No. 9785, issued 27 Sep 1889, Sangamon County, Illinois.
Mary R. Hay swears she was born 6 Jan 1844 in Springfield, Illinois. She is about to travel abroad "in Germany and other Continental Countries."
Sworn 25 Sep 1889 before Clinton L. Conkling, Notary Public.
Charles E. Hay swears he is acquainted with Mrs. Mary R. Hay and the facts stated by her are true.
Sworn 25 Sep 1889 before Clinton L. Conkling, Notary Public.
Description: 45 yrs, 5; 2", medium forehead, blue eyes, "ordinary" nose, medium mouth, "ordinary" chin, black hair "changing to gray," medium dark complexion, round face.
Send passport to: Mrs. Mary R. Hay, c/o Stuyvesant House, New York City, New York.
[rubber stamp at "bottom: William Ridgely, Steamship Agent and Foreign Exchange Broker, Springfield, Ill., U.S.A."]
[Note: William was her brother.]