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U. S. DEPARTMENT OF LABOR
TRIPLICATE
NATURALIZATION SERVICE
to pérsem
No. 8736
STATES OF
DECLARATION OF INTENTION
Invalid for all purposes seven years after the date hereof
UNITED STATES OF AMERICA
In the
UNUTED-STATES-IISTRIC
Court
DISTRICT OF OREGON.
ss:
DISTRICT OF OREGON.
of
ge,
Progner Henri ter Meulen
aged
75
years,
occupation
Retired Wevy officer
, do declare on oath that my personal
description is: Color White, complexion
feir
height
feet
8 inches,
weight
166 pounds, color of hair
grey
, color of eyes
blue
other visible distinctive marks Sear over the left aye.
I was born in
Betevier Duteh East Indies
on the
11th. day of
October
,
anno Domini I 848 I now reside
at
662 Cherrelton Street, Eugene Ore
(Give number, street, city of town, and State.)
I emigrated to the United States of America from
Antworp, Belgium
on the vessel
S. s, Mongolia
my last
(If the alien arrived otherwiee than by vessel, the character of conveyance or name of transportation company (divorged)
foreign residence was
Velkenturg, The Netherlands I am
not.married; the name
of my
{
wife
husband
}
is
she
he
}
was born at
and now resides at
It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
prince, potentate, state, or sovereignty, and particularly to
Nilhelmina,
Queen of the #etherlands
of whom I am now a subject;
I arrived at the port of
New York
, in the
State of
New Yerk
on or about the
22nd. . day
of
Verch
, anno Domini I 924; I 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
to become a citizen of the United States of America and to permanently reside therein
So HELP ME GOD.
Propper Herri ter Merlen
(Original signature of declarant)
Subscribed and sworn to before me in the office of the Clerk of
[SEAL]
said Court this of J u 1 unno Domini 192 4
0. H. MARSH
By Clerk of the GNITED STATES DISTRICT DEPUTY Qlerk.
Court.
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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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Context sent to Scholar
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Document source metadata
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Page context
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"ocrText": "U. S. DEPARTMENT OF LABOR\nTRIPLICATE\nNATURALIZATION SERVICE\nto pérsem\nNo. 8736\nSTATES OF\nDECLARATION OF INTENTION\nInvalid for all purposes seven years after the date hereof\nUNITED STATES OF AMERICA\nIn the\nUNUTED-STATES-IISTRIC\nCourt\nDISTRICT OF OREGON.\nss:\nDISTRICT OF OREGON.\nof\nge,\nProgner Henri ter Meulen\naged\n75\nyears,\noccupation\nRetired Wevy officer\n, do declare on oath that my personal\ndescription is: Color White, complexion\nfeir\nheight\nfeet\n8 inches,\nweight\n166 pounds, color of hair\ngrey\n, color of eyes\nblue\nother visible distinctive marks Sear over the left aye.\nI was born in\nBetevier Duteh East Indies\non the\n11th. day of\nOctober\n,\nanno Domini I 848 I now reside\nat\n662 Cherrelton Street, Eugene Ore\n(Give number, street, city of town, and State.)\nI emigrated to the United States of America from\nAntworp, Belgium\non the vessel\nS. s, Mongolia\nmy last\n(If the alien arrived otherwiee than by vessel, the character of conveyance or name of transportation company (divorged)\nforeign residence was\nVelkenturg, The Netherlands I am\nnot.married; the name\nof my\n{\nwife\nhusband\n}\nis\nshe\nhe\n}\nwas born at\nand now resides at\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to\nNilhelmina,\nQueen of the #etherlands\nof whom I am now a subject;\nI arrived at the port of\nNew York\n, in the\nState of\nNew Yerk\non or about the\n22nd. . day\nof\nVerch\n, anno Domini I 924; I am not an anarchist; I am not a\npolygamist nor a believer 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\nSo HELP ME GOD.\nPropper Herri ter Merlen\n(Original signature of declarant)\nSubscribed and sworn to before me in the office of the Clerk of\n[SEAL]\nsaid Court this of J u 1 unno Domini 192 4\n0. H. MARSH\nBy Clerk of the GNITED STATES DISTRICT DEPUTY Qlerk.\nCourt."
}