[Stampled on document:]
DEPARTED FROM SAN FRANCISCO
NOV 4 1905
STATE OF CALIFORNIA
CITY AND COUNTY OF SAN FRANCISCO
YEE JOCK LEONG being sworn, says, that he is a native born citizen of the United States, that he was born in San Francisco, california [sic] at 741 Sacramento Street about 1884.
That your affiant returned to China many years ago and returned on the Ex. S.S. American Maru August 17th, 1903 That upon due investigation of your affiant's status as such native he was ordered landed, and was landed at the Port of San Francisco, August , 22nd, 1903.
[Signature in Chinese]
Yee Jock Leong
Subscribed and sworn to before me this 28th
day of September, 1905.
[Seal] Thomas S. Burnes