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Page 475 of 1298
I can add historical knowledge about this page.
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OCR
I have
used another name in this country than that given at the beginning of this form. If so, it was
I
used that name because it was wrote followed
Antoni Zinewicy Anthony zinavage
The full name of the person shown on my steamship ticket was
My mother's maiden name was
My maiden name was (if woman)
My post-office address is
The ticket on which I came to this country was bought at
Wilkes - Bave Penn
(City)
(Country)
arrival by ship: Name of steamship line was 3rd, class
1st cabin
If
{
2d 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
new
fact
At that time I intended to remain (permanently, temporarily, for Visit, in transit)
(State which)
The was was
person in the United States I coming to Cronista
Kasrisan
The in the United States I Plains Henk
(Give name in full)
place was going to was
The of of the I traveled with mother and Sister
names some persons or passengers were
ADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME From OR THROUGH CANADA OR MEXICO:
(a) The place in Canada where I landed was
, on
(Month)
(Day)
(Year)
(b) The place in
{
Canada
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
(e) 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
GOVERNMENT PRINTING OFFICE
14
8
(OVER)
(Signature of applicant)
Page data
- Page
- 475
- Source index
- 0
- Type
- photo
- Media ID
- 0c015b11328b2f88
- Size
- unknown
Document data
- ID
- 159596813
- Core
- doc
- Type
- document
DTO data
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"contentType": "document",
"title": "File numbers 4874 - 5509, 1926-1930",
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Context sent to Scholar
Document identity
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"core": "doc",
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Document source metadata
{
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Document source extras
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Page context
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"pageIndex": 0,
"type": "photo",
"url": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships-0002/18-0177_US-MA/18-0177_US-MA_21/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930_00475.jpg",
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"ocrText": "I have\nused another name in this country than that given at the beginning of this form. If so, it was\nI\nused that name because it was wrote followed\nAntoni Zinewicy Anthony zinavage\nThe full name of the person shown on my steamship ticket was\nMy mother's maiden name was\nMy maiden name was (if woman)\nMy post-office address is\nThe ticket on which I came to this country was bought at\nWilkes - Bave Penn\n(City)\n(Country)\narrival by ship: Name of steamship line was 3rd, class\n1st cabin\nIf\n{\n2d cabin\n3d cabin\n}\nI\narrived 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\nnew\nfact\nAt that time I intended to remain (permanently, temporarily, for Visit, in transit)\n(State which)\nThe was was\nperson in the United States I coming to Cronista\nKasrisan\nThe in the United States I Plains Henk\n(Give name in full)\nplace was going to was\nThe of of the I traveled with mother and Sister\nnames some persons or passengers were\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME From OR THROUGH CANADA OR MEXICO:\n(a) The place in Canada where I landed was\n, on\n(Month)\n(Day)\n(Year)\n(b) The place in\n{\nCanada\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(e) If not examined, state why, and give the circumstances of your entry\nCanada\n(f) The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nGOVERNMENT PRINTING OFFICE\n14\n8\n(OVER)\n(Signature of applicant)"
}