th. 1916.
(State or territory)
(Give exact month, day, and year)
ADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME From OR THROUGH CANADA OR MEXICO:
(a) The 1 lace in Canada where I landed was
, on
(Month)
(Day)
(Year)
Canada
(b) The place in
from which I entered the United States was
Mexico
(c) On
(Month)
(Day)
(Year)
(d) The place where I was examined for admission at the United States border was
(le) If not examined, state why, and give the circumstances of your entry
{
Canada
(f) The place in
Mexico
where I bought my railroad ticket to come to the United States was
this Haa Verkade
e14-8
(Signature of applicant)
(OVER)
Page data
- Page
- 242
- Source index
- 0
- Type
- photo
- Media ID
- 71f5f384be78bfd0
- Size
- unknown
Document data
- ID
- 159596813
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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Document source metadata
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Document source extras
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Page context
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"ocrText": "If by ship Name of steamship line was\n2d 1st cabin cabin\n3d cabin\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\n(State which)\nI traveled on (an immigration visa, a passport, a permit)\n(State which)\nI paid\nhead tax at\n, on\n(State amount)\n(City)\n(State or country)\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\nAt that time I intended to remain (permanently temporarily, for visit, in transit)\n(State which)\nThe person in the United States I was coming to was\n(Give name in full)\nThe place in the United States I was going to was\nThe names of some of the persons or passengers I traveled with were\nMy last place of foreign residence was\nChester\nEngland\n(City or town)\n(Country)\na\nI am\nmarried. The name of my\nis\nHendrik Verkade\nwas born at\nhusband\nHe\nLeiden. Holland\nand now resides at\nNew London. Conn, said\nI am now a subject of and intend to renounce allegiance to Queen Wilhelmina, of Holland queen\n98 4ardner Avenue\n(Write name and title of sovereign and country of which now a subject;\nor, of if citizen the of Republic, Metherlands write of Republic only)\na name\nI arrived at the United States Immigration port of\nNew York.\n(City or town)\nN Y.\n,\non August 7th. 1916.\n(State or territory)\n(Give exact month, day, and year)\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME From OR THROUGH CANADA OR MEXICO:\n(a) The 1 lace in Canada where I landed was\n, on\n(Month)\n(Day)\n(Year)\nCanada\n(b) The place in\nfrom which I entered the United States was\nMexico\n(c) On\n(Month)\n(Day)\n(Year)\n(d) The place where I was examined for admission at the United States border was\n(le) If not examined, state why, and give the circumstances of your entry\n{\nCanada\n(f) The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nthis Haa Verkade\ne14-8\n(Signature of applicant)\n(OVER)"
}