Passport ID:                    

Court/Consulate Location:       
Passport Type:                  
Application Number:             
Oath Date:                      




Name:                           
Immigrant ID:                   MOBL-03SEP1919-1-U1-0016 

Age:                             years 
Birth Date:                     
Birth Place:                    

Occupation:                     
Height:                         
Eye Color / Hair Color:          / 

Residence Address:              

Leaving Country:
                                27-Apr-1922 / New York, NY (Rochambeau) / France: visiting relatives


Other Relationship:             

Name:                           
Immigrant ID:                   

Occupation:                     

Emigrated From (Date):          
Resided in USA:                 

Naturalization Date / Location / Court:
                                 /  / 

Witness Name / Occupation / Residence / Time Known Applicant:
                                 /  /  / 

Send Passport To:               
                                

Comments:
husband born in Armenia / two small moles on right cheek

Children:

Action	Name	Birth Date	Birth Place	Comments
	Karibjanian [Gharibjanian], France			daughter of applicant