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1. My place of residence is.

10. FACTS FOR PETITION FOR NATURALIZATION

U.S. Department of Labor, Naturalization Service

(Alien should state here his true, original, and correct name in full.)

(If alien hus used any other name in this country, that name should be shown on line immediately above.) (Number and name of street.)

(City or town.)

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(Place where alien got on ship or train to come to the United States.)

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(If the alien arrived otherwise than by vessel, the character of conveyance or name of transportation company should be given.) at which time my height was....feet. ..inches; complexion.. color of hair,...............; color of eyes.. occupation,..............

destined to.

(City or town.)

; destined to.

....

and accompanied by

(State.)

(Person or persons to whom destined.)

(If the alien came under some other name than his own name, the name used on the steamship must be given here, or the record of arrival cannot be found.) (If the alien arrived as a stowaway or deserting seaman, or in any other manner than as a passenger, please so state.) 5. I declared my intention to become a citizen of the United States on the ........day of. at.

19.

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(Location of court.)

(Petitioner, if a widower, should give the name of his wife when living, and state place of her birth, and fact of her death; if not married, he should enter "not" in first sentence.)

at.

(City or town.)

and now resides at.

(Country.)

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(State or country.)

(Number and street.)

of birth, and place of residence of each of said children is as follows:

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....

I have.....

children, and

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8. I am able to speak the English language.

(Name of sovereign and country of which alien is now a subject.)

9. I have resided continuously in the United States since the.

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10. I have. heretofore made petition for United States citizenship. (If petitioner has heretofore made application for citizenship, the facts required should be fully stated in the following blanks :) I previously petitioned for citizenship to the.......

...

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The cause of such denial has since been cured or removed.

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My Declaration of Intention No........ , is sent with this application.

Give names, occupations, and residence addresses of two witnesses, citizens of the United States, who have known you for at least five years, last past, as a resident of the State in which petition is made, who will make affidavit that you are a person of good moral character, that you are qualified in every way to be admitted a citizen of the United States, and who will appear with you before the clerk when petition is filed and also be present at the hearing of the petition by the court.

If you have resided in the State in which petition is made for at least one year, last past, but less than five years, the two witnesses must verify the entire period of residence within said State, and the remaining portion of the five years' residence in some other State must be shown at the hearing by the testimony of the same or other witnesses appearing in person, or by depositions taken under section 10 of the naturalization act of June 29, 1906. The required form for notice to take depositions may be obtained from the clerk of court when petition is filed.

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Names of witnesses who will be substituted by me if those appearing with me at the time of filing my petition for naturalization are unable to appear at the time of the hearing

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If you wish to change the name that you have signed to your "Certificate of Arrival" and to your "first paper," ("Declaration of Intention"), you must change it in Court and sign your new name to your “second paper” (“Petition for Naturalization") and always use it afterwards. The fee for your "Petition for Naturalization" and your final admission paper, "Certificate of Naturalization," is four dollars. The facts of your life are now open to the public and a period of ninety days is set aside for any objection to be raised against you.

During these ninety days, you should:

1. Remain in the United States.

2. Make sure that your two witnesses will appear with you in Court again.

If they are sick or absent you may find two others who can swear to the same facts, subject to the rules of the Court governing the substitution of witnesses.

If they refuse to appear, you should tell the Clerk of the Court, who will compel them to do so. But in this case you must first deposit with the Clerk a sum of money to cover the legal witness fees.

II. Court hearing on the petition.

After ninety days (provided nobody objects) your witnesses and you receive notice to go before the United States District Attorney at Court for an oral (spoken) examination. Your witnesses must give proof of:

(1) Your residence (where you live).

(2) Your moral character (that you are a morally good man).

(3) Your belief in the principles of the Constitution of the United States.

You will be examined:

(1) About your knowledge of the Government of the United States. (Study ¶ 29.)

(2) About the Constitution of the United States. (Study ¶¶ 32-40 inclusive.)

(3) About the simple facts of City, State, and National Government in the United States. (Study Chapters II and III.)

12. The oath of allegiance.

If this examination is satisfactory to the Court, you take the following oath (swear to the truth of statement) to give up allegiance to any other country, and to give your allegiance to the United States:

"I hereby declare on oath, that I absolutely and entirely renounce and abjure all allegiance and fidelity to any foreign prince, potentate, state or sovereignty, and particularly to (name of sovereign of country) of whom I have heretofore been a subject; that I will support and defend the Constitution and Laws of the United States of America against all enemies, foreign and domestic, and that I will bear true faith and allegiance to the same."

13. You have now become an American citizen.

This makes you a citizen of this country. You may now claim the protection of this Government wherever you may be. You also have the right to vote for those men whom you wish to help make the laws of the country.

14. Review of important points for the "second paper ("Petition for Naturalization ”).

Taken out at least two years after the "first paper."

Fee: four dollars.

Two witnesses required. They appear two separate times.
Examination required.

Oath of allegiance required.

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If lost, papers may be replaced by certified copies secured from the Court that issued the originals.

15. The form of the Certificate of Naturalization

Forgery of this certificate will be punished by a fine of $10,000, or imprisonment for not more than ten years, or both.

THE UNITED STATES OF AMERICA

CERTIFICATE OF NATURALIZATION

Description of holder: age,...........; height,..

.; complexion,...

.; color,

; color of eyes, .

; color

of hair,. ......; visible distinguishing marks, Name, age, and place of residence of wife,

Names, ages, and places of residence of minor children.

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in the year of our Lord nineteen hundred and... . . . . . .,

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who previous to his (her) naturalization was a citizen or subject of at present residing at number

.street, .city (town),. .State (Territory or District), having applied to be admitted a citizen of the United States of America pursuant to law, and the court having found that the petitioner had resided continuously within the United States for at least five years and in this.......for at least one year immediately preceding the date of the hearing of his (her) petition, and that said petitioner intends to reside permanently in the United States, had in all respects complied with the law in relation thereto, and that..he was entitled to be so admitted, it was thereupon ordered by the said court that ..he be admitted as a citizen of the United States of America.

In testimony whereof the seal of said court is hereunto affixed on the... .day of... nineteen hundred and

....

in the year of our Lord .and of our Independence the

(Official character of attestor.)

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