English Translation

M/ CM的1 (SPECIALIST) APPLICATION FOR ASSISTANCE APPLICATION FOR SUPPORT WATTS LATNER/USA PCIRO ORIGINAL Family name (family name) 4. a 5. Identity No. (certificate No.) CORCON 17.6,1948 V 104. 584 2. Other Spelling or aliases (other used spelling or 6. Citizenship (national citizenship names) Austria 3. R. C., Prot., Ev., Other Religion (Rome-kath., prot, Jud., Z MS in other faith) (Family status led., verh, sep., geh, verw., unaccompanied) r. kath Cee Relationship to head Town, province and 8. Names (names) (degree of relationship to Date of birth Citizenship country of birth Family head) (date of birth) (State citizen) (City, Province and Geburtsland) 1. Man (man) GICKLHORN Hosef Prof.Dr. Mar 18.7.1891 Oe 2. Woman (Woman) Rerme née Czernin CSR Caaan 14.2,1897 4 Graz Children (children) - e 4. 5. 6. 7. 9. Other Membera of Family (other family members) a) Full names (voile names) b) c) (P e) f) (8 10. Places of residence for last 10 years For who (For whom) Dates Town or village, province and country GICKLHORN 1935 - 45 Prague and wife 1945 - so far Vienna 81134