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State of
Washington, County of Asotin
I, Mary Cooper Jacobs, a Native and Loyal Citizen of the
USA hereby apply to the Department of State, at
Washington, for a passport.
I solemnly swear that I was born at St. Joseph, in the
State of Michigan, on or about the 20th day of October,
1880, that my husband Charles S. Jacobs, was born in
Albion, Michigan and is now residing at Asotin, Asotin
County, Washington....that I have resided outside the
United States at the following places for the following
periods: Always lived in USA and that I am domiciled in
the US, my permanent resident being at Asotin,
Washington, where I follow the occupation of
Teacher....I am about to go abroad temporarily; and I
intend to return to the United States within 3 months
with the purpose of residing and performing the duties
of citizenship therein; and I desire a passport for use
in visiting the countries hereinafter named for the
following purpose:
England, Holland, France, Switzerland, Italy for Study
and Travel
I intend to leave the United States from the port of
Detroit Michigan to said from Montreal, Canada sailing
on board the Mount Royal Canadian Pac. on June 28, 1924.
Age 43
5'2 tall
Forehead: Medium, Eyes: Brown, Nose: Regular, Mouth:
Rather small, Chin: Regular, Hair: Grey, Complexion:
Fair, Face: Round or Oval
I, J.E. heritage, solemnly
swear that I am a native citizen of the US, that I
reside at Asotin, Wash, that I have known the above Mary
Cooper Jacobs personally for four years and know her to
be a native of the US, and that the facts stated in her
affidavit are true to the best of my knowledge and
belief
Asotin, Wash. May 22, 1924
J.E. Heritage, County Auditor for Asotin County, Wash.
State Of Wisconsin
County Of Kenosha
Henry S. Cooper, being first duly sworn, on oath
deposes and says that he is a citizen of the United
States, and a resident of the city of Kenosha, county of
Kenosha and state of Wisconsin; That he is the father of
one Mary Cooper Jacobs, who is making application for
passport for use in visiting England, Holland, France,
Switzerland and Italy for the purpose of study and
travel; that the said Mary Cooper Jacobs was born at the
city of St. Joseph, in the state of Michigan, on the
20th day of October, A.D. 1880.
©Shauna Williams |