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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5035
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
I desire to file my Declaration become a citizen.
Jan of Intention Lichwala (first paper) to
Mr.
My name is
Mrs.
/
John LichweLL
; age,
38
years.
Miss
(Alien should print or typewrite here true, original, and correct name)
(Give age last birthday)
My present occupation is Weaver
My personal description is: Color, white ; complexion, dark
; height, 5 feet 6
inches;
weight, 148 pounds; color of hair. brown
;
color of eyes,
;
other visible distinctive marks: Scarat and of left thurt
I was born in
Bolicslaw, Galicia, now Poland
(City or town)
(Country)
on
the 26
day of February
, 1889
My present residence is
67 Fountain t Norwich
Conn.
(Number and street)
(City or town)
(County)
(State)
The or me was
place where I took the ship train which landed in the United States Rotterdam
Holland
, on
(Month)
(Day)
(Year)
The name of the ship or railroad on which I came was Caronia
paid
My last place of foreign residence was
Bolicslaw
galicia
(City or town)
(Country)
wife
I am
is Maryafulia foregare
She
married. The name of my
husband
}
was born at
He
Chicopee Falls, Mass.
, and now resides at
said 67 Fountain st. , norwich
I am now a subject of and intend to renounce allegiance to
Poland.
(Write name and title of sovereign and country of which now a subject;
or, if citizen of a republic, write name of republic only)
I arrived at the United States immigration port of
New City town)
York
or
New
York
,on
(State or territory)
april 14ff8 (Give 7, 1907 day, and year)
exact month,
(OVER)
Page data
- Page
- 323
- Source index
- 0
- Type
- photo
- Media ID
- a54ede859bf0d30c
- 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": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5035\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\nI desire to file my Declaration become a citizen.\nJan of Intention Lichwala (first paper) to\nMr.\nMy name is\nMrs.\n/\nJohn LichweLL\n; age,\n38\nyears.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is Weaver\nMy personal description is: Color, white ; complexion, dark\n; height, 5 feet 6\ninches;\nweight, 148 pounds; color of hair. brown\n;\ncolor of eyes,\n;\nother visible distinctive marks: Scarat and of left thurt\nI was born in\nBolicslaw, Galicia, now Poland\n(City or town)\n(Country)\non\nthe 26\nday of February\n, 1889\nMy present residence is\n67 Fountain t Norwich\nConn.\n(Number and street)\n(City or town)\n(County)\n(State)\nThe or me was\nplace where I took the ship train which landed in the United States Rotterdam\nHolland\n, on\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was Caronia\npaid\nMy last place of foreign residence was\nBolicslaw\ngalicia\n(City or town)\n(Country)\nwife\nI am\nis Maryafulia foregare\nShe\nmarried. The name of my\nhusband\n}\nwas born at\nHe\nChicopee Falls, Mass.\n, and now resides at\nsaid 67 Fountain st. , norwich\nI am now a subject of and intend to renounce allegiance to\nPoland.\n(Write name and title of sovereign and country of which now a subject;\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port of\nNew City town)\nYork\nor\nNew\nYork\n,on\n(State or territory)\napril 14ff8 (Give 7, 1907 day, and year)\nexact month,\n(OVER)"
}