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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5161 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 upper left-hand corner of all copies of CARD INDEX declaration, immediately under your INDEX BOOKS declaration number. DISTRICT DIRECTOR OF NATURALIZATION. MANIFESTS (NOTE TO CLERK OF COURT.-To guide you in preparing Tho black face lines on this form contain statements nikolitsa the Declaration: Georgest 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. My. My name is Ms. miss (Alien should Nicholitsan typewrite here true, g original, Padelopoulan and name) age, 2 (Give H. last/oirthday) Miss print or correct age 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 Nikalitsa Padelapoulou My mother's maiden name was aristea Karapipety My maiden name was (if woman) Weaver Scan My present occcupation is My personal description is: Color, white ; complexion, witair ; height, 5. of 14 inches; feet other visible distinctive marks: Scarnrighteide weight, 114 pounds; color of hair, Dark Brown : color of eyes, Blue standay I was born in agoulinitsa, (City or town) olymbhas, Greece (Country) on the 19 day of may , 1903 My is present residence 24 Elm St norwich, new London County Conn (Number and street) (City or town) (County) (State) My post office address is 69 P.O Box norwich, Conn. The place where I took the ship or train which landed me in the United States was Peramu Greece piracus. , on nove 8 1920 (Month) (Day) (Year) The ticket on came to country was which I this bought at Peraeus Greece (City) (Country) The of the ship railroad which I ME Gacci HELCAS name or on came was (OVER) c14-8

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574
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Document data

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5161\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\nupper left-hand corner of all copies of\nCARD INDEX\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION.\nMANIFESTS\n(NOTE TO CLERK OF COURT.-To guide you in preparing Tho black face lines on this form contain statements\nnikolitsa the Declaration: Georgest\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.\nMy.\nMy name is\nMs.\nmiss (Alien should Nicholitsan typewrite here true, g original, Padelopoulan and name) age, 2 (Give H. last/oirthday)\nMiss\nprint or correct\nage\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 Nikalitsa Padelapoulou\nMy mother's maiden name was aristea Karapipety\nMy maiden name was (if woman) Weaver Scan\nMy present occcupation is\nMy personal description is: Color, white ; complexion,\nwitair\n; height, 5. of 14 inches;\nfeet\nother visible distinctive marks: Scarnrighteide\nweight, 114 pounds; color of hair, Dark Brown : color of eyes, Blue standay\nI was born in\nagoulinitsa,\n(City or town) olymbhas,\nGreece\n(Country)\non the\n19\nday of may\n, 1903\nMy is\npresent residence 24 Elm St norwich, new London County Conn\n(Number and street)\n(City or town)\n(County)\n(State)\nMy post\noffice address is 69 P.O Box norwich, Conn.\nThe place where I took the ship or train which landed me in the United States was\nPeramu Greece\npiracus.\n, on\nnove\n8\n1920\n(Month)\n(Day)\n(Year)\nThe ticket on came to country was\nwhich I this bought at Peraeus\nGreece\n(City)\n(Country)\nThe of the ship railroad which I ME Gacci HELCAS\nname or on came was\n(OVER)\nc14-8"
}