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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5111 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 of Intention (first paper) to become a citizen. Mr. My name is Mrs. Miss Antoni (Alien should print typewrite Ziniewic here true, original, and correct ; age, 19 years. or name) (Give age last birthday) My present occupation is Paper mill Hand. My personal description is: Color, white ; complexion, light ; height, 5 feet 63/4 inches; weight, 130 pounds; color of hair, light ; color of eyes, brown ; I was other born visible in distinctive marks: on the 27 day of (City or town) november austria (Country) countrious Paland , 1907 My present residence is R.K.S.HI (Number and street) (County) (State) Conn Spragne (City or town) The place where I took the ship or train which landed me in the United States was , on August 15 1912 (Month) (Day) (Year) The name of the ship or railroad on which I came was Pyrtem I am not married. The name of my { My last place, of foreign residence was Roland (City or town) said Brajows (Country) wife } She is husband was born at He ,and now resides at , I am now a subject of and intend to renounce allegiance to Paland (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 your (City or town) sext 1912 , on (State or territory) 14-8 (Give exact month, day, and year) (OVER)

Page data

Page
474
Source index
0
Type
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Media ID
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Size
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Document data

ID
159596813
Core
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Type
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DTO data
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Context sent to Scholar

Document identity
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Page context
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5111\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 of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nMiss\nAntoni (Alien should print typewrite Ziniewic here true, original, and correct\n; age,\n19\nyears.\nor name)\n(Give age last birthday)\nMy present occupation is\nPaper mill Hand.\nMy personal description is: Color, white ; complexion, light\n; height, 5 feet 63/4 inches;\nweight, 130 pounds; color of hair, light\n;\ncolor of eyes, brown\n;\nI was other born visible in distinctive marks:\non the 27\nday of\n(City or town) november austria (Country) countrious Paland\n,\n1907\nMy present residence is\nR.K.S.HI\n(Number and street)\n(County) (State) Conn\nSpragne\n(City or town)\nThe place where I took the ship or train which landed me in the United States was\n, on August\n15\n1912\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was\nPyrtem\nI am not married. The name of my {\nMy last place, of foreign residence was Roland (City or town) said Brajows (Country)\nwife\n}\nShe\nis\nhusband\nwas born at\nHe\n,and now resides at\n,\nI am now a subject of and intend to renounce allegiance to\nPaland\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 your (City or town) sext 1912\n, on\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}