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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5230
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:
40301
RECORDS EXAMINED
NATURALIZATION SERVICE
Place number
in
upper left-hand corner of all copies of
CARD INDEX
declaration, immediately under your
INDEX BOOKS
MOV 30 1927
declaration number.
OFFICE OF EXAMINER
DISTRICT DIRECTOR OF NATURALIZATION
MANIFESTS
NEW BAVEN, CONN.
ULEAKING or LABOR
I desire to file my Declaration of Intention (first paper) to become a citizen.
29
Mr.
My name is
Mrs.
-
Valent Lidak
; age, 1898 Suly 14, years.
Miss
(Alien should print or typewrite here true, original, and correct name)
(Give age last birthday)
My present occupation is
putter
My personal description is: Color, white ; complexion, fair
; height, 5 feet 6 inches;
weight, 172 pounds; color of hair, brown
; color of eyes,
blue
;
thumb. other visible distinctive marks: austrial grand
I was born in
Bistricanc (City or/town) Bradslan (Country)
on
the July day of 14th
1898.
My present residence
is 253 norwich new London Conn (State)
Broadway
(Number and street)
(City or town)
(County)
The place where I took the ship or train which landed me in the United States was
Fughnee
oktober
28
1922.
, on
(Month)
(Day)
(Year)
The name of the ship or railroad on which I came was
Maurektania
the
lastplace of foreign was
the
residence said Bistrica m Bratislani Cechoslovatic (Country)
(City or town)
wife
partic
is Albbeta mihalovie is
She
Bistric I am DEG
name of my
was born at
1
Cecholoratia husband and now resides at said 253 horrich Espens
I
am
now
of and intend to renounce allegiance to the Cecholovakia
(Write name and title of sovereign and country of which now
or, a name
Czechloslovak
if citifen of republic, write of republic only) Republic
I arrived at the United States immigration port of
new york (City town)
or
Onew York (State territory) State
on november 3.d.
1922.
,
or
14-8
(Give exact month, day, and year)
(OVER)
7536
It
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Document data
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- Core
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- Type
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DTO data
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5230\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:\n40301\nRECORDS EXAMINED\nNATURALIZATION SERVICE\nPlace number\nin\nupper left-hand corner of all copies of\nCARD INDEX\ndeclaration, immediately under your\nINDEX BOOKS\nMOV 30 1927\ndeclaration number.\nOFFICE OF EXAMINER\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nNEW BAVEN, CONN.\nULEAKING or LABOR\nI desire to file my Declaration of Intention (first paper) to become a citizen.\n29\nMr.\nMy name is\nMrs.\n-\nValent Lidak\n; age, 1898 Suly 14, years.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is\nputter\nMy personal description is: Color, white ; complexion, fair\n; height, 5 feet 6 inches;\nweight, 172 pounds; color of hair, brown\n; color of eyes,\nblue\n;\nthumb. other visible distinctive marks: austrial grand\nI was born in\nBistricanc (City or/town) Bradslan (Country)\non\nthe July day of 14th\n1898.\nMy present residence\nis 253 norwich new London Conn (State)\nBroadway\n(Number and street)\n(City or town)\n(County)\nThe place where I took the ship or train which landed me in the United States was\nFughnee\noktober\n28\n1922.\n, on\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was\nMaurektania\nthe\nlastplace of foreign was\nthe\nresidence said Bistrica m Bratislani Cechoslovatic (Country)\n(City or town)\nwife\npartic\nis Albbeta mihalovie is\nShe\nBistric I am DEG\nname of my\nwas born at\n1\nCecholoratia husband and now resides at said 253 horrich Espens\nI\nam\nnow\nof and intend to renounce allegiance to the Cecholovakia\n(Write name and title of sovereign and country of which now\nor, a name\nCzechloslovak\nif citifen of republic, write of republic only) Republic\nI arrived at the United States immigration port of\nnew york (City town)\nor\nOnew York (State territory) State\non november 3.d.\n1922.\n,\nor\n14-8\n(Give exact month, day, and year)\n(OVER)\n7536\nIt"
}