English Translation

Form B 27 Repatriation questionnaire Family name: First name: (possible in Drucschrift) (emphasize name) Date of birth: Birth place: Country of origin: Nationality: (according to passport) Do you have a German passport? yes - no. (to be deleted as appropriate) Are you looking for a foreign passport?yes - no, (to apply) Are You stateless? yes – no. If married, name of Jhrer's wife: or Jhres' husband In which country did you work for at least 2 months? Exact date of return to Germany: Have you ever been in the Besitş of a Rükwanderer-ID? yes - no. (Inapplicable must be deleted) Date Signature