Hebrew Immigrant Aid Society, Boston, Massachusetts

              FormN-600
(Old 2400)
0. S. DEPARTMENT OF JUSTICE
IMMIGRATION AND NATURALIZATION SERVICE
(Edition of 1-13-41)
No.
APPLICATION FOR CERTIFICATE OF DERIVATIVE CITIZENSHIP
INCLUDING STATEMENT CONCERNING ARRIVAL OF APPLICANT
For use in searching records of arrival:
RECORDS EXAMINED
RECORD FOUND
Card index 
Index books
Manifests 
Place 
Name
Date .
Manner	
Marital status
(Signature of person making search)
TO THE APPLICANT: Do not write above tki3 line.    Read carefully and follow the instructions on page 4 hereof
(This form must be completely filled out—preferably on a typewriter)
Take or mail this to
DISTRICT DIRECTOR OF IMMIGRATION AND NATURALIZATION
EManuel Marcus
without 
residing at
3 Surfside Rd.f
(Number and street)
. hereby
(City or town) (County) (State)
apply to the Commissioner of Immigration and Naturalization for a certificate showing that I am a derivative citizen of the
United States of America.
In support  of my application I  enclose three photographs of myself each of which I have signed, and money order
No On the sum of $5, made payable to the order of the "Commissioner of Immigration and Naturalization,
Washington, D. C," in payment for this application, and submii the followin^facts:
(1)  I arrived in thejlnited States through the port of
under the name of on	
on the vessel  
Kay-15 1919
f Ho norltll (If otherwuo than by yes-el. show manner of arrival) 
(If arrival was through arrived at the port of  
on   on the vessel .
(2)  I have  absent from the United States as follows:
(Dates of departure and return, port, of entry, and 
or other 
I have been absent at any other time.
(3)  I have used another name in this country than that given above.
(If so) It was
B Manual Marcus
I used that name because	
(4) The full name of the person shown onjiiy steamship ticket was
(5) I was born 
(City or town)
(6) My father's full name is/was	
(7) My mother's maiden name was	
(8) (If a married woman) My maiden n
(9) My last foreign residence was
Bessie RakoeIn
England
(City or town)
(10)  The place where I took the ship or train which landed me in the United States was

(Country) 
(11) The ticket on which I came to this country was bought at. 	
(Country)
(12) (If arrival by ship) Name of steamship line was 	
first, second, or third cabin      I arrived as a passenger, stowaway, seaman,

(State which. Giving particulars)
none
(14) I paid $.  head tax at	
(City Or town) (State)
(15) I was examined by United States immigration officers at.
member of crew, or otherwise 
(13) I traveled on an immigration visa, a passport^or permit to 

(City or town State or countn
(16) (If not examined, state why, and give the circumstances of your entry 	
(17) The person in the United States to whom I was coming was	
(18) The place in the United States to which I was going was 
(19) The names of some of the passengers or other persons I trailed with and their relationship to me, if any, are 
assengers or other persons 1 trairelea witn
Jessie  brother Marry

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