Court: Declaration of Intention of Simon Christensen Balling, 1934

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Volume: 1
Page: 13

DECLARATION OF INTENTION
United States of America, Dsitrict of Oregon} ss:
In the United States District Court of Oregon, at Medford, OR

name: Simon Christensen Balling
residing: 912 Main St., Klamath Falls, Klamath, OR
occupation: salesman
aged: 58
sex: male
color: white
complexion: dark
color of eyes: blue
color of hair: brown
height: 5 ft 9 in
weight: 187
visible distinctive marks: none
race: Scandinavian
nationality: Denmark
born in: Skive, Denmark
date: 12 Oct 1875
married: no
name: 
when: 
where: 
born in: 
date: 
arrived: 
when: 
now resident: 
chidren: no
last foreign residence: Holsterbro, Denmark
emigrated from: Aarhus, Denmark
arrived: New York, NY
under name of: Simon Christensen Balling
date: Jun 1896
vessel: unknown, Cunard Line
signed: Simon Christensen Balling
where: Medford, OR
when: 25 Jun 1934
clerk: G. H. Marsh
deputy clerk: G. O. Taylor
lawful entry certificate: