English Translation

Hoo (I) REGiSTRATION Na A.E.F. D.P. REGISTRATION RECORD For coding purposes 89H81h B.C.D. E. F.G.H.I. 3. rt Duplicate-CZERNIN ARON M. Single Married PO4-JE4 F. Widowed Divorced (2) Family Name Other Given Names (3) Sex ) Marital Status () Claimed Nationality doc5.1919 Bialostock Po4AND HEIHIL (8) Number of Accom- panying Family T (6) Birthdate Birthplace Province Country (7) Religion (Optional) Memembers: (9) Number of GZERNIN 773 CENIA Dependents: (10) Full Name of Father (11) Full Maiden Name of Mother kOVNILSI dIS (L) (13) Last Permanent RESidence oR ResidenCe JANDARY 1, 1938. IN/Sd Bialostock Po4OND City or Viliage C Country City or Village Province Country mechauiles (14) Usual Trade, Occupation or Profession (15) Performed in Vhat/Kind of Establishment (16) Other Trades or Occupations (18) Do You Claim pil to be a Pris- b. ruo a. c. one of War (17) Languages Spoken in Order of Fluency Yes No ) Amount and Kind of Curreney in your Posession (20) S Cresn. (21) Signature 28861 Assembly of Registrar: of registrar: Date: Center No. (22) Destination or vol mm DO Reception Center: QuN Jo GoN Liity or Villiage Province Country I oo) ET ZI TT OT 6 82 14 15 16 17 18 19 20 21 22 23 24 25 26 22 28 for Issue Tomip. to fsracl m 26.-30.5:49. 2.groe. (24) REmaRks I33 DP-2 1-18L08-01