Page:United States Statutes at Large Volume 54 Part 1.djvu/1187

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54 STAT.] 76TH CONG. , 3 D SESS.-CH. 876-CT. 14 , 1940 1153 One such photograph shall be affixed to each such declaration or certificate issued by the Commissioner and one shall be affixed to the copy of such declaration or certificate retained by the Service. DECLARATION OF INTENTION SEc. 331. An applicant for naturalization shall make, under oath Averments before, and only in the office of, the clerk of court or such clerk's authorized deputy, regardless of the place of residence in the United States of the applicant, not less than two nor more than seven years at least prior to the applicant's petition for naturalization, and after the applicant has reached the age of eighteen years, a signed declara- tion of intention to become a citizen of the United States, which declaration shall be set forth in writing, in triplicate, and shall con- tain substantially the following averments by such applicant: (1) My full, true, and correct name is ---- (full, true name, without abbreviation, and any other name which has been used, must appear here). (2) My present place of residence is - (number and street), - city or town),- (county), (State). (3) My occupation is (4) Iam- years old. (5) My personal description is as follows: Sex -; color-, complexion - , color of eyes - , color of hair - , height feet - inches, weight - pounds; visible distinctive marks-; race -

present nationality

- . (6) I was born on (month, day, and year), in (city or town), (county, district, province, or state), - (country). (7)Iam- married; the name of my wife or husband is

we were married on --

-- (month, day, and year), at (city or town), - (state or country); he or she was born at - (city or town), (county, district, province, or state), (country), on -- (month, day, and year); and entered the United States at (city or town), (State), on --- (month, day, and year), for permanent residence in the United States, and now resides at (city or town), (state or country). (8)Ihave- 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:. (9) My place of last foreign residence was --- (city or town), (county, district, or province), (country). (10) I emigrated to the United States from (city or town), (country). (11) My lawful entry for permanent residence in the United States was at - (city or town), (State), under the name of --- ,on

(month, day, and year), on the (name of vessel or other means of conveyance). (12) I have - been absent from the United States, having departed therefrom on - (dates of departures), from the port or ports of --- , upon the following vessels or other means of conveyance: -- - - (names of vessels or conveyances upon departures); and returned to the United States on (dates of return to the United States), at the port or ports of , upon the following vessels or other means of conveyance (names of vessels or conveyances upon return). 193470°-41-PT . --- 73