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ORIGINAL
U.S. DEPARTMENT OF LABOR
JAMIDITO
UCSADEPARTMENT OF LABQB
ORIGINAL
8616
SERVICE
No.
No. 8617
SERVICE
811 the all
STATES OF
E
13
DECLARATION OF INTENTION
DECLARATION OF INTENTION
Invalid for all purposes seven years after the date hereof
Invalid for all purposes seven years after the datevhereof
STATE OF CALIFORNIA
n)
In the
SUPERIOR Court
STATE
Caunty of LOS Tingeles
Caunty of Los Angeles
nl
In the SUPERIOR
Court
ss:
The State of California.
ss:
The State of California.
of
in and for Los Angeles County.
to
of
in and for Los Angeles County.
de
max Berman
aged 44 years,
21098 William Doovas
aged
30 years,
occupation
Failor
do declare on oath that my personal
occupation
Barber
do declare on oath that my personal
description
is: Color white complexion Dark height 5 feet 4
inches,
description is: Color: white complexion Dark height 5 feet 9 inches,
weight 145 pounds, color of hair Black color of eyes Brown
weight 150 pounds, color of hair Brauen Tied : color of teyes - Brown
other I visible born distinctive Kiew marks scaron Russed forshed Became in Canada British subject]
other visible distingtive marks
was in
I was born in Deudena
Nery
Grues
on the
15th
day of
april
anno Domini I 871; I now reside
on the
to
day of January anno Domini I 8N I
at 212 So. Garey (Give are number, atreet, Pomona city or town. and State.) leal AND
at
Oaks (Give number, atreet, city discussion or town, nowsreside
I emigrated to the United States of America from
Windsor leanda
I emigrated to the United States of Ameriça from
Naples Italy
on the vessel
Grand Frank Ry
: my last
on the vessel
Dorig
Compantions
my
last
(II the alien arrived otherwing thankby vessel, the character of congagance name of transportation company should be given.)
(It the allen arrived oth wise than by vessol, the character of uveyance or Cigansportation company should be given.)
foreign residence was
Loronto Censha
foreign residence, was
Soudina
Freed
It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
prince, potentate, state, or sovereignty, and particularly to
prince, potentate, state, of sovereignty; and particularly to Constanting
V, King of Great Britain and Ireland.
of whom I am now a subject:
Amy of the Hellenes
of whom I am now a subject
4 arrived at the port of
DETROIT
in the
I arrived at the port of New your
to noq add it be in the
State of
mich
on or
about the 1st
day
State of
NAY
on or
about the : 28 day
of
march
anno Domini 911 I am not an anarchist: I am not a
of
may
can't anno Domini i 905 1 am not an anarchist: I am not
a
polygamist nor a believer in the practice of polygamy; and it is my intention in good faith
polygamist nor la believér in the practice of polygamy: and it is my intention in good faith
to become a citizen of the United States of America and to permanently reside therein:
to become a citizen of the United States of America and to permanently reside therein:
So HELP ME GOD.
000 BM 08
So HELP ME God.
William boovas
000 em 9438 02
max Buman
coriginal algnasure of declament.)
tuchood santaya
(Original algnature of declarant.)
for como Subscribed and sworn to before me in the office of the Clerk of
to alsold to soitto ert Subscribed and sworn to fore me in the office of the Clerk of
Citpt li [SEAL.]
Court this 19th day of april , Domini
anno 191
City
ITSEAL
single Court this 19 day of April anno Domini 191
H. J. Lelande
COUNTY CLERK AND IT-OFFICIO OF
COUNTY CLERK AND EX CLERK DE
COURT IN AND FOR THE COUNTY
H.I. Lelande THE SCICR CONNTY
OFiLOS ANGELES, STATE OF CALIFORNIA.
of LOS ANGELES, STATE or VALIFORNIA,
Clerk of the
Court.
the Court
By
Clerk.
By
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"ocrText": "128\n129\nORIGINAL\nU.S. DEPARTMENT OF LABOR\nJAMIDITO\nUCSADEPARTMENT OF LABQB\nORIGINAL\n8616\nSERVICE\nNo.\nNo. 8617\nSERVICE\n811 the all\nSTATES OF\nE\n13\nDECLARATION OF INTENTION\nDECLARATION OF INTENTION\nInvalid for all purposes seven years after the date hereof\nInvalid for all purposes seven years after the datevhereof\nSTATE OF CALIFORNIA\nn)\nIn the\nSUPERIOR Court\nSTATE\nCaunty of LOS Tingeles\nCaunty of Los Angeles\nnl\nIn the SUPERIOR\nCourt\nss:\nThe State of California.\nss:\nThe State of California.\nof\nin and for Los Angeles County.\nto\nof\nin and for Los Angeles County.\nde\nmax Berman\naged 44 years,\n21098 William Doovas\naged\n30 years,\noccupation\nFailor\ndo declare on oath that my personal\noccupation\nBarber\ndo declare on oath that my personal\ndescription\nis: Color white complexion Dark height 5 feet 4\ninches,\ndescription is: Color: white complexion Dark height 5 feet 9 inches,\nweight 145 pounds, color of hair Black color of eyes Brown\nweight 150 pounds, color of hair Brauen Tied : color of teyes - Brown\nother I visible born distinctive Kiew marks scaron Russed forshed Became in Canada British subject]\nother visible distingtive marks\nwas in\nI was born in Deudena\nNery\nGrues\non the\n15th\nday of\napril\nanno Domini I 871; I now reside\non the\nto\nday of January anno Domini I 8N I\nat 212 So. Garey (Give are number, atreet, Pomona city or town. and State.) leal AND\nat\nOaks (Give number, atreet, city discussion or town, nowsreside\nI emigrated to the United States of America from\nWindsor leanda\nI emigrated to the United States of Ameriça from\nNaples Italy\non the vessel\nGrand Frank Ry\n: my last\non the vessel\nDorig\nCompantions\nmy\nlast\n(II the alien arrived otherwing thankby vessel, the character of congagance name of transportation company should be given.)\n(It the allen arrived oth wise than by vessol, the character of uveyance or Cigansportation company should be given.)\nforeign residence was\nLoronto Censha\nforeign residence, was\nSoudina\nFreed\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to\nprince, potentate, state, of sovereignty; and particularly to Constanting\nV, King of Great Britain and Ireland.\nof whom I am now a subject:\nAmy of the Hellenes\nof whom I am now a subject\n4 arrived at the port of\nDETROIT\nin the\nI arrived at the port of New your\nto noq add it be in the\nState of\nmich\non or\nabout the 1st\nday\nState of\nNAY\non or\nabout the : 28 day\nof\nmarch\nanno Domini 911 I am not an anarchist: I am not a\nof\nmay\ncan't anno Domini i 905 1 am not an anarchist: I am not\na\npolygamist nor a believer in the practice of polygamy; and it is my intention in good faith\npolygamist nor la believér in the practice of polygamy: and it is my intention in good faith\nto become a citizen of the United States of America and to permanently reside therein:\nto become a citizen of the United States of America and to permanently reside therein:\nSo HELP ME GOD.\n000 BM 08\nSo HELP ME God.\nWilliam boovas\n000 em 9438 02\nmax Buman\ncoriginal algnasure of declament.)\ntuchood santaya\n(Original algnature of declarant.)\nfor como Subscribed and sworn to before me in the office of the Clerk of\nto alsold to soitto ert Subscribed and sworn to fore me in the office of the Clerk of\nCitpt li [SEAL.]\nCourt this 19th day of april , Domini\nanno 191\nCity\nITSEAL\nsingle Court this 19 day of April anno Domini 191\nH. J. Lelande\nCOUNTY CLERK AND IT-OFFICIO OF\nCOUNTY CLERK AND EX CLERK DE\nCOURT IN AND FOR THE COUNTY\nH.I. Lelande THE SCICR CONNTY\nOFiLOS ANGELES, STATE OF CALIFORNIA.\nof LOS ANGELES, STATE or VALIFORNIA,\nClerk of the\nCourt.\nthe Court\nBy\nClerk.\nBy"
}