Declaration of Intent
Common Pleas Court, Washington Co, PA
14 Nov 1919
I, Adolph Schilinski , aged 39, occupation laborer, do declare on oath that my personal description is: Color: white; complexion: light; color of eyes: blue; other visible distinctive marks: none. I was born in Zublosky, Poland, on the ___ day of ___, anno Domini 1880; I now reside at Box 33, Slovan, Washington Co. I emigrated to the USA from Germany on the vessel do not know; my last foreign residence was Zublosky, Poland. I am married; the name of my wife is Mary; she was born at Zublosky, Poland, and now resides at Slovan, PA. It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign prince, potentate, state, or sovreignty, and particularly to the Republic of Poland, of whom I am now a subject. I arrived at the port of New York, in the state of NY, on or about the ____ day of ____, anno Domini 1900.
Signed by Adolph Schilinski, his mark.