Page:United States Statutes at Large Volume 34 Part 1.djvu/634

 604 FIFTY-NINTH CONGRESS. Sess. I. Ch. 3592. 1906. particularly to. , of which I am now a citizen (subject); I arrived at the (port) of -, in the State (Territory or Distnct) of -- on or about the. day of .. anno DQmlD1. . ; I am not an anarchist; I am not a polygamist nor a believer in the praetwe of poly y; 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.· (Original signature of declarant) .. . - . - - . . Subscribed and sworn to (ailirmed) before me this day of .. , anno Domini ... [1.. s.] .. --- (Olhcial character of attestor.) P¤¤¤mnf¤·¤n¢¤r•¤— mmm0N FOR NATURALIZATION. hstion. · - - Court of .. . In the matter of the tition of .. --- .-- to be admitted as a citizen of the United States of America. To the. . Court: ' The petition of. . - . respectfully shows: First. M full name is .. - .. Second. Liy lace of residence is number .. - . street, - of .. , State (Territory or District) of .. . hird. My occupation is - -. Fourth. I was born on the .. day of .. at ... Fifth. I emigrated to the United States from` .. , on or about the .. day of .. , anno Domini. ,, and arrived at the port of - - -- --, in the United States, on the vessel. .. Sixth. I declared my intention to become a citizen of the United States on the .. day of .. at. , in the .. court of Seventh. I am - - married. My wife’s name is .. . . She was born_in .. and new resides at ... I have .. children, and the name, date, and lace of birth and place of residence of each of said children is as follows:. . . . ; .. . . ; .._.. Eighth. I am not a disbeliever in or opposed to organized government or a member of or atliliated with any organization or body of persons teaching disbelief in organized government. I am not a polygamist. nor a believer in the practice of polygamy. I am attached to the principles of the Constitution of the nited States, and it is my intention to become a citizen of the United States and to renounce absolutely and forever all allegiance and fidelity to any foreign rince, potentate, state, or sovereignty, and particularly to .. , og) which at this time I am a citizen (or subject), and it is my intention to reside permanently in the United States. Ninth. I am able to speak the English language. Tenth. I have resided continuously in the United States of America for a term of live years at least immediately preceding the date of this tition, to wit, since -- ---., anno Domini . . -- .. ., and in the State lTerritory or District) of .. for one year at least next preceding the date of this petition, to wit, since - day of -- .- --, anno Domini. Eleventh. I have not heretofore made petition for citizenship to any court. (I made lpetition for citizenshi to the .. court of .. at . -, and the said petition was d)enied by the said court for the following reasons and causes, to wit, -. - ., and the cause gf such demal has since been cured or removed.)