English Translation

12a Which guarantors can you give for your ethnicity? Where 2. Name......... 8. Number of children: 1. First name..............Rel.Concession .Mother's language 2. " 4 11 " 3. " ....... 4 11 11 4: 11 "1 11 .... 11 5: 11 11 11 ..... 6. 11 1 ..... "1 7. 11 11 1 9. Which Sohulen visited your children before the 1.9.39? (exact name of the school genus)... (exact description of the school genre).. ch always, also before the 1.9.1939, to the German people h knows that in case of false information outside the folk community I present myself. Declaration are not made, so all reasons reben. 11. I assure affidavit that I answered the above questions truthfully. I know that in the case of deliberately false information, I am punishable. ..........19.. (self-handed signature) Free for examination..........................19.