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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 4892 NOT TO BE FILLED IN BY ALIEN U. S. DEPARTMENT OF LABOR 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 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 Mro. CHARLES LEBARON MCLELLAN ; age, 23 (Alien should print or typewrite here true, original, and correct name) years. Migg (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 My mor ther's maidon name was My maiden namo was (if woman) My Electrician present occcupation is My personal description is: Color, White ; complexion, Dark fair 6112 ; height, 5 feet P inches; weight, 130 pounds; color of hair, Dark Brown ; color of eyes, Aray ; other visible distinctive marks: white streak of hair, leftacle of head None I was born in Moncton New Brunswick Canada (City or town) (Country) on the 23 day of February , 1903 My present residence is 35 Deane strict Groton. New hondon, Conn. My post office address is 35 (Number Deane street) street (City or town) scroton, (County) Conn and (State) The where I took the which landed said Moncton. Hew place ship or train me in the United States was Brunswick, Canada October , on 1905 (Month) (Day) (Year) The ticket on which I came to this country was bought at The name of the ship or railroad on which I came was Inter Colonial (City) Raulroad (Countay) (OVER) c14-8

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4892\nNOT TO BE FILLED IN BY ALIEN\nU. S. DEPARTMENT OF LABOR\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.\n'MANIFESTS\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 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\nMro.\nCHARLES LEBARON MCLELLAN\n; age,\n23\n(Alien should print or typewrite here true, original, and correct name)\nyears.\nMigg\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\nMy mor ther's maidon name was\nMy maiden namo was (if woman)\nMy Electrician\npresent occcupation is\nMy personal description is: Color, White ; complexion, Dark\nfair\n6112\n;\nheight, 5 feet P inches;\nweight, 130 pounds; color of hair, Dark Brown\n; color of eyes,\nAray\n;\nother visible distinctive marks: white streak of hair, leftacle of head None\nI was\nborn in Moncton New Brunswick\nCanada\n(City or town)\n(Country)\non the 23\nday of February\n, 1903\nMy present residence is 35 Deane strict Groton. New hondon, Conn.\nMy post office address is\n35 (Number Deane street) street (City or town) scroton, (County) Conn\nand\n(State)\nThe where I took the which landed said Moncton. Hew\nplace ship or train me in the United States was\nBrunswick, Canada\nOctober\n, on\n1905\n(Month)\n(Day)\n(Year)\nThe ticket on which I came to this country was bought at\nThe name of the ship or railroad on which I came was\nInter Colonial (City) Raulroad (Countay)\n(OVER)\nc14-8"
}