English Translation

For each person (including children and wives) a separate form must be completed. For minors or wives, the completion must be carried out as a rule by the authorized representative (father) or the husband. This also applies if there is no property or income of the minors, or spouses, — please read the form carefully before completion! Write clearly! Strike out what does not apply. Any question has to be answered! DECLARATION OF COMPANY. First name (remark name) and surname (for wives also maiden name): Occupation: Last employment (company, salary, salary) Apartment (city, district, street and house number, since when?) Are you in sub-rent? Do you have sub-tenants? Born in District Land Confession: Nationality: Citizen-Leg.-No. Marital status (lone, married, widowed, divorced, living separately): Spouse: First name (underlining the name), former name, race and dates of birth: matrimonial property status (goods community, etc.): Children: (also those over 21 years): a) Living in a common household: Names and dates on birth: b) Living outside the shared household: Personalities, Address: Which children have their own assets or income (height)? Which family members migrate along?