54 STAT.] 76TH CONG. , 3D SESS.-CH. 876-OCT. 14 , 1940 1155 (11) My lawful entry for permanent residence in the United States was at (city or town), (State), under the name of -, on (month, day, and year), on the (name of vessel or other means of conveyance), as shown by the certificate of my arrival attached to this petition. (12) I have - een absent from the United States, having departed therefrom on - - (dates of departures), from the port or ports of , upon the following vessels or other means of conveyance: (names of vessels or convey- ances upon departures); and returned to the United States on (dates of return to the United States), at the port or ports of -, upon the following vessels or other means of conveyance: (names of vessels or conveyances upon return). (13) I have resided continuously in the United States of America for the term of five years at least immediately preceding the date of this petition, to wit, since --- , and continuously in the State in which this petition is made for the term of six months at least immediately preceding the date of this petition, to wit, since (14) I declared my intention to become a citizen of the United States on (month, day, and year), in the (name of court) Court of -- , at- (city or town), --- (State). (15) I have - heretofore made petition for naturalization number - ,on (month, day, and year), at (city or town), -- (county), (State), in the - --- (name of court), and such petition was dismissed or denied by that Court for the following reasons and causes, to wit: and the cause of such dismissal or denial has since been cured or removed. (16) I am not an anarchist, nor a disbeliever in or opposed to organized government, nor a member of or affiliated with any organi- zation or body of persons teaching disbelief in or opposition to organized government. (17) I am attached to the principles of the Constitution of the United States and well disposed to the good order and happiness of the United States. (18) It is my intention in good faith to become a citizen of the United States, and to reside permanently therein. (19) It is my intention to renounce absolutely and forever all allegiance and fidelity to any foreign prince, potentate, state, or sovereignty of whom or which at this time I am a subject or citizen. (20) Attached hereto and made a part of this, my petition for naturalization, are my declaration of intention to become a citizen of the United States (if such declaration of intention be required by the naturalization law), a certificate of arrival from the Immigration and Naturalization Service of my said lawful entry into the United States for permanent residence (if such certificate of arrival be required by the naturalization law), and the affidavits of the two verifying witnesses required by law. (21) Wherefore, I, petitioner for naturalization, pray that I may be admitted a citizen of the United States of America, and that my name be changed to (22) I, aforesaid petitioner, being duly sworn, depose and say that I have (read) (heard read) this petition and know that the same is true of my own knowledge except as to matters herein stated to be alleged upon information and belief, and that as to those matters I believe it to be true; and that this petition is signed by me with my
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