HomeMy WebLinkAboutJustason, Miriam Florence - Naturalization Records i ORIGINAL UNITED STATES OF AMERICA
(To be retained by
Clerk of Court)
DECLARATION OF INTENTION No. 191
(Invalid for all purposes seven years after the date hereof)
STATE OF PENNSYLVANIAa In the Common Pleas Court
(
fs COUNTY OF FR.ANKLIN. �: of Franklin Colulty at Qi fiber burg, Pam-
- (1) My full,true,and correct name is.__M I. .. 1__/2.Q ?UCQ_J A tia$OA
(Full. itho t.bbayaph hae Men used.meat.ppear hen)
I�t q tot,�.„(�• ---
(2) My present place of residence is__Y_153�elan1L_Alte.0 WfP.erS .1r ``na
f ,,11 ac (NnmM..nd.t,.ne)T (ay or towW ( Ner) s ( (3) My occupation is___I i,gt sn.
( (4) I am_'tS] years old. (5) I was born on Y 8511 l 6__, in �l lr_PY'Q,Vtend OOntar ,Q,Canada
,,,„,,, (Month) mil,a fir) (Year) ,,e or town) ((County. province. opts) (Couotea)
(6) My personal description is as follows: Sex__nina1e ,color_Will ti ,complexion za �}
tt�,color of eyes _--- -��-----__----
color of hair____31Dnne___,height____5____feet___Q .t,inches,weight_1QQ___pounds,visible distinctive marks____IS?X_O
race____ i sb. ,present nationality___British
(7) I am_not__married;the name of my wife or husband is ;we were married on
(Month) (Dar) (Year)
at ;he or she was born at
(CW or town) (Bite a*counter) (City.e town) (County.dl.triet.prov).oe.or.let.) (Counter)
OR ;and entered the United States at
(Month) (D.y) (Year) (City or town) Mato)
on (Mouth) (Day) (Year) for permanent residence in the United States,and now resides at
(City or town) (County and etete)
(8) I have children;and the name,sex,date and place of birth,and present place of residence of each of said children who is living,are as follows:
f t
(8) My last place of foreign residence was Arthur Ontario Canada (10) I emigrated to the United States from
� �� (City or town) Ca„a da(County.dietriet.province,or elate) (Country)
liaraiS�iial (11) My lawful entry for permanent residence in the United States was
tY ) (90 fifer)
at____ J era_ $ 9� Ne3p_xQ under the name of Miriam Florence Justason
on Qr about` � ,.__by_'Bailraad__train
Odonth) (Dar) (Year) (Name of.,ee.el or other mean.of eenyey.nee)
(12) Since my lawful entry for permanent residence I have___nClt._been absent from the United States,for a period or periods of 6 months or longer,as follows:
• DEPARTED FROM TUE UNITED STATES RETURNED TO THE UNITED STATES
DATE VESSEL OR OTHER MEANS DATE VESSEL OR OTHER MEANS
PORT (Month,day, or CONVEYANCE PORT (Month,day,
year) year) OF CONVEYANCE
i
I
/ C (13) I have not heretofore made declaration of intention: No. .,on
(Month) (DU) (Ye.) (City(City a bean)
(Comb') (Mete) in the
(Name of eeu<a
.4. (14) It is my intention in good faith to become a citizen of the United States and to reside permanently therein. (15) I will,before being admitted to citizenship,
renounce absolutely and forever all allegiance and fidelity to any foreign prince,potentate,state,or sovereignty of whom or which at the time of admission to citizenship
I may be a subject or citizen. (16) I am not an anarchist;nor a believer in the unlawful damage,injury,or destruction of property,or sabotage;nor a disbeliever in
or opposed to organized government;nor a member of or affiliated with any organization or body of persons teaching disbelief in or opposition to organized government.
(17) I certify that the photograph affixed to the duplicate and triplicate hereof is a likeness of me and was signed by me.
my I do swear knowledge (affirm)
Saan belief:) t30 the HELL ME QOD a made and the intentions I have expressed in this declaration of intention subscribed by me are true to the best of
i W.4.4i/441evdenet .wit --- -other arm if Need) - - -
jSubscribed and sworn to(affirmed) before me in the form of oath sh wmabove in the office of the
Clerk of said Court,at Chamber sburgi Pennsylvania
�1
this 2gti1 day of ,�t�p,.ril , anno Domini 19_T? I hereby certify that
Certification No. 3 2221g'+ from the Commissioner of Immigration and Naturalization,
O showing the lawful entry for permanent residence of the declarant above named on the date stated in
this declaration of intention,has been received by me,and that the photograph affixed to the duplicate
• (DO NOT ATTACH PHOTOGRAPH TO THIS and triplicate hereof is a likeness of the docleran
COPY OF DECLARATION) (SEAL]
rI:of the C PleasPl�
By
Cyr. (C (!' Court.
flepuly Clerk.
Form N-315
U. S. DEPARTMENT OF JUSTICE .la—ieiie U.S.GOVERNMENT PRINTING espies
IMMIGRATION AND NATURALIZATION SERVICE
(Edition of 1-13-41)
i
JUSTASON, Miriam Florence
DOB 1/5/1896
Vo13 No 191 Declaration of Intention