English Translation

C0OE300 JheligiCl:24,149 Lem. 9.46. U.S..2.1946 ON MOLLVSIN (1) A.E.F. D.P. REGISTRATION RÉCORD For coding purposes Original Duplicate A. B. o a E. F. G. 'H I. J. CcM.822060.N M. Single X Married GNNAN GERTRUD F. X Widowed Divorced V.D S (2) Family Name Other Given Names (3) Sex (4) Marital Status (5) Claimed Nationality 13.6.2S. URIEGSDORF CSR 3.C. (8) Number of Accom- Birthdate Birthplace Country panying Family Province Members: 2 (7) Religion (Optional) (9) Number of CZERNIN Dependents: FRANZ BICHTA ANNA (10) Full Name of Father (11) Full Maiden Name of Mother (12) Desired Destination (13) Last Permanent RESidEnce oR RESidencE January 1, 1938. U.S.A. KAIEGSDORF CSR City or Village Province Country City or village Province Conntry (14) Usual Trade, Occupation or Profession (15) Performed in What Kind of Establishment (16) Other Trades or Occupations (18) Do You Claim GERM.b. to be a Pris- X B. c. oner of War (17) Languages Spoken in Order of Fluency Yes No (19) Amount and Kind of Currency in your Possession (20) Signature S feln bernin (21) Signature Date: 24.5.49. Assembly of registrar: Ceentr No. (22) Destination or Ettlingen Pubvergatenstr 13 Reception Center: Namé or Number J0 CO Province Country (23) Code 1 2 3 4 5 OT 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 for Issue (24) REMARKS DP-2 10-30781-1