Application Number: 48227
Issued: April 18, 1911
United States of America, State of Illinois, County of Cook
I, James Filipek a naturalized and loyal citizen of the United States, do hereby apply to the Department of State at Washington for a passport for myself
(the phrase "and wife and my minor children as follows" was crossed out, implying that they did not accompany him)
In support of the above application, I do solemnly swear
that I was born at Koleucich, in Bohemia on or about the 10th day of September 1863;
that I emigrated to the United States, sailing on board the VESSEL (Name Unknown), from Hamburg, on or about the 1st day of May, 1889;
that I resided 22 years, uninterruptedly, in the United States, from 1889 to Date, at Chicago, Ill & Pueblo, Colo;
that I was naturalized as a citizen of the United States before the Criminal Court of Cook County at Chicago, on the 2nd day of April, 1900, as shown by the accompany Certificate of Naturalization;
that I am the identical person described in said Certificate; that I am domiciled in the United States, my permanent residence being at Chicago, in the state of Illinois where I follow the occupation of Merchant;
that I am about to go abroad temporarily; that I intend to return to the United States within six months with the purpose of residing and performing the duties of citizenship therein.
Furthermore, 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 mental reservation or purpose of evasion; so help me God.
Sworn to before me this 10th day of April, 1911
James Filipek
Julia A Brejcha (Notary Public)
Description of Applicant:
Age: 47
Stature: 5 feet (no number of inches were filled in)
Forehead: High & Broad
Eyes: Light Blue
Nose: Medium Straight
Mouth: Medium
Chin: Receding
Hair: Light
Complexion: Light
Face: Round
Identification:
Chicago April 10, 1911
I hereby certify that I know the above named James Filipek personally, and know him to be the identical person referred to in the within-described Certificate of Naturalization, and that the facts stated in his affidavit are true to the best of my knowledge and belief.
Charles A. Churau
311-127 No. Dearborn St. (address of witness)
Applicant desires passport sent to following address:
James Filipek
3001 Emerald Ave
Chicago, Illinois