English Translation

110 — 203 Annex to 52.514 par./South Tyrol v. 6.2.40 Employment Office Supreme Administrative Authority Questionnaire on the "agreement on the distribution of the burden of supply for the benefit of the people of Germany and German nationals moving to Germany" of 22 December 1939, which was taken over by Italy's former public=legal servant 1st juname First name e 2. Former Service Title Former Service Section Former Residence 3. That Service Title That Service Section That Residence 4. When did the staff member leave? When did his family leave? 5. For what months were the salaries paid by Jtalien after 31 December 1939? At what amount for each month? (net in Lire) From which place were the remuneration paid? 6. For which months were the salaries paid by the official German immigration and return office? To what amount for each month? (net in Lire) 7. Did the staff member on 1 January 1940 have debts under Article 8 of the agreement? How much are the remaining obligations? How high is the monthly repayment rate paid so far? Description of the debt certificates or supporting documents, for example, 8. Name of the Italian pension fund in which the staff member was registered?