I,

Issued

$1.00

30

50

18

a native and loyal citizen of the United States, hereby

apply to the legation of the United States at myself, accompanied by my wife —

for a passport for and minor children as follows: 18-. and

in the State of

-. on

I solemnly swear that I was born at or about the day of, 18-; that my father is a — citizen of the United States; that I am domiciled in the United States, my permanent residence being at in the State of —, where I follow the occupation of - -; that I left the United States on the - day of 18—, and am now temporarily sojourning at --; that I am the bearer of passport No. —, issued by

of

on the -day -, 18-; that I intend to return to the United States within - with the purpose of residing and performing the duties of citizenship therein; and that I desire the passport for the purpose of

Oath of allegiance.

Further, I do solemnly swear that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I take this obligation freely, without any mental reservation or purpose of evasion. So help me God.

LEGATION OF THE UNITED STATES AT

Identification.

I hereby certify that I know the above-named

18-.

person

ally, and know h- to be a native-born citizen of the United States, and that the facts stated in h-- affidavit are true to the best of my knowledge and belief.

[Address of witness ]

NOTE. This form is to be filled out in duplicate, one copy being retained on the files of the legation and the other forwarded with the quarterly returns to the Department of State. It may be so filled out by the applicant, in which case no fee therefor is chargeable.

FORM NO. 177.
Application for passport.

(Paragraph 151.)

NATURALIZED.

Fee for passport

Fee for filling out application in duplicate.
Fee for administering oath in duplicate..
No..]

I,

a naturalized and loyal citizen of the United States,

for a pass

and minor

born at

on the

day of

day

hereby apply to the legation of the United States at port for myself, accompanied by my wife, children, as follows:

18-; and

I solemnly swear that I was born at

of

on or about the

18-; that I emigrated to the United States, sailing on board

on or about the day of

18-; that I

from
years, uninterruptedly, in the United States, from to
-; that I was naturalized as a citizen of the United States
court of

at —, on the - day of

18-, as shown by the accompanying certificate of naturalization; that I am the bearer of passport No. -, issued by

18-, which is returned herewith; that I am the identical person referred to in said certificate and passport; that I am domiciled in the United States, my permanent residence therein being at

day of

the State of, where I follow the occupation of —; that I last left the United States on the 18-, on board the 18-; that I have resided in 18—; that I am now temporarily

arriving in
the day of
since the day of
residing at
within

--; and that I intend to return to the United States with a purpose of residing and performing the duties of citizenship therein.

I desire the passport for the purpose of

Oath of allegiance.

Further, I do solemnly swear that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I take this obligation freely, without any mental reservation or purpose of evasion: So help me God.

I hereby certify that I know the above-named

person

ally, and know h- to be the identical person referred to in the withindescribed certificate of naturalization, and that the facts stated in haffidavit are true to the best of my knowledge and belief.

[Address of witness.]

NOTE. This form is to be filled out in duplicate, one copy being retained on the files of the legation and the other forwarded with the quarterly returns to the Department of State. It may be so filled out by the applicant, in which case no fee therefor is chargeable.

I. a naturalized and loyal citizen of the United States, hereby apply to the Department of State, at Washington, for a passport for myself, accompanied by my wife, children, as follows:

born at

I solemnly swear that I was born at of, 18-; that my

and minor

on the

day of

emigrated to the United States, sailing on on or about the day of

18-;

years, uninterruptedly, in the United States, from

; that he was naturalized as a citizen of the

United States before the day of

18-, as shown ralization; that I am the that I have resided in the years, from

court of

at

on the by the accompanying certificate of natuof the person described in said certificate; United States, uninterruptedly, for

to, at --; that I am domiciled in the United

States, my permanent residence being at where I follow the occupation of

in the State of

; that I am about to go abroad

temporarily; and that I intend to return to the United States with the purpose of residing and performing the duties of citizenship therein.

Oath of allegiance.

Further, I do solemnly swear that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I take this obligation freely, without any mental reservation or purpose of evasion: So help me God.

Sworn to before me this day of

I hereby certify that I know the above-named

person

ally, and know h-to be the - of the person referred to in the withindescribed certificate of naturalization, and that the facts stated in haffidavit are true to the best of my knowledge and belief.

[Address of witness.]

Applicant desires passport sent to following address:

FORM No. 179.

Certificate of deposit of passport and registry of a citizen of the United

States.

(Paragraph 165.)

CONSULATE OF THE UNITED STATES OF AMERICA, AT

Age
Height
Forehead

Eyes

189-.

The undersigned Consul of the United States of America, certifies that a citizen of the United States of America, is registered in this consulate, and is the bearer of passport