SS Vaderland
Required by the regulations of Commerce and Labor of the United States, under Act of Congress approved February 20, 1907, to be delivered to the United States Immigration Officer of any vessel having such passengers on board upon arrival at a port in the United States. S.S. Vaderland, sailing from Antwerp October 2 1909, Arriving at Port of New York October 12, 1909
Affidavit of the Master or Commanding Officer, or First or Second Officer.
I, Thomas G. Barrudy, Master of the SS Vaderland, from Antwerp, do solemnly, sincerely, and truly swear that I have caused the surgeon of said vessel sailing therewith, or the surgeon employed by the owners thereof, to make a physical and oral examination of each and all of the aliens named in the foregoing List or Manifest Sheets 41 in number, and that from the report of said Surgeon and from my own investigation, I believe that no one of said aliens is an idiot, or imbicile, or a feeble-minded person or insane person, or a pauper, or is likely to become a public charge, or is afflicted with tuberculosis or with a loathsome or dangerous contagious disease, or is a person who has been convicted of, or who admits having committed a felony or other crime or misdemeanor involving moral turpitude, or is a polygamist or one admitting belief in the practice of polygamy, or an anarchist, or under a promise or agreement, express or implied, to perform labor in the United States, or a prostitute, or a woman or girl coming to the United States for the purpose of prostitution, or for any other immoral purpose, and, that also, according to the best of my knowledge and belief, the information in said List or Manifest, concerning each of said aliens named thereon, is correct and true in every respect. (signed) ????? ??????????
Sworn to before me this Oct 12 1909 at NY. (signed) O.E. Hackett, Immigration Officer
Affidavit of Surgeon
I, D.A. Oliviers, Surgeon of the SS Vaderland, sailing vessel, do solemnly, sincerely and truly swear that I have had 3 years experience as a Physician and Surgeon and that I am entitled to practice such by and under the authority of University of Louvain, and that I have made a personal examination of each of the aliens named herein, and that the foregoing List or Manifest Sheet 41 in number, are, according to the best of my knowledge and belief, full, correct, and true in all particulars, relative to the mental and physical condition of such aliens.
Sworn to before me, this Oct 12 1909 at NY (signed) O.E. Hackett, Immigration Officer
Columns represent:
1) Number on list.
2) Name in Full; Family and Given.
3) Age in years and months.
4) Sex.
5) Married or Single.
6) Calling or Occupation.
7) Able to Read and Write
8) Nationality: Country of which citizen or subject
9) Race of People.
10) Last Permenant Residence; Country / City or Town.
11) Name and address of nearest relative or friend in country whence alien came.
12) Final Destination; State, City or Town.
13) * Number on List.
14) Whether having a ticket to such final destination.
15) By whom was passage paid?
16) Whether in possession of $50 and if less, how much?
17) Whether ever before in the United States; and if so, when and where?
18) Whether going to join a relative or friend; and if so, what relative or friend,
and his name and complete address.
19) Ever in prison or almshouse institution for the care and support of the insane,
or supported by charity. If so, which?
20) Whether a Polygamist?
21) Whether an Anarchist.
22) Whether coming by reason of any offer, solicitation, promise, or agreement,
expressed or implied, to labor in the United States?
23) Condition of Health, Mental and Physical.
24) deformed or Crippled, Nature of time, and cause.
25) Height; Feet and Inches.
26) Complexion (skin)
27) Color of; Hair and Eyes.
28) Marks of Identification.
29) Place of Birth; Country and City or Town
PASSENGER LINKS
581 Palka
582 Zabowski
583 Gorzl
584 Skroch M
585 Skroch F
586 Skroch J
587 Skroch H
588 Bukala
589 Zakrzewski
590 Koudralzka
591 Pstryj M
592 Pstryj P
593 Pstryj K
594 Marczszanka
595 Stankowicz
596 Plonowska
597 Lubacz
598 Moros
599 Nanczorukowa
600 Witul
601 Rusykowska
602 Markowski
603 Grochowski
604 Moises
605 Urbanowiz
606 Wawczenick F
607 Wawczenick S
608 Zilkowska J
609 Zilkowska Z
610 Jakubczyk
581 Palka, Ignacz; 19y 6m; male; single; farm lab; can read/write;
nat'l: Austria; race: Polish;
last res. Czudec, Austria;
rel. in homeland: mother Aniela Palka;
destination: E. Orange, NY;
passage pd. by sister; in poss.of $32;
rel. in U. S. sister Zusanna Palka;
5'9"; skin: fair hair: br eyes: br;
birthplace: Czudec, Austria
582* Zabowski, Walerian; 19y 3m; male; single; farm lab; can read/write;
nat'l: Russia; race: Polish;
last res. Tyseanz, Russia;
rel. in homeland: father Leonard Zabowski;
destination: Detroit, Mich.;
passage paid by cousin; in poss. of $25;
rel. in U. S. cousin Tyb????;
never been in U. S. before;
5'4" skin: fair hair: br eyes: br;
birthplace: Tyseanz, Russia
583* Gorzl, Walenty; 24y 8m; male; single; farm lab; can read/write;
nat'l: Austria; race: Polish;
last. res. Stekorska, Austria;
rel. in homeland: father Jan Gorzl;
destination: Detroit, Mich.;
passage paid by sister; in poss. of $28;
rel. in U. S. sister Julia M?????a;
5'5" skin: fair hair: br eyes: bl;
birthplace: Stekorska, Austria
584 Skroch, Marga; 25y 0m; female; married; housewife; can read/write;
nat'l: Austria; race: Polish;
last res. Orbniki, Austria;
rel. in homeland: mother Kath Skroch;
destination: Munsing, Mich.;
passage paid by husband; in poss. of $24.50;
rel. in U. S. husband Jan Skroch;
4'10" skin: fair hair: br eyes: bl;
birthplace: Ddeniki, Austria
585 Skroch, Franzisek; 5y 6m; male; single;
nat'l: Austria; race: Polish;
destination: Orbniki, Austria;
rel. in homeland: Kath Skroch;
destination: Munsing, Mich.;
passage paid by: father;
rel. in U. S. father Jan Skroch;
birthplace: Ddeniki, Austria
586 Skroch, Janina; 2y 8m; female; single;
nat'l: Austria; race: Polish;
last res: Orbniki, Austria;
rel. in homeland: Kath Skroch;
destination: Munsing, Mich.;
passage paid by father;
rel. in U. S. father Jan Skroch;
birthplace: Ddeniki, Austria
587 Skroch, Hewyk; 11m; female; single;
nat'l: Austria; race: Polish;
last res: Orbniki, Austria;
rel. in homeland: Kath Skroch;
destination: Munsing, Mich.;
passage paid by father;
rel. in U. S. father Jan Skroch;
birthplace: Ddeniki, Austria
588* Bukala, Rozalia; 17y 6m; female; single; can read/write;
nat'l: Austria; race: Polish;
last res. Debica, Austria;
rel. in homeland: mother Magd. Bukala;
destination: NYS
passage paid by father; no money;
rel. in U. S. father Walenty Bukala;
4'9" skin: fair hair: fair eyes: br;
birthplace: Debica, Austria
589 Zakrzewski, Josef; 22y; male; single; lab; cannot read/write;
nat'l: Russia; race: Polish;
last res. Poniveski, Russia;
rel. in homeland father Josef Zakrzewski;
destination: Brockton, Mass.;
passage paid by brother; in poss. of $8;
rel. in U. S. brother Jan Zakraewski;
5'9" skin: dk hair: br eyes: br;
birthplace: Poniveski, Russia
590 Koudralzka, Ludwiga; 18y; female; single; servant; cannot read/write;
nat'l: Russia; race: Polish;
last res. Kraylo, Russia.
rel. in homeland mother Alisab. Koudralzka;
destination: Central Falls, RI;
passage paid by broth il; in poss. of $11;
rel. in U. S. brother il Anton Mozyka;
5'; skin: fair hair: br eyes: br;
birthplace: Kraylo, Russia
591 Pstryj, Marsya; 26y 7m; female; married; housewife; cannot read/write;
nat'l: Austria; race: Polish;
last res. Lutowiska, Austria;
rel. in homeland: brother Filip Pistryj;
destination: Bayonne City, NY;
passage paid by husband; in poss. of $20;
rel. in U. S. husband Pakob Pstryj;
4'11"; skin: dk hair: fair eyes: bl;
birthplace: Lutowiska, Austria
592 Pstryj, Peter; 11y 3m; male; single;
nat'l: Austria; race: Polish;
last res. Lutowiska, Austria;
rel. in homeland: Filip Pistryj;
destination: Bayonne City, NY;
passage paid by father;
rel. in U. S. father Pakob Pstryj;
birthplace: Lutowiska, Austria
593* Pstryj, Kaska; 7y 6m; female; single;
(remaining information identical to line above)
594 Marczszanka, Kasimira; 17y; female; single; cannot read/write;
nat'l: Russia; race: Polish;
last res. Tochishisek, Russia;
rel. in homeland mother Maria Mavczszanka;
destination: Fishkill on Hudson, NY;
passage paid by grandfather;
in poss. of $25;
rel. in U. S. grandfather Kasimir Marciszanka;
4'11" skin: dk hair: bl eyes: bl;
birthplace: Tochishisek, Russia
595 Stankowicz, Stanislowa; 19y; female; single; cannot read/write;
nat'l: Russia; race: Polish;
last res. Tochishisek, Russia;
rel. in homeland mother Agnczka Stankowicz;
destination: Fishkill on Hudson, NY;
passage paid by stepbrother; in poss. of $27;
rel. in U. S. stepbrother Jan Stankowicz;
5'2" skin: fair hair: br eyes: br;
birthplace: Tochishisek, Russia
596 Plonowska, Juliana; 18y; female; married; housewife; can read/write;
nat'l: Russia; race: Polish;
last res. Janopol, Russia;
rel. in homeland: father Valentin Plonowska;
destination: Lawrence Mass.;
passage paid by: husband; in poss. of $4;
rel. in U. S. husband Piotr Plonowska;
5'1" skin: fair hair: fair eyes: bl;
birthplace: Janopol, Russia
597 Lubacz, Bronislaw; 20y; male; single; farm lab; cannot read/write;
nat'l: Russia; race: Polish;
last res: Kozski, Russia;
rel. in homeland: father M?thas Lubacz;
destination: Hazledon, PA;
passage paid by brother; in poss. of $10;
rel. in U. S. brother Prsius Lubacz;
5'6" skin: dk hair: fair eyes: bl;
birthplace: Kozski, Russia
598* Moros, Falka; 27y; male; married; farm lab; cannot read/write;
nat'l:Austria; race: Polish;
last res. Wilkamazowiska, Austria;
(non-immigrant alien printed over last res.);
rel. in homeland wife A????tya Moros;
destination: Scranton, PA;
passage paid by: brother; in poss. of $15;
rel. in U. S. brother Ilka Moroz;
5'11" skin: dk hair: br eyes: bl;
birthplace: Wilkamazowiska, Austria
599* Nanczorukowa, Anna; 24y; female; single; servant; cannot read/write;
nat'l: Russia; race: Polish;
last res. Ch????, Russia;
rel. in homeland: mother Maria Nanczurakowa;
destination: Middleton, Conn.
passage paid by self; in poss. of $25;
rel. in U. S. cousin Teofila Rybosawa;
5'4" skin: fair hair: fair eyes: bl;
birthplace: Ch????, Russia
600 Witul, Stefan; 27; male; single; farm lab; cannot read/write;
nat'l:Russia; race: Polish;
last res. Miczento, Russia;
rel. in homeland: father Klemens Witul;
destination: Middleton, Conn.;
passage paid by self; in poss. of $28;
rel. in U. S. cousin Wojcich Senko;
5'7" skin: dk hair: br eyes: br;
birthplace: Miczento, Russia
601* Rusykowska, Marya; 24y; female; single; servant; cannot read/write;
nat'l: Russia; race: Polish;
last res: Fernowitz, Russia;
rel. in homeland: friend Adam Kerzi;
destination: Chicago, Ill.;
passage paid by father; in poss. of no money;
rel. in U. S. father Stanisl. Ruszkowska;
5'2" skin: dk hair: br eyes: br;
birthplace: Fernowitz, Russia
602* Markowski, Solom 17y; male; single; farm lab; can read/write;
nat'l: Russia; race: Polish;
last res: Wisni, Russia;
rel. in homeland: father Fran Markowski;
destination: NYS;
passage paid by brother; in poss. of $11;
rel. in U. S. brother Jan Markowski;
5'6" skin: fair hair: br eyes: br;
birthplace: Wisni, Russia
603* Grochowski, Bronislaw; 18y; male; single; farm lab; cannot read/write;
nat'l: Russia; race: Polish;
last res: Ukowa, Russia;
rel. in homeland: father Vincente Grochowski;
destination: NYS;
passage paid by: uncle; in poss. of $8;
rel. in U. S. uncle Felix Stanczszyk;
5'7" skin: fair hair: fair eyes: bl; birthplace:
Ukowa, Russia
604* Moises, Piotrz; 17y; male; single; labr; can read/write;
nat'l: Russia; race: Polish;
last res: Wirczochi, Russia;
rel. in homeland: father Vincenz Moises;
destination: Hazleton, PA;
passage paid by: broth i. l.; in poss. of no money;
rel. in U. S. brother i. l. Levusri Ostrzicki;
4'9" skin: fair hair: fair eyes:
bl; birthplace: Wirczochi, Russia
605 Urbanowiz, Piotr; 21y; male; single; labr; can read/write;
nat'l: Russia; race: Polish;
last res: Casolob, Russia;
rel. in homeland: father Wojsek Urbanowiz;
destination: Port Richmond, N. Y.;
passage paid by: brother; in poss. of $25;
rel. in U. S. brother Jos. Urbanowiz;
5'8" skin: dk; hair: fair eyes: bl;
birthplace: Casolob, Russia
606 Wawczenick, Felix; 31y; male; married; day lab; cannot read/write;
nat'l: Russia; race: Polish;
last res: Csiry, Russia;
rel. in homeland: wife Apolonia Wawizenick;
destination: Buffalo, NY;
passage paid by: self; in poss. of: $28;
been in U.S. 1905 Buffalo;
rel. in U. S. brother Andry Wawszenik;
5'4" skin: fair hair: br eyes: bl;
birthplace: Osiry, Russia
607 Wawczenick, Stanislaw; 41y; male; married; day lab; cannot read/write;
nat'l: Russia; race: Polish;
last res. Csiry, Russia;
rel. in homeland: wife Mariana Wawizenick;
destination: Syracuse, NY;
passage paid by: self; in poss. of $28;
rel. in U. S. broth. i.l. Mateusz Jasniki;
5'5" skin: dk hair: br eyes: bl;
birthplace: Osiry, Russia
608* Zilkowska, Josefa; 29y; female; married; housewife; cannot read/write;
nat'l: Russia; race: Polish;
last res: Layah, Russia;
destination: Jersey City, NJ;
passage paid by: husband; in poss. of $25;
been in U. S. 1901/7 Jersey City, NJ;
rel. in U. S. husband Jan Zilkowski;
5' skin: ?? hair: br eyes: bl;
birthplace: Layah, Russia
(entry stamped as non-immigrant alien)
609* Zilkowska, Zofia; 3m; female;
all other info same as above except rel. is her father,
no physical description,
never been in U. S.
610* Jakubczyk, Julianna; 22y; female; married; housewife; cannot read/write;
nat'l: Austria; race: Polish;
last res: Lubatowa, Russia;
rel. in homeland: Antoni Kupczik;
destination: Bayonne, NJ;
passage paid by: husband; in poss. of no money;
rel. in U. S. husband Jak. Jakubczyk;
5' skin: dk hair: br eyes: bl;
birthplace: ????????, Austria
Transcriber's Notes:
* The use of an * indicates an omission or error made by the original recorder.
* The use of a ? indicates a word or letters that could not be read due to quality of
original document
582: surname of cousin looks like Tybuliczno, the only parts that are very
clear are the "Tyb" and the "zno", the rest I'm not certain of
583: the only thing I'm certain of is that the surname of the sister begins
with an "M" and ends with an "a"; in between are probably 7 letters that
make the name look like "Mototabra"
598: first name of wife looks like "Ahatya" or "Alnatya" -- I'm only certain
of the "A" and the "tya"
599: last residence and birthplace looks like "Chinon" or "Chinou"; I'm
only certain of the "Ch" and that there is an "i" somewhere after it. There
appear to be four letters after "Ch"
610: birthplace looks like "Sachtowa" although last residence is Lubatowa.
Reviewer's Notes:
583: 8-Tel-2-12-32 (505) is written in the occupation coloumn. These numbers pertain
to naturalization, click here for more information.
588: X is in front of the name. This means this passengers was temporarily detained, see
PAGE 39, passenger 588 for more information.
23-115642 - 6-10-42 - 505 is written in the occupation coloumn, click here for more information.
593: 2-444263 - 15/14/26 is written in the occupation coloumn. These numbers pertain
to naturalization, click here for more information.
601: X is in front of the name. This means this passengers was temporarily detained, see
PAGE 40, passenger 601 for more information.
602: X is in front of the name. This means this passengers was temporarily detained, see
PAGE 39, passenger 602 for more information.
603: X is in front of the name. This means this passengers was temporarily detained, see
PAGE 40, passenger 603 for more information.
604: X is in front of the name. This means this passengers was temporarily detained, see
PAGE 36, passenger 604 for more information.
608: X is in front of the name. This means this passengers was temporarily detained, see
PAGE 40, passenger 608 for more information.
609: X is in front of the name. This means this passengers was temporarily detained, see
PAGE 40, passenger 608 for more information.
610: X is in front of the name. This means this passengers was temporarily detained, see
PAGE 40, passenger 610 for more information.
* For a brief history of this ship please go to Page 1 using the link at the bottom of this page.
National Archives and Records Administration: Film T715, Reel 1353
Transcribed by Stephanie Holladay a member of the
Immigrant Ships Transcribers Guild
5 May 2000
Reviewed by Ines Mannhardt a member of the
Immigrant Ships Transcribers Guild
April 2004
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