UNITED STATES DEPARTMENT OF JUSTICE
Immigration and Naturalization Service
Mail or take to:
IMMIGRATION AND NATURALIZATION SERVICE
O
O
Form approved.
Budget Bureau No. 43-R079.7
ALIEN REGISTRATION
(Show the exact spelling of your name aa it appear* on your alien registration receipt card, and tho number of your card. If yon did not
register, so state.)
Name. j_io_U^..i/.)-^Ar.	
No. ,,.A--q--fg^-lz^-.--	
APPLICATION TO FILE PETITION FOR NATURALIZATION
(See INSTRUCTIONS, page 5.    BE SURE YOU UNDERSTAND EACH QUESTION BEFORE YOU ANSWER IT.)
I desire to file a petition for naturalization in the—
 _ Court at.
Date:
(Na
of Court)
(City)
(State)
(Print or type your present name)
(Print or type apartment number, street address, and if appropriate "in care of")
(City)
(County)
(State)
(la) Was your father or mother ever a citizen of the United States?    □ Yes    |jf No.    If "Yes" give full information
(lb) Can you read and write English?   □ Yes   57 No.   Speak English?   □ Yes   □ No.   Sign your name in English?   Q Yes   ENo.
(2) In what places in the United States have you lived during the last 5 years ?       /
6S 4vKxL>    JdAUr^t^
"f>rv and
From—
To—
Street Address
City and State
(«)
(b)
(c)
(-)
(e)
... 19.
... 19.
., 19.
., 19.
., 19.
... 19.
... 19..
.., 19..
., 19..
., 19..
(3) What were the names, addresses, and occupations (or types of business) of your employers during the last 5 years'
none, write "None.") N q y\J-—   	
(If
From—
To—
Employee's Name
Address
Occupation or Type
op Business
(o)  19	
 .„., 19	
(b) .                     , 19	
 , 19	
(<?)   , 19	
 _ , 19	
(d)  , 19	
 , 19	
(e)   - , 19	
  19	
(4) Have you been out of the United States since you first arrived?    Q Yes    0 No.    If "Yes" fill in the following information for every absence of less than 6 months.
Date Departed
Date Returned
Name op Ship, or op Airline, Railroad Company, Bus
Company, or Other Means Used To Return to the
United States
Place or Port op Entry Through Which You
Returned to the United States
(5) How many times have you been married?  L    How many times has your husband or wife been married? _„_il/___UUr
If either of you has been married more than once, fill in the following; information for each previous marriage.
Date Married
(a)
(6)
(«)
(-)
Date Marriage Ended
Name op Person to Whom Married
Sex
(Check one)
Person Married Was
Citizen D   Alien Q
a □
a □
□ □
a □
How Marriage Ended
Form N-400 (Rev. 10-20-59)
(1)
(Over)