U. S. DEPARTMENT OF LABOR

NATURALIZATION SERVICE

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No. 6071

UNITED STATES OF AMERICA

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DECLARATION OF INTENTION

Invalid for all purposes seven years after the date hereof

United States of America,   }                                           In the District Court of the United

Eastern District of Missouri } ss:                                       States for the Eastern Division

                                                                                        Eastern Judicial District of Missouri.

I, Nik Dohr, aged 53 years, occupation Tailor, do declare on oath that my personal description is: Color white, complexion Florid, height 5 feet 5 inches, weight 193 pounds, color of hair brown, color of eyes blue, other visible distinctive marks none; I was born in Nagy Jecsa, Hungary, on the 29th day of May, anno Domini 1859; I now reside at 1013 Lafayette Ave., St. Louis Mo. I emigrated to the United States of America from Hamburg, Germany on the vessel Kaiserain Auguste Victoria; my last foreign residence was Nagy Jecsa, Hungary. It is my bone fide intention to renounce forever all allegiance and fidelity to any foreign prince, potentate, state, or sovereignty, and particularly to Francis Joseph Emperor of Austria and Apostolic King of Hungary, of whom I am now a subject; I arrived at the port of New York, in the State of New York on or about the 8th day of February, anno Domini 1902; I am not an anarchist; I am not a polygamist nor a believer in the practice of polygamy; 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

NIK DOHR

Subscribed and sworn to before me in the office

of the Clerk of said Court at St. Louis, Mo.,

this 30th day of December, anno Domini 1912

W.W. NALL, Clerk