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Form asoa
TRIPLICATI
No. 1/1f/11
STATES OF
Department of Commerce and Tabor
BUREAU OF IMMIGRATION AND NATURALIZATION
DIVISION OF NATURALIZATION
DECLARATION OF INTENTION
(Invalid for all purposes seven years after the date hereof)
In the SUPERIOR Cou
STATE OF CALIFORNIA
ss:
STATE or
3, County of Los Angales Alban of - THE FOR Lee
ANGELES COUNTY,
aged 29 year
Salesman
do
declare on oath
that my person
occupation description is: Color Whate complexion Light affirm height I feet inche
weight 150 pounds, color of hair Light color of eyes Blue
None
other visible distinctive marks
Domini Johnson I 02 0 I now reside at on the was born in It of Las epail
Mataga
(
ne
Angeles
I
emigrated Mexico City MexAc
on the vossel
to * the Mexican United States of America from Central Railway my las
foreign residence was
Mensce City Mexico
Das
It is my bona fide intention to renounce Mohnson XII
forever all allegiance and to any foreig
King
prince, potentate, state, of or sovereignty, Spain and particularly Oll Paso to of
citiaen
which I am now a subject
forago
as to
in th
arrived at the port of
State
Twas
Subse
Tessitory of
on
or about the ph da
of District Mary
anno
Domini goe am not an anarchist: I am
not
polygamist nor a believer in the practice of polygamy; and it is my intention in good fait
Deele
to become a citizen of the United States of America and to permanently reside therein
So HELP ME GOD.
Arthur Diabetes
(Original signature of declarant
Subscribed before me
day of Domini 6A 1907
to
and sworn to anno this
[SEAL ]
PERIOR ANGEL pourte
By
al
be
given.
allen
arrived
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"ocrText": "Form asoa\nTRIPLICATI\nNo. 1/1f/11\nSTATES OF\nDepartment of Commerce and Tabor\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\nDECLARATION OF INTENTION\n(Invalid for all purposes seven years after the date hereof)\nIn the SUPERIOR Cou\nSTATE OF CALIFORNIA\nss:\nSTATE or\n3, County of Los Angales Alban of - THE FOR Lee\nANGELES COUNTY,\naged 29 year\nSalesman\ndo\ndeclare on oath\nthat my person\noccupation description is: Color Whate complexion Light affirm height I feet inche\nweight 150 pounds, color of hair Light color of eyes Blue\nNone\nother visible distinctive marks\nDomini Johnson I 02 0 I now reside at on the was born in It of Las epail\nMataga\n(\nne\nAngeles\nI\nemigrated Mexico City MexAc\non the vossel\nto * the Mexican United States of America from Central Railway my las\nforeign residence was\nMensce City Mexico\nDas\nIt is my bona fide intention to renounce Mohnson XII\nforever all allegiance and to any foreig\nKing\nprince, potentate, state, of or sovereignty, Spain and particularly Oll Paso to of\ncitiaen\nwhich I am now a subject\nforago\nas to\nin th\narrived at the port of\nState\nTwas\nSubse\nTessitory of\non\nor about the ph da\nof District Mary\nanno\nDomini goe am not an anarchist: I am\nnot\npolygamist nor a believer in the practice of polygamy; and it is my intention in good fait\nDeele\nto become a citizen of the United States of America and to permanently reside therein\nSo HELP ME GOD.\nArthur Diabetes\n(Original signature of declarant\nSubscribed before me\nday of Domini 6A 1907\nto\nand sworn to anno this\n[SEAL ]\nPERIOR ANGEL pourte\nBy\nal\nbe\ngiven.\nallen\narrived"
}