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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5013
U. S. DEPARTMENT OF LABOR
NOT TO BE FILLED IN BY ALIEN
FOR USE OF OFFICIALS SEARCHING IMMI-
NATURALIZATION SERVICE
GRATION RECORDS
CLERK OF COURT:
RECORDS EXAMINED
Place number
In
CARD INDEX
upper left-hand corner of all copies of
declaration, immediately under your
INDEX BOOKS
declaration number.
DISTRICT DIRECTOR OF NATURALIZATION.
MANIFESTS
(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements
in the regular orderas 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:
aaron (Alien should print Schumyately or typewrite here thue, original,
; age,
52
years.
Miss
and 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 Carowr Schuncyathy
My name was
mother's maiden Hannah Wallowitch
My maiden name was (if woman)
My present occcupation is
Grocer merchant
My personal description is: Color, White ; complexion, dark far ; height, 5 feet 41/2 inches;
weight, 150 pounds; color of hair, Gray
; color of eyes, Gray
;
other
visible distinctive marks: none Scars in left patm
I was born in
Baturia
Russia
(City or town)
(Country)
on
the 2 and day of October
,
18754
My present residence is
32 Walden Ave, New London Newsondon Cours
(Number and street)
(City or town)
(County)
(State)
My post office address is
32 Walden ave.
The
place where I took the ship or train which landed me in the United States was Hamburg,
Germany
on march
30
,
1906
(Month)
(Day)
(Year)
The ticket on which 1 came to this country was bought at
Vilna
Russias
(City)
(Country)
The name of the ship or railroad on which I came was
Patricia
(OVER)
014-8
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Document data
- ID
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- Core
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- Type
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DTO data
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Context sent to Scholar
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5013\nU. S. DEPARTMENT OF LABOR\nNOT TO BE FILLED IN BY ALIEN\nFOR USE OF OFFICIALS SEARCHING IMMI-\nNATURALIZATION SERVICE\nGRATION RECORDS\nCLERK OF COURT:\nRECORDS EXAMINED\nPlace number\nIn\nCARD INDEX\nupper left-hand corner of all copies of\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION.\nMANIFESTS\n(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements\nin the regular orderas 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:\naaron (Alien should print Schumyately or typewrite here thue, original,\n; age,\n52\nyears.\nMiss\nand name)\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 Carowr Schuncyathy\nMy name was\nmother's maiden Hannah Wallowitch\nMy maiden name was (if woman)\nMy present occcupation is\nGrocer merchant\nMy personal description is: Color, White ; complexion, dark far ; height, 5 feet 41/2 inches;\nweight, 150 pounds; color of hair, Gray\n; color of eyes, Gray\n;\nother\nvisible distinctive marks: none Scars in left patm\nI was born in\nBaturia\nRussia\n(City or town)\n(Country)\non\nthe 2 and day of October\n,\n18754\nMy present residence is\n32 Walden Ave, New London Newsondon Cours\n(Number and street)\n(City or town)\n(County)\n(State)\nMy post office address is\n32 Walden ave.\nThe\nplace where I took the ship or train which landed me in the United States was Hamburg,\nGermany\non march\n30\n,\n1906\n(Month)\n(Day)\n(Year)\nThe ticket on which 1 came to this country was bought at\nVilna\nRussias\n(City)\n(Country)\nThe name of the ship or railroad on which I came was\nPatricia\n(OVER)\n014-8"
}