Immigrant Ships
Transcribers Guild

SS Kaiser Wilhelm der Grosse

Affidavit of Surgeon

I, Dr. Ludeke, Surgeon of the "Kaiser Wilhelm der Grosse" sailing therewith do solemnly, sincerely, and truly swear that I have had fifteen years experience as a Physician and Surgeon, and that I am entitled to practice as such by and under the authority of the university of Munster, and that I have made a personal examination of each of the aliens named herein, and that the foregoing Lists or Manifest Sheets, 25 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 the 7th December 1910 in New York (signed) PA Donaghue Immigration Officer

SALOON, CABIN, AND STEERAGE ALIENS MUST BE COMPLETELY MANIFESTED.

LIST OR MANIFEST OF ALIEN PASSENGERS FOR THE UNITED STATES IMMIGRATION OFFICER AT PORT OF ARRIVAL. Required by the regulations of the Secretary 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 by the Commanding Officer of any vessel having such passengers on board upon arrival at a port in the United States.

Columns represent:
 1) No. on List;
 2) Name in Full (Family name, Given name);
 3) Age in Years and Months;
 4) Sex; 
 5) Married or Single;  
 6) Calling or Occupation;
 7) Able to: Read Write;
 8) Nationality; (Country of which citizen or subject.)
 9) Race or people;
10) Last permanent residence; (Country and City or Town.)
11) The name and complete address of nearest relative or friend in 
    country whence alien came;
12) Final destination; (State and City or Town.)
13) No. on List; (Since this is the same passenger number as column 1,
    column 13 will be eliminated in each passenger's paragraph.)
14) Whether having a ticket to such final destination;
15) By whom was passage paid? (Whether alien paid his own passage,
    whether paid by relative, whether paid by any other person or 
    by any corporation, society, municipality, or government.)
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?
    (If yes, year or period of years.  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 almhouse or institution for care and treatment
    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, length of time, and cause;

Supplemental information required by Naturalization Act approved June 29, 1906:
25) Height in Feet and Inches;
26) Complexion;
27) Color of Hair and Eyes;
28) Marks of Identification;
29) Place of birth: Country and City or town.


1079  Serociak 

1080  Pupczyk

1081  Syczyk

1082  Pavelczak 

1083  Haluszczak

1084  Urban

1085  Danycak

1086  Pohlod

1087  Kopylec

1088  Lazoryszyn

1089  Polulak

1090  Wolk

1091  Porianda

1092  Bajus

1093  Szegda

1094  Schmejda

1095  Babad, L

1096  Babad, E

1097  Ondra

1098  Hajicek

1099  Bach, Mi

1100  Bach, Ma

1101  Skorupa

1102  Piszarik

1103  Zapotoczky

1104  Gula, M

1105  Gula, J

1106  Brilowski

1107  Biernat

1108  Lentzner

 
1079  Serociak, Andrezej, 18y, male, single, farm laborer; can read/write; nat-Austria; 
      race-Ruthenian; last resi: Galicia, Gladyszow; relative: wife, Pauline Serociak,
      Gladyszow, Galicia; final dest: NJ-Jersey City; tkt?-no; passage pd by self; has 
      $25; in US before?-no; going to: brother, Lukasz Syrociak, 2128 Dudly Str, Jersey
      City, NJ; in prison-no; polygamist-no; anarchist-no; promise of work?-no; 
      health-good; crippled-no; height: 5'8"; complex-fair; hair-bld; eyes-bl; marks of 
      ID-no; place of birth: Galicia, Gladyszow

 
1080  Pupczyk, Deonisy, 36y, male, single, farm laborer; can't read/write; nat-Austria; 
      race-Ruthenian; last resi: Galicia, Gladyszow; relative: wife, Wazwaza Pupczyk,
      Gladyszow, Galicia; final dest: NJ-Jersey City; tkt?-no; passage pd by self; has 
      $36; in US before?-yes, 1899 to 1908, Jersey City, NJ; going to: brother-in-law (same
      as #1079); in prison-no; polygamist-no; anarchist-no; promise of work?-no; health-good; 
      crippled-no; height: 5'1"; complex-fair; hair-br; eyes-bl; marks of ID-no; place of 
      birth: Galicia, Gladyszow

 
1081  Syczyk, Hryhorij, 24y, male, single, farm laborer; can read/write; nat-Austria; 
      race-Ruthenian; last resi: Galicia, Terpeliwka; relative: father, Petro Syczyk,
      Terpeliwka, Galicia; final dest: Pa-Northampton; tkt?-yes; passage pd by self; has 
      $20; in US before?-no; going to: brother, Fiedor Syczyk, Box 304, Northampton, Pa; 
      in prison-no; polygamist-no; anarchist-no; promise of work?-no; health-good; 
      crippled-no; height: 5'6"; complex-fair; hair-br; eyes-gr; marks of ID-no; place 
      of birth: Galicia, Terpeliwka

 
1082  Pavelczak, Teofila, 17y, female, single, maid serv; can't read/write; nat-Austria; 
      race-Ruthenian; last resi: Galicia, Raducin; relative: father, Ivan Pavelczak,
      Raducin, Galicia; final dest: NY-Cohoes; tkt?-yes; passage pd by self; has $25; in 
      US before?-no; going to: stepsister, Justyna Pelecz, 199 Ontario Str, Cohoes, NY; 
      in prison-no; polygamist-no; anarchist-no; promise of work?-no; health-good; 
      crippled-no; height: 5'0"; complex-fair; hair-bld; eyes-bl; marks of ID-no; place 
      of birth: Galicia, Raducin

 
1083  Haluszczak, Michal, 27y, male, single, farm laborer; can read/write; nat-Austria; 
      race-Ruthenian; last resi: Galicia, Szczawno; relative: wife, F?nna Haluszczak,
      Szczawno, Galicia; final dest: Pa-Mahanoy Plane; tkt?-yes; passage pd by self; has 
      $20; in US before?-no; going to: acquaintance, Ivan ????th, Frankville, Pa; in 
      prison-no; polygamist-no; anarchist-no; promise of work?-no; health-good; 
      crippled-no; height: 5'5"; complex-fair; hair-br; eyes-bl; marks of ID-no; place 
      of birth: Galicia, Szczawno

 
1084  Urban, Ivan, 35y, male, married, farm laborer; can read/write; nat-Austria; race-
      Ruthenian; last resi: Galicia, Kulaszna; relative: wife, Tenna Urban, Kulaszna,
      Galicia; final dest: Pa-Mahanoy Plane; tkt?-yes; passage pd by self; has $25; in US 
      before?-yes, 1901-1909, Mahanoy Plane, Pa; going to: acquaintance, Stefan
      Grzyczyczyn, Mahanoy Plane, Pa; in prison-no; polygamist-no; anarchist-no; promise 
      of work?-no; health-good; crippled-no; height: 5'5"; complex-fair; hair-br; eyes-bl;
      marks of ID-no; place of birth: Galicia, Kulaszna

 
1085  Danycak, Mykolaj, 33y, male, married, farm laborer; can read/write; nat-Austria; 
      race-Ruthenian; last resi: Galicia, Chlopczyce; relative: father, Ivan Danycak,
      Chlopczyce, Galicia; final dest: NY-Seneca Falls; tkt?-yes; passage pd by self; 
      has $25; in US before?-yes, 1906 to 1909, Scranton, Pa; going to: brother-in-law,
      Michal Makar, Box 352, Seneca Falls, NY; in prison-no; polygamist-no; anarchist-no; 
      promise of work?-no; health-good; crippled-no; height: 5'2"; complex-fair; hair-bld;
      eyes-bl; marks of ID-no; place of birth: Galicia, Chlopczyce

 
1086  Pohlod, Andrej, 38y, male, married, farm laborer; can't read/write; nat-Austria; 
      race-Ruthenian; last resi: Galicia, Suserek; relative: wife, Kancia Pohlod, Suserek;
      final dest: Pa-Glen Campbell; tkt?-yes; passage pd by self; has $19; in US before?-
      yes, 1905-1908, Glen Campbell, Pa; going to: acquaintance, Ferync Mytro, Glen
      Campbell, Pa; in prison-no; polygamist-no; anarchist-no; promise of work?-no; 
      health-good; crippled-no; height: 5'10"; complex-fair; hair-br; eyes-bl; marks of 
      ID-no; place of birth: Galicia, Suserek

 
1087  Kopylec, Ivan, 24y, male, single, farm laborer; can't read/write; nat-Austria; 
      race-Ruthenian; last resi: Galicia, Suserek; relative: father, Wasyl Kopylec,
      Suserek, Galicia; final dest: Pa-Wilgus; tkt?-yes; passage pd by self; has $20; in 
      US before?-no; going to: Michailo Kopylec, Wilgus, Pa; in prison-no; polygamist-no; 
      anarchist-no; promise of work?-no; health-good; crippled-no; height: 5'7"; complex-
      fair; hair-br; eyes-gr; marks of ID-no; place of birth: Galicia, Suserek

 
1088  Lazoryszyn, Maciej, 30y, male, married; farm laborer; can read/write; nat-Austria; 
      race-Ruthenian; last resi: Pa-Ginter; relative: wife, Helena Lazoryszyn, Suserek,
      Galicia; final dest: Pa-Houtzdale; tkt?-yes; passage pd by self; has $20; in US 
      before?-yes, 1905 to 1909, Ginter, Pa; going to: brother-in-law, Oleksa Beca,
      Ginter, Pa; in prison-no; polygamist-no; anarchist-no; promise of work?-no; 
      health-good; crippled-no; height: 5'5"; complex-fair; hair-br; eyes-gr; marks of 
      ID-no; place of birth: Galicia, Suserek ("non-immigrant alien" stamped over
      place of last residence and above occupation column are the numbers 6-77743 -505-
      10/3/39)

 
1089  Polulak, Jurko, 25y, male, married; farm laborer; can read/write; nat-Austria; 
      race-Ruthenian; last resi: Galicia, Suserek; relative:wife, Marya Polulak, Suserek,
      Galicia; final dest: Pa-Houtzdale; tkt?-yes; passage pd by self; has $20; in US 
      before?-no; going to: acquaintance, (same as #1088); in prison-no; polygamist-no; 
      anarchist-no; promise of work?-no; health-good; crippled-no; height: 5'8"; complex-
      fair; hair-br; eyes-gr; marks of ID-no; place of birth: Galicia, Suserek

 
1090  Wolk, Wasyl, 37y, male, married; farm laborer; can read/write; nat-Austria; race-
      Ruthenian; last resi: Galicia, Suserek; relative: wife, Nastia Wolk, Suserek,
      Galicia; final dest: Pa-Houtzdale; tkt?-yes; passage pd by self; has $20; in US 
      before?-no; going to: brother-in-law, (same as #1088); in prison-no; polygamist-no; 
      anarchist-no; promise of work?-no; health-good; crippled-no; height: 5'10"; 
      complex-fair; hair-br; eyes-gr; marks of ID-no; place of birth: Galicia, Suserek

 
1091  Porianda, Anna, 17y, female, single, maid serv; can read/write; nat-Austria; race-
      Ruthenian; last resi: Galicia, Koneczna; relative: father, Dmytro Porianda, 
      Koneczna, Galicia; final dest: NJ-Jersey City; tkt?-no; passage pd by self; has $22;
      in US before?-no; going to: cousin, Seman Wyskowicz, 106 Morris Str, Jersey City,
      NJ; in prison-no; polygamist-no; anarchist-no; promise of work?-no; health-good; 
      crippled-no; height: 4'11"; complex-fair; hair-bld eyes-br; marks of ID-no; place of
      birth: Galicia, Koneczna
      This passenger was detained, click here for further information,

 
1092  Bajus, Filip, 17y, male, single, farm laborer; can read/write; nat-Austria; race-
      Ruthenian; last resi: Galicia, Czarno; relative: father, Fedko Bajus, Czarno, 
      Galicia; final dest: NJ-Jersey City; tkt?-yes; passage pd by self; has $15; in US 
      before?-no; going to: acquaintance, Seman Wyskowicz, 106 Morris Str, Jersey City,
      NJ; in prison-no; polygamist-no; anarchist-no; promise of work?-no; health-good; 
      crippled-no; height: 5'5"; complex-fair; hair-br; eyes-gr; marks of ID-no; place 
      of birth: Galicia, Czarno

 
1093  Szegda, Paraska, 17y, female, single, maid serv; can read/write; nat-Austria; race-
      Ruthenian; last resi: Galicia, Szegdy; relative: father, Jacko Szegda, Teplice, 
      Galicia; final dest: Pa-Philadelphia; tkt?-no; passage pd by self; has $27; in US 
      before?-no; going to: brother-in-law, Stanislaw Sokol, 931 Hancona Str, 
      Philadelphia, Pa; in prison-no; polygamist-no; anarchist-no; promise of work?-no; 
      health-good; crippled-no; height: 5'2"; complex-fair; hair-br; eyes-gr; marks of 
      ID-no; place of birth: Galicia, Szegdy

 
1094  Schmejda, Peter, 37y, male, married; farm laborer; can read/write; nat-US Citizen;
      last resi: Galicia, Koneczna; relative: wife, Anna Schmejda, Koneczna, Galicia;
      final dest: NJ-Jersey City; tkt?-yes; passage pd by self; has $20; in US before?-
      yes, 1882 to 1903, Jersey City, NJ; going to: Citizen (across the columns regarding
      prison, polygamy, etc is written: "Common Pleas, JC NJR 1903"; in prison-no; 
      polygamist-no; anarchist-no; promise of work?-no; health-good; crippled-no;  
      (nothing else recorded)

       
1095  Babad, Leib, 23y, male, married; shoemaker; can read/write; nat-Russia; race-
      Hebrew; last resi: Russia, Bialoczerkov; relative: father, Wolf Babad, 
      Bielaczerkov, Kiev, Russia; final dest: NY-New York; tkt?-yes; passage pd by self; 
      has $15; in US before?-no; going to: uncle, J. Lessan, 333 28th Str, NY; in 
      prison-no; polygamist-no; anarchist-no; promise of work?-no; health-good; crippled-
      no; height: 5'1"; complex-fair; hair-blk; eyes-br; marks of ID-no; place of birth: 
      Russia, Bialoczerkov

 
1096  Babad, Esther, wife, 22y, female, married, housewife; can read/write; nat-Russia; 
      race-Hebrew; last resi: Russia, Bialoczerkov; relative: father-in-law, (same as
      #1995); final dest: NY-New York; tkt?-yes; passage pd by husb; $ (w/#1095); in US 
      before?-no; going to: (same as #1095); in prison-no; polygamist-no; anarchist-no; 
      promise of work?-no; health-good; crippled-no; height: 5'2"; complex-fair; hair-
      bld; eyes-gr; marks of ID-no; place of birth: Russia, Bialoczerkov

 
1097  Ondra, Josef, 24y, male, married; wheelwright; can read/write; nat-Austria; race-
      Bohemian; last resi: Moravia, Borsice; relative: wife, Maria Ondra, Borsice, 
      Moravia; final dest: Pa-Pittsburg; tkt?-yes; passage pd by self; has $12; in US 
      before?-yes, 1905 to 1907, ??ttdale, Pa; going to: acquaintance, Martin Hlozek, 
      Ambridge, Pa; in prison-no; polygamist-no; anarchist-no; promise of work?-no; 
      health-good; crippled-no; height: 5'9"; complex-fair; hair-blk; eyes-bl; marks of 
      ID-no; place of birth: Moravia, Borsice (see #1098)

 
1098  Hajicek, Anton, 28y, male, married; farm laborer; can read/write; nat-Austria; race-
      Bohemian; last resi: Moravia, Borsice; relative: wife, Kata Hajicek, Borsice, 
      Moravia; final dest: Pa-Pittsburg; tkt?-yes; passage pd by self; has $43; in US 
      before?-yes, 1905 to 1907, Ambridge, Pa; going to: brother-in-law, Martin Hlozek,
      Ambridge, Pa; in prison-no; polygamist-no; anarchist-no; promise of work?-no; 
      health-good; crippled-no; height: 5'8"; complex-fair; hair-br; eyes-br; marks of
      ID-no; place of birth: Moravia, Borsice (see #1097)

 
1099  Bach, Michael, 27y, male, married; farm laborer; can read/write; nat-Hungary; race-
      German; last resi: Hungary, Nemet Czernya; relative: father, Peter Bach, N. 
      Czernya, Tor, Hungary; final dest: Oh-Cleveland; tkt?-yes; passage pd by self; has 
      $40; in US before?-yes, 1906, Philadelphia; going to: brother-in-law, Filip Ludwig,
      3099 W 105 Str, Cleveland, Oh; in prison-no; polygamist-no; anarchist-no; promise 
      of work?-no; health-good; crippled-no; height: 5'6"; complex-fair; hair-bld; eyes-
      bl; marks of ID-no; place of birth: Hungary, Czernya

 
1100  Bach, Magdalena, 24y, female, married, housewife; can read/write; nat-Hungary; 
      race-German; last resi: Hungary, Nemet Czernya; relative: father-in-law, Peter
      Bach (same address as #1099); final dest: Oh-Cleveland; tkt?-yes; passage pd by
      husb; $ (w/1099); in US before?-no; going to: (same as #1099); in prison-no; 
      polygamist-no; anarchist-no; promise of work?-no; health-good; crippled-no; height: 
      5'1"; complex-fair; hair-bld; eyes-bl; marks of ID-no; place of birth: Hungary, 
      Czernya

 
1101  Skorupa, Peter, 19y, male, married; farm laborer; can read/write; nat-Hungary; race-
      Slovak; last resi: Hungary, Also Komarusk; relative: wife, Ann Skorupa, Also
      Komarusk, Saros, Hungary; final dest: NJ-Passaic; tkt?-no; passage pd by self; has 
      $33; in US before?-yes, 1900 to 1907, Barnesboro, Pa; going to: sister, Maria
      Skorupa, 52 Gay Str, Passaic, NJ; in prison-no; polygamist-no; anarchist-no; 
      promise of work?-no; health-good; crippled-no; height: 5'6"; complex-fair; hair-
      bld; eyes-bl; marks of ID-no; place of birth: Hungary, Komarusk

 
1102  Piszarik, Andras, 18y, male, single, farm laborer; can't read/write; nat-Hungary; 
      race-; last resi: Hungary, Vargany; relative: father, Fetzo Piszarik, Vargany,
      Hungary; final dest: Pa-Barnesboro; tkt?-yes; passage pd by self; has $24; in US 
      before?-no; going to: brother, Majk Piszarik, Barnesboro, Pa; in prison-no; 
      polygamist-no; anarchist-no; promise of work?-no; health-good; crippled-no; height: 
      5'5"; complex-fair; hair-br; eyes-br; marks of ID-no; place of birth: Hungary,
      Vargany

 
1103  Zapotoczky, Janos, 24y, male, married; farm laborer; can read/write; nat-Hungary; 
      race-Slovak; last resi: Hungary, Batorhezy; relative: wife, Anna Zapotoczky,
      Batorhazy, Saros, Hungary; final dest: Pa-Barnesboro; tkt?-yes; passage pd by self; 
      has $25; in US before?-yes, 1904 to 1907, Barnesboro, Pa; going to: brother, Vasyl
      Zapotoczky, Barnesboro, Pa; in prison-no; polygamist-no; anarchist-no; promise of 
      work?-no; health-good; crippled-no; height: 5'8"; complex-fair; hair-br; eyes-br; 
      marks of ID-no; place of birth: Hungary, Batorhezy

 
1104  Gula, Mihaly, 18y, male, single, farm laborer; can't read/write; nat-Hungary; race-
      Slovak; last resi: Hungary, Batorhezy; relative: father, Jan Gula, Batorhezy, Saros,
      Hungary; final dest: Pa-Barnesboro; tkt?-yes; passage pd by self; has $28; in US 
      before?-no; going to: brother, Jan Gula, Barnesboro, Pa; in prison-no; polygamist-
      no; anarchist-no; promise of work?-no; health-good; crippled-no; height: 5'5"; 
      complex-fair; hair-br; eyes-br; marks of ID-no; place of birth: Hungary, Batorhezy

 
1105  Gula, Janos, 17y, male, single, farm laborer; can't read/write; nat-Hungary; race-
      Slovak; last resi: Hungary, Batorhezy; relative: mother, Maria Gula, Batorhezy, 
      Saros, Hungary; final dest: Pa-Barnesboro; tkt?-yes; passage pd by self; has $28; in 
      US before?-no; going to: father, Jan Gula, Barnesboro, Pa; in prison-no; polygamist-
      no; anarchist-no; promise of work?-no; health-good; crippled-no; height: 5'4"; 
      complex-fair; hair-br; eyes-br; marks of ID-no; place of birth: Hungary, Batorhezy

 
1106  Brilowski, Thomas, 63y, male, married; farmer; can read/write; nat-US Citizen;
      last resi: Mass-Webster; relative: sister, Magdalena Ostowka, Goronoshin, Germany;
      final dest: Mass-Webster; tkt?-no; passage pd by self; has $?; in US before?-yes,
      1883-1900, Webster, Mass; going home to farm, Webster, Mass; in prison-no; 
      polygamist-no; anarchist-no; promise of work?-no; health-good; crippled-no; (across 
      columns regarding prison, polygamy, etc is written: "Superior Court Worcester Mass, 
      Lols??? 41781. No other information is written)

 
1107  Biernat, Wavrzyniec, 23y, male, single, farm laborer; can read/write; nat-Austria; 
      race-Polish; last resi: Galicia, Rycerka gor; relative: mother, Franciska Biernat,
      Rycerka gorna, Galicia; final dest: NJ-Oldbridge; tkt?-no; passage pd by self; has 
      $20; in US before?-no; going to: friend, Jan Ploskonka, #85, Oldbridge, NJ; in 
      prison-no; polygamist-no; anarchist-no; promise of work?-no; health-good; crippled-
      no; height: 5'8"; complex-fair; hair-bld; eyes-bl; marks of ID-no; place of birth: 
      Galicia, Rycerka (the number 7-13179 505 are written above occupation column. See
      also passenger #787, pg 25)

 
1108  Lentzner, Amalia, 23y, female, single, maid serv; can read/write; nat-Russia; race-
      German; last resi: Russia, Kostopol; relative: father, August Lentzner, Kostopol,
      Wolyn, Russia; final dest: Mass-Worcester; tkt?-no; passage pd by self; has $85; in 
      US before?-yes, 1906-1910, Worcester, Mass; going to: brother-in-law, A Botcher,
      19 Carlton Str, Worcester, Mass; in prison-no; polygamist-no; anarchist-no; promise 
      of work?-no; health-good; crippled-no; height: 5'4"; complex-fair; hair-bld; eyes-
      br; marks of ID-no; place of birth: Russia, Studez


Transcriber's Notes:     

A ? indicates letter or letters that could not be read because of the quality
of the document or the handwriting of the original lister. Every attempt is
made to list possibilities when feasible.

The numbering system is that of the transcriber and not of the original 
lister. The form allows for 30 passengers per page, but at times the original
lister did not completely fill the page. When possible the transcriber has 
listed 30 passengers per page.

Parentheses are used by the transcriber to clarify or add additional informa-
tion.  They were not placed by the original lister.

The lister frequently abbreviated son-in-law as "sil" and brother-in-law as
"bil"; transcriber spelled these completely for ease in understanding.

The lister abbreviated "male" as "m" and "female" as "f"; transcriber spelled
these completely for ease in reading. Lister also abbreviated "married" as "m"
and "single" as "s"; again, these were spelled completely by transcriber.

Occasionally there were numbers written in above the column, particularly the
occupation column. These refer to the naturalization process. See jewishgen.org
for an explanation.

National Archives and Records Administration, Film T715. Reel; 160-5, Volume 3536,

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