No. 1064

UNITED STATES OF AMERICA

_________________

Department of Commerce and Labor

BUREAU OF IMMIGRATION AND NATURALIZATION

DIVISION OF NATURALIZATION

___________________________

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, Adam Rausch, aged 44 years, occupation Ice-man, do declare on oath that my personal description is: Color white, complexion fair, height 5 feet 4 1/2 inches, weight 135 pounds, color of hair brown, color of eyes gray, other visible distinctive marks none; I was born in Szakalhaza Hungary, on the 8th day of November, anno Domini 1863; I now reside at 1722 S. 11th St. St. Louis Mo. I emigrated to the United States of America from Bremen Germany on the vessel* "Darmstadt"; my last foreign residence was Szakalhaza, 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 Franscis Joseph Apostolic King of Hungary, of which I am now a subject; I arrived at the port of Baltimore, in the State of Maryland on or about the 17th day of February, anno Domini 1907; 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

ADAM RAUSCH

Subscribed and sworn to before me this 1st

day of June, anno Domini 1908

W.W. NALL, Clerk