English Translation

21a transcript. A/ N a m e /for women also birth name/: First Names /Remarking the name: Birthday: Place of birth and circle: Racial affiliation: Nationality: Home law: Marital status: Academic degrees /Borrowing university and date of death/: Occupation: Post office: Service: Criminal penalties: Existing assets /liabilities, cash, capitals, rights, etc./: Measures already in place under criminal law: Last residence: B/ Wife and children in the common household: the same information as above on A/