DEPARTMENT OF STATE
UNITED STATES OF AMERICA
JANUARY 20, 1912

STATE OF NEW JERSEY
COUNTY OF ESSEX

I, W. Hull Botsford, a Native and Loyal Citizen of the
United States, hereby apply to the Department of
State, at Washington, for a passport for myself.

I solemnly swear that I was born at MILLPORT, in the
State of NEW YORK, on or about the 23 day of NOVEMBER,
1886; that my father is a NATIVE citizen of the United
States; that I am domiciled in the United States, my
permanent residence being at ORANGE, in the State of
NEW JERSEY, where I follow the occupation of
ARCHITECT; that I am about to go abroad temporarily;
and that I intend to return to the United States
within FOUR months, with the purpose of residing and
performing the duties of citizenship therein.

OATH OF ALLEGIANCE

Further, 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 any mental reservation
or purpose of evasion. SO HELP ME GOD.

W. HULL BOTSFORD

Sworn to before me this 19th day of January, 1912

FRANK A. STINSON
NOTARY PUBLIC, STATE OF NEW JERSEY

DESCRIPTION OF APPLICANT

AGE: 25 Years
STATURE: 5 Feet, 7 Inches, Eng.
FOREHEAD: Rather sloping
EYES: Grey
NOSE: Slightly Hollow
MOUTH: 1 7/8" & Straight
CHIN: Slight Dimple
HAIR: Blonde
COMPLEXION: Blonde (sic)
FACE: Wei--- over left eye
Vertical wrinkle between eyes

JANUARY 9, 1912

I hereby certify that I have known the above-named W.
Hull Botsford personally for FOUR years, and know him
to be a native-born citizen of the United States, and
that the facts stated in his affidavit are true to the
best of my knowledge and belief.

CHARLES F. STERLING
318 Belleville Ave.
Newark, N.J.

Applicant desires passport sent to following address:

W. HULL BOTSFORD
419 N. MAIN ST.
ORANGE, N.J.