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2761 91 dis
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
The name on was
full of the person shown my steamship ticket mixatos Tapos
My mother's maiden was Ellenge
name
My maiden name was (if woman)
My post-office address is
The ticket on which I came to this country was bought at
Patras
Greece
(City)
(Country)
Greek Line
1st cabin
If arrival by ship: Name of steamship line was
2d cabin
3rd
3d cabin
I arrived (passenger, stowaway, seaman, member of crew, otherwise) (State which)
as or
passenger
I traveled on (an immigration visa, a passport, a permit)
passport
(State which)
I paid
head tax at
,on
(State amount)
(City)
(State or country)
(Month)
(Day)
(Year)
I was examined by immigration officers at
Ellis Bland my
At that to
time I intended remain (permanently, temporarily, for visit, in transit) (State which)
Christor
permanently
The person in the United States I was coming to was
Brother
(Give name in full)
The place in the United States I was going to was
Holyoki mass
The names of some of the persons or passengers I traveled with 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)
Canada
(b) The place in
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
Myjing Dayor
OVERNMENT PRENTING OFFICE 14-8
(OVER)
Michael (Signature Lagos of applicant)
Page data
- Page
- 505
- Source index
- 0
- Type
- photo
- Media ID
- 3313d20dc281945b
- 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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"type": "photo",
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"ocrText": "2761 91 dis\nI have\n/\nused another name in this country than that given at the beginning of this form. If so, it was\nI used that name because\nThe name on was\nfull of the person shown my steamship ticket mixatos Tapos\nMy mother's maiden was Ellenge\nname\nMy maiden name was (if woman)\nMy post-office address is\nThe ticket on which I came to this country was bought at\nPatras\nGreece\n(City)\n(Country)\nGreek Line\n1st cabin\nIf arrival by ship: Name of steamship line was\n2d cabin\n3rd\n3d cabin\nI arrived (passenger, stowaway, seaman, member of crew, otherwise) (State which)\nas or\npassenger\nI traveled on (an immigration visa, a passport, a permit)\npassport\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\nEllis Bland my\nAt that to\ntime I intended remain (permanently, temporarily, for visit, in transit) (State which)\nChristor\npermanently\nThe person in the United States I was coming to was\nBrother\n(Give name in full)\nThe place in the United States I was going to was\nHolyoki mass\nThe names of some of the persons or passengers I traveled with 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)\nCanada\n(b) The place in\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\n}\nwhere I bought my railroad ticket to come to the United States was\nMyjing Dayor\nOVERNMENT PRENTING OFFICE 14-8\n(OVER)\nMichael (Signature Lagos of applicant)"
}