Page:United States Statutes at Large Volume 54 Part 1.djvu/1188

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PUBLIC LAWS-CH. 876-OCT. 14, 1940 (13) I have - heretofore made declaration of intention number ,on (month, day, and year), at (city or town), (county), (State), in the (name of court). (14) I am not an anarchist, nor a disbeliever in or opposed to organized government, nor a member of or affiliated with any organi- zation or body of persons teaching disbelief in or opposition to organized government. (15) It is my intention in good faith to become a citizen of the United States and to reside permanently therein. (16) I will, before being admitted to citizenship, renounce 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. (17) I certify that the photograph affixed to the duplicate and triplicate hereof is a likeness of me and was signed by me. (18) So help me God. PETITION FOR NATTUrILJzATIoN Averments. SEO. 332. (a) An applicant for naturalization shall, not less than two nor more than ten years after such declaration of intention has been made, make and file in the office of the clerk of a naturalization court, in duplicate, a sworn petition in writing, signed by the appli- cant in the applicant's own handwriting, if physically able to write, and duly verified by witnesses, which petition shall contain sub- stantially 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: 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); entered the United States at - (city or town), - (State), on (month, day, and year), for per- manent 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 last place of foreign residence was -- - (city or town), , (county, district, or province), (country). (10) I emigrated to the United States from (city or town), ----- (country). 1154 [54 STAT.