English Translation

26 Appendix a aattel German People's List ts Branch................. Additional questionnaire for the determination of German ethnicity No.... 1. Confession: godly, evangelical, catholic............ Confession of the spouse: Godly, Protestant, Catholic....... 2. Where employs:.............. Activity before the 1.9.1939:... 3. Name, first name and origin of the parents, grandparents: Father:...... .born... in mother:.... Grandfather (father):.. from grandmother " Grandfather: Grandmother 11 4. On point 12 of the above questionnaire: Which schools did you visit: tgo a) German...... from b) Polish....... 5. On point 9 of the preceding questionnaire: Indication of nationality or mother tongue in Polish military passport: ..... 6. On item 10 of the questionnaire: which associations listed there, etc. Did you belong before the 1.9.1939? from until 19 7. Point 12 of the above questionnaire: What persecutions (prisons and fines, economic charges, deportations, etc.) were you subjected to because of your commitment to the German people?...