Translation Request - Polish - Emigration Record

Dawn95

I'm looking for help translating this emigration document from Polish to English if possible please. I've been able to Google Translate some of it, especially the typed text, but am struggling being able to read some of the handwriting. I'm hoping that maybe someone who knows Polish will be more successful.

For anyone who's interested, this is the resource I got the document from - https://collections.ushmm.org/search/catalog/irn38652?rsc=28550&cv=0&x=1617&y=2165&z=6.8e-5

Thank you so much!

Marya Wertepna Borki Wielkie - 1926 - RG-31.104M.0140.00000354-S - HIGH QUALITY.jpg

Eppich Maria

Warszawa, Street Marszalkowska 144. Page 199.

Cunard Line, Tarnopol

Application

For farmers and agricultural laborers, intending to immigrate to Canada

Directed to Emigration Office in Warszawa

Or to

Branch of Emigration Office in Lviv

Name and surname: Marya Wertepna, daughter of Krynol (Hrynol?)

Age: born year 1906

Occupation: an agricultural laborer

Number of family members intending to emigrate together with this person, their names and ages: she will be alone

Addres: residence of those intending to emigrate, village: Borki Wielkie, Tarnopol, District Borki Wielkie

Religion: Greek-Catholic

Ownership of property (a farm, buildings, inventory): 2 acres of fields

Estimated value of property: $260.00

Will someone stay on the farm or will it be sold and to whom: it will be sold to pay for travel

How much money will the person have after paying for the ship ticket: $50.00

Does this person intend to return to this country or intends to bring later relatives to Canada, and who would that be: so far she does not know

I request the certificate for the free of charge emigration passport.

Signature: Marya Wertepna

Stamp 9045, dated 31st March 1926

The truthfulness of the above declaration is confirmed by the municipal office, Borki Wielkie, 27th March 1926. Stamp and signature.

Dawn95

Eppich Maria - thank you, I appreciate this so much! Makes my day. ☺