| |
|
thumbnail image: |
thumbnail image: |
 |
 |
| image size 471 kb |
image size 472 kb |
|
LIST OR MANIFEST OF ALIEN PASSENGERS FOR THE UNITED
STATES IMMIGRATION OFFICER AT PORT OF ARRIVAL
|
|
Required by the regulations of the Secretary of
Commerce and Labor of the United States, under act of Congress
approved February 20, 1907 to be delivered to the United States
Immigration Officer by the Commanding Officer of any vessel having
such passengers on board upon arrival at a port in the United States. |
|
S.S.
Vaderland sailing from Antwerp, December 7, 1912 |
|
| |
| 1. |
2. |
3. |
4. |
5. |
6. |
|
No. on List |
NAME IN FULL |
Age |
Sex |
Married or Single |
Calling or Occupation |
|
Family Name |
Given Name |
Yrs. |
Mos. |
| 28 |
Tachna |
Boruch |
20 |
- |
male |
single |
shoe maker |
|
|
|
| 7. |
8. |
9. |
10. |
11. |
| Able to |
Nationality |
Race or People |
Last Permanent Residence |
Name and complete
address of nearest relative or friend in country whence alien came. |
| Read |
Write |
Country |
City or Town |
| no |
no |
Russia |
Hebrew |
Russia |
Czyzew |
- |
|
| |
| 12. |
13. |
14. |
15. |
16. |
| Final Destination |
No. on List |
Whether having ticket to
final destination |
By whom was passage paid |
Whether in possession of
$50, and if less how much. |
| State |
City or Town |
| New York |
New York |
28 |
yes |
aunt |
$25 |
|
| |
| 17. |
18. |
| Whether ever before in
the United States; and if so, whom and where? |
Whether going to join a
relative or friend, and his name and complete address. |
| Yes or No. |
If Yes - |
| Year or period of years |
Where? |
| no |
- |
- |
uncle: Mr. A Weinstein
New York, 230/32 Madison St.
|
|
|
|
| 19. |
20. |
21. |
22. |
23. |
24. |
| Ever been incarcerated? |
Whether a Polygamist. |
Whether an Anarchist. |
Condition of Health, Mental and
Physical. |
Deformed or Crippled. Nature,
length of time, and cause. |
Whether arriving for reason of
employment or solicitation? |
| no |
no |
no |
good |
no |
no |
|
|
|
| 25. |
26. |
27. |
28. |
29. |
| Height |
Complexion |
Color of - |
Marks of Identification |
Place of Birth |
| Feet |
Inches |
Hair |
Eyes |
Country |
City or Town |
| 5 |
3 |
fair |
brown |
brown |
none |
Russia |
Czyzew |
|
