104-10180-10010 wa . INSEXNG INSOUMATION { INSTAUCTIONS: insert “ASSIGN” we 7 after 201. .¢ number aeeded. Sign Same MICOLE Meee i SRW ARE 20}- ee parte oF s.nts eee rr] Ere eee sae nn ee oT <a es —P * aye va . 2 oa &. SIVEN NAME. MIDDLE AME A fet = $ and — c . ° a SURNAME GIVEN NANE MIDOLE MAME i a 3. - th pel i re oT SURNAME GIVEN NAME. MIOOLE MAME ke SURNAME GIVEN NAME MIOULE NAME ube Shree DRROLETR PREBIOUS er erence YS TCabarhicAbich: SECRET eeckercs uses RERUN CO IEA SAE ASE rH fa Pl ety pc aR : oa ate K ] comrneeo ' a! eer eretres Pare Me Qe
‘oes GGNENUATION OF Ui alGn ‘ ; . INDEXING INFORMATION ; Se CREAT ' ata ~ Log. : ce mane wa ee ee a ee en INSTRUCTIONS: tnsert “ASSIGN" after 201. if number ncedad. i ' — ————————— i i ; J I I : i ' | ; 2/° —— Cerone SR BBB ror MIDOLE NAME i ; 201- H t se Citv 7 TOWN OF BIRTH ' : ei RESIOENCE : : eo t ; oF i 1 i ad | t : ! MIQOLE NAME SURNAME GIVEN NAME nom werre faatretsse Or ote mee sie (mn ates inne + ? i i i $ SURNAME GIVEN NAME MIDDLE NAME ; 201- [[Cinv7TOWN OF BIRTH i : RESIDENCE : : : 1 4 : , : H Hy i i 3 t _— GIVEN NAME MIDOLE NAME ; 5 201i- : f ‘s| sree _eercnnss enna alpen nett te te ee : . Cit¥/ TOWN OF BIRTH os H ' 4 RESIOENCE i 1 ‘ . t . eect ; Poa OCCOL ATE PReviOUs CLASSIFICATION t “PACE RO ‘ tomas Sid foitions : t eH ; SECRE? | ff] convinuse i BL wee rer arp Er SEAR a tae SEE OEE mony threaten eresnsenanennnenstnen cn am. samara" AAR a EERE $F EranromaRsene etter tne Rom
14-00000 oe t shes ae a “ee ite sort sme ernenmenae eres <tare cera mitt 4 teen nnenae BERT mente Me he Rey sete er wine oe a crate acteecunetcereeranneetamtnr an wet BATCH ' wee tt Tee Tb p OS a er Oe Mer APL ree E ee ” INDEXING INFORMATION: BSECRES /  AMRW ~ LOU a a INSTRUCTIONS: Insert “ASSIGN” after 201- if number neaded, | SURNAME GIVEN NAME MIDDLE NAME 201 - Fle g-c9 4 F TY TOWN OF BINTH rd ne ee a cre a r eesenerae n  te SURNAME GIVEN NAME MIDOLE MAME 201 = 4 CITY/TOWN OF BIRTHS — s RESIDENCE as ¢ . nee — ri _ SERNAME GIVEN NAME MIDOLE MAME i Fone OBSOLETE eREvious | CLABOIFIGATION i | PAGERS. wes 53d ROITIONS SECRE®? [i] conrinuto ho : at eee Seemerer meen anette tacre te TaN eaten tenn BEE ee thine te nent me hee ue enti nttnenersnrer ee naan, eR EE ae tn eee tte. ct hatin Wie mk
wo et oay Bo SF ‘ ra RW o« LG) INDENING IND OHMATION i INSTRUCTIONS: insert "ASSIGN" afters 201. Jf number needed. sod — . neon ners ieee er nes nee Pe WY AUE IVE NAME PIOCLE NAS yURMAME GIVEN MAME MIDDLE MAME H en SURNAM SURNAME GIVEN NAME MIDOLE NAME 201 . SEX OATE OF BIRTH COUNTRY OF BIRTH CITY/TOWN OF BIRTH “CUTiZENSHIP "|" SCCUPATION RESIDENCE OTHER NAMEG - STAVE TYPE (AKA. ALIAS, MAIDEN) SURNAME GIVEN MAME MIOCLR MAME { i} 20t- eat ne eer pr rt SEX DATE OF GIRTH | COUNTRY OF BIRT CITY/TOWN OF BIRTH OCCUPATION RESIOENCE CITIZENSHIP ADDITIONAL INFORMATION: ae rte rn eterna 5 . , PAGE NO Fone OBSCLATE ORaVIGUG f CLASSIS ATION : ; i ‘ . ft roves 53d Kormions | BECAN® | YC] continue i &3 | . : os eieteemetnemeantedtemeaen ate re ene
INSTRUCTIONS; Insert “ASSIGH” aftar 201. if number nacded, 1 INDEXING INFORMATION i SECRET AL MEY LGOL i 201- {TY TOWN OF BIRTH 7 GIVER bo aha e AAIOOLE bie ae ©. RESIDENCE CITY/TOWN OF GIAT MIDDLE MAME CRAGRIPIC A TIPa COSOLETE PREVIOUS . eos Tio : ‘ j ; Cz cee ee a nt ee. 201- "| CtPY/ TOWM OF BIRTH ~ : “AUSIDENCE TF AGE NO ‘ teen ‘hh ceveeurecrenenentnecenametttnarenevsmenccaavimmmend’ Ptemattnaete © concn tm eee ee
14-00000 selene Se em dete iin taneous ces } CUNTINUATION OF DG°ATCH CS TON Bete Be Synergy AMG MEO H INGIYING INFORREATION GSECNE® NOY = 1601 INSTRUCTIONS: Insert “ASSKEN” ofiar 201. 1f number nceded. renew rarer wey s Nr rrarer eer’ Bids, Pata 201- we OF sInTH + a mearnene ety et npitnnen oAn le Yuisare weenie enemnmtpetatte tao memento eee Oe nw AY me ede Steer smite gerne nee + us MIDOLE NAME SURNAME | 201i- | Glty, TOWN OF GIRTH | TRESIOENCE MIQOLE NAME ee RARE GIVEN Mans 5} : i an REO cette — COBRMETE PAE nts CRAB RIPIG ATI | oon $34 anirre , wea 3 Tos SECRE® { a3 wR SED Ce a Renate 08 ett ee mrt sceeenatentaniaiernsetemnrsasesomnas eto cs coment an EA ett nn a TROY MURA dealt ter nae wero
2 IML L SUNS INE ETL Se ; tasert “ASSIGN” after 29f- if number needed, INSTRUCTIONS; teem BURN 4uE GIVEN Be AME rade ane 7 ay MIELE WAME ' BURNAME GIVEN MAME MILE NAME i .— ry rc " o Al F . af GIVEN MAME MIOCLE NAME GIVEN NAME MIDDLE NAME SURNAME GIVEN NAME MICSLE NAME f Pome OBR LEE Page eoug i CRAGBUF Cation : weag 830 coTONE | a \ BECRE® } sosrimero oom as oe ~ - remaster ene es easement ree nent + cnt Si meni miter dete a aeceen en mee mena 4,
| Nou Sa INFORMATION BECRET | AMM © LEOL t t ‘ j INSTRUCTIONS: — inser? “ASSIGN” after 201. if numbor noeded. { Shs Sst SALE, a Male Pn ltt Be BELLE a Bennett ARR. i j i 201- § fows or pata 7 - q [nce ~ d eae ees meen, comnts yi ee a | See D CaO nen i i | i i § { ! i | i i : i ' ! H ! 3 { |i { . 2 Kagan Sl ln Edabitelttatt BamntbrtaBn But RR — wT ae " Ree | 7 r a | t | ° | yO y . SURNAME GIVEN NAME MIDOLE NAME I | an | j i | | q —— | | dl | i | | 7 > | i i : : SURNAME Givrls NAME MIDOLE NAME f f i i i i i ' i | . ' : . | | | i H H i i 4 i i { i 1 i ! i q | Sevennnren serve ; ‘ a | en een eeenneee : aod Hi t , Poy COMMETE PHEVICUG | CUAGOIFIC ATION 1 , PAGE NO 1 tose 530 O-TOome i i gz] t 4 : : CUNTINVED j 47 ; et caer ernane BR CRE Tes a een ! i.
14-00000 i | INDEXING INFOMATION , BECKET : AMRW - 1L6yl i - a ‘ , INSTRUCTIONS:  Inser? “ASSIGN” after 201. if number needed. 1 | i WICCLE MAME } i ' 201- i j pinta ee iwetowN OF BiATH | j rs REG oENcE SSS t / | i j | , GIVEN MAME MIDDLE NAME” t 2 UMMA Ae SURNAME GIVEN MAME MIDDLE NAME SuUBHAME GIVEN MAME MiGOLE NAME i | | i ; | | | * CLAGRIB IL ATE PAGE RO. Poo CSHCOLLIE PREV ICUS 4 ro es 53d aorrione H SRCRET : Dal CONTINUED 4 } : eteetaeiieini tite ti eet ete nine ninee tes nat anata nanan tds aaennnnnemes & ° — aeRO NET Scare
14-00000 ee Pe He OW Ne n+ vom enero ee ew Sess ot ae a INCIAGNGS INC TMA INSFRUCTIONS:  tesert “ASSIGN™ after 201. Hf numbor nceded, Ba, Ge aa Givin wae TION SECRET AXEN © LL BICOL E Na bee 20t- 1CENCE FS. TRAE Givin NAME MIDOLE NAME fe & 20i- TTv) TOWN OF BIRTH Sates GIVEN NAME if MIOOLE NAME : Se wawege GIVEN NAME SutNaw se GIVEN MAME six H SATE OF BIRTH COUNTRY OF BIATH C°ATRESSiPr OCCUPATION “OTMER MAMES © STATS PYPR (ANA, ALIAS. MAIDEND HIDOLE SAME { ; 201- | CITY; TOWN OF BIRTH RESIOENCE MISOLE NAME ‘ | 201- CITY) TOWN OF BIRTH . . rrr te err PE NE Pega pen epee pg oc neers pepe AR ESAT EON een ae r £ ADINTIOMAL INFORMATION: OCBSOLATE PREVWIOUA Sid fOrTIONS j ‘ Se memnenmnaaeanamaamadl Fors ee CRASSIFICAT IC BECRET vale BO . & | COMTINYED . &9 et serene eA SM REDEEM ESSE OAC A POPE MEN
14-00000 SS eee  sattee nan eet remap mUeT # - chs | MTEMING INFORMATION RECRET INSTRUCTIONS: Invert “ASSIGN” after AQ aumber needed. Giada L unl 8 BEE. MICDLE Some wriewe rs AaB Ml Pn tl LAL ’ MOLE NAME i j 20!- ciyy TOWN OF BIRTH REGICENCE ME 344.282. LEEW ENB AE, PALA A LE. 4 q q y SURNAME GIVEN NaMg MIDOLE NAME 201 SEX | DATS OF BIRTH COUNTRY OF BIRTH CHY. TOWN OF BIRTH CiTEENMSHIP GCCUPATION - RESIDENCE N OTMER NAMES ~ STATE TYPE CAKA, ALIAS, MAIDEN) ADDITIONAL INFORMATION: OTHER MAWES . GTATE TYPE VARA. ALIAS. MAIDEN) “ADGITIGNAL INFORMATION: OMMLETE PREVIOUS Paoth eres.) BURMA ME GIVEN BARE acer tt ng ngreraerernnan Ex | DATS OF BIRTH r COUNTRY OF BIRTH _ | i CITIZENS CD CCCUPATIONS ea eestenpenenntstg ce OR tA ttt ANN ATO MIDDLE HAME | g01- eee | Cif¥7; TOWN OF BIRTH ae cram ResoEnce COMBE CALS SECRET £) Coe TED seme tennpenen gummastanrnins errruscerrrvprin meme dat ise SPT ti EEE rare. siememmeemrraetrsiaannn ee eR ae emer eRe FEE EEE SEER canPatnsataaatatet aimtenseesintinnatesearnestttbinh tans ed F ETRE A cients Anat ALAA AALS OE NE TTL, 4 Pi . #408 NO ne mee te
BRE UME AEM ANS weg & { : . we ttm UPA | : : ; | INDEXING “XSHC4MATION SSCRET [ABW = 1693 i Le ee nn | INSTRUCTIONS: fear? “ASSIGN” after 201. if sumber needed. ; . i ] BUTNAMET GIVEN mawe BIDOL TE NAME ‘ ! H hod. Ag | | | i 9 | SaNaE Given NAME GinDLE MAME 7 | SURNAME GIVEM MAME MIOULE MAME 3 201- re CITY/TOWN OF BIRTM . RESIDENCE MIDOLE NAME Giv ard MARE. 201- WH OF BIRTH HiDOLE NARE j Given MAME | eae ¢ ee ee aa TPM EPR PS wy se : ™ e } : 83d aot Trg i : ty} CONTI ED ‘ i bs 9 CRAG ty wT oie SECRET ceeateatmeenednienenemeaenceneine aneurin ee aa Sa ™. eer RTP MONEE 3 RR A a ont AE - FT eae RETR ioahioeeatia einen
ee eee ee 5 neem eentens mmm nae A, teen Mee P Scat gs AN S ML CFT S j | | CONTUATION GF GISPAICH Peapernye anon oe ; : | INDEXING INFORMATION SECRET ANN - 1691 : H arn -: woe a mee ve nme i a eee me Set ne ee vo ~f H 4 INSTRUCTIONS: Iairt “ASSIGN” after 201- number needed. asiVEN Nahe eg Wl RAVE { ; 20t- y [7] ere Frown or nia 2 } RESIOENCE : 4 i ' t : H * i $ : , i 2 SURYA GIVEN NAME MC NAME f i 201° i C CITY, TOWN OF BIRTH H ¢ “RESIDENCE { t i Bie: | } | t x i 2 t t : t ; i | 3 SURNAME GIVEN NAME MiOOLE NAME | i Pa po H i [er : i : | al ‘ : ‘ ' ‘ . } t : i i i i i ; t i ‘ t ; : | : ‘4 » j > q H ul . tr + H : ; 3 a i ES } 4 t a + a "epee tvanarnan-nannanpangnaneneevangeteerr—rsattettet-wv—wrseeerdevartns—eeeeeeeeennetatghananaatnasn annette eT TTT ‘ SURNAME GINEM Mam & Perret ae tl | l ae Pace ap DATES etcetera tern a EEE TUL BPA ETEK PAEY Owe i Knee te tr ray tern Pvaw 4) % He hates 7 corey d ited : gS Pen 7) ‘ BECRET . pit anv eia remepenctntn ems ob incertae abe ACEC ODIO TIBI 9 coe aneene ae A Ste PARMA TDSEANE Me eA ence OE
14-00000 ae He AAR bee ws gues MOTUS CRE ERATOR METER AIL ON ET EO EBL BIOKEIELE BOF SGD onl, RO pe etme ony at wet sae ore stent eset saneees H i Ae ae ote he OUT PRI TE i INDEXING INFORMATION SICRET AM - 11 INSTRUCTIONS: fnsert “ASSIGN” ofter 201. if mombee noedad. cs. SABE, Bt na BL, PALLISER. Be BE, ii st tes ates 4 ae... bot. OP git q 4 a GIVEN MAME MIDDLE MAME | . i City/Town OF BINT SURNAME CIViRENOMIP OCCUPATION ARS OLMCE OTMEH HAMEG - STATE TVPE (AKA, ALIAS, MAIDEN) “AOGITIONAL INFORMATION: MIDOLA NAME SURNAME GIVEN MAME 201- rrr) DATE OF GIATH COUNTRY GF BINTH | CHTY/TaaN OF BIRTHS CiTiZENGHIP OECUPATION REBICENCE enema i coe et ED or tere ee re # Nt OTMER MAMRG ¢ GTATE TYPE (AKA, ALIAS, #A.ORMP ADDITIONAL INFORMATION: Givi Name MIDGLE NAME | s BURMAME ~ | 201 asm centres __ eee ee an 7 oEx GATE OF BIRTH | COUNTRY OF WERTH CVV) TOWN OF BIRTH ci TikeNSHIy a waaioince i OYMER MAMES - STATE TYPE TARA. ALIAS, MAIDEN) MIO. Awe PURNAME GIVEN MAME ; . 201- DATE OF BIRTH TT EOUNTRY OF BATE Soe moron | ctrys twa 66 BIR Ts { occurarion ; i @ VvPE ¢ARA ALTAR, BAIOENT OIMeH RAUES . OF son TeOhas InPCOMATION. A aecatiaeaaanmemenmasnetimmenmamiedeens Pe ¥ Beak Boat H ea eemcnerenesnnseoroemtngasnacnnpattnt enantio n enneie :Fm h  eaAge te Soman meth Leet ee AeRty owen ones chat “ieee OPC TTY FSS Y OCT ee Y i soe i wa, Sid TA hOne { ARB 0R 8 7 BG) suas ' 33 t 2: Ao Panett Taian ot es o - A « fh Ag mann RR ea le SIE MI 2 DanC TERE 4 PE ne eee a Otero tans ae,
74-90000 i a ee ee cer bd i ee) CS i Searls INSTRUCTIONS: taser? “ASSIGN” after 20f- if number needed, { BUR MAME ery Pu Aad MIM F WAM gs ij 201- a wr OF Bint” ce pe dese nng eee a ne et ott GIVEN NAME Mince, § SAME i 9 Sis BPA wae ROTO SOF GTO main ces ote tes gmoney ws \Aeelaenmrme nemmameqane em age outs DUANAME GIVEN NAME MIGDLE MAME 201- frown oF BinTH ence | al oS Mee RIAA onan TORT A 8 IG ALOR Ape OO ree a ELAEH “ad PogRNN i fon miberennee earppetem “a . : BGAN A Me GIVEN NAM MID OL. & by a pag rn ‘ a: ' % 4 : . } i fe ‘ iy ‘ i o : eG ' ‘ ' ' MOC R beh roe ‘ { . 5 BUAN AME . ERA a BA, 201- | . bn OF Sint Fee cre tennrecenren iene anime tnemtn peng meng re eee cee ren Lemme serteee Miter, = pai iaenialie Mineetetemmtiamoeateemn barat aan meaemneee eens serene meee ene aneeaeaamene reuieate nate Semanal PE BTR EW eR . rer ety perk en reas BIG Bak Tree t $F apenas Beara 3 ;  BREREG h] weer Lead oy -atee NTRS AO RITA BT BN EIA EMBO TICS LIES ONTO AS ECA ANAL salen + Be ae Et eA BERETS PTD IEE GT Ae TOS AIT AP PH acm RE eee ee homme Mn
Lehane Pde ERNE 5 eh, Met eR Ay SLURS AN i CONN ASO OF UMPATCH : ; i INDESING INFORMS TN i SECRSE? MOEN @ LOL ' 3 . a . - oe : peeerees wom sola meee eee nee peee wee tn ee ee t H ! INSTRUCTIONS: frsert “ASSIGN” aftor 201. Hf number needed. | | i Br TAME MILE POA ME ] | | ! 201- ' | ae [OT Cares tevwes of mare — | Bend Mellel i ron) ao aeoence ———_ | oF k | iene a on a | \ i _ nnn CS | | AQ \ 1 | 9 [mma PATRON eer Feri s7-T8 "ATT Aa : 4 a Q a a i >: sneer ee i nl. sm S| nn tists) a: 7.5.1: an ae 3 SURNAME 1 fa | i | : | | | Een v ES | _ i pf rr | | i | j rd 1 SURNAME Gtvl “a MAME MIOULE MAME | | 4 | 201- i s lity 7 Town OF Bist “jd i _. ___ ann ‘ c lsinognce H ; 6 reo oreemenamnnes mn \ } : : j ms err trteeetineemenmanf : : | H Ht { 4 ! i . ' : t + 5 BUR MAME GIVEN MAME WiODLE MAME ‘ ' 201+ ' : E [Grey twin OF Grate ‘pesoanch ee : Precreeremmcceey mcrae + yan oret en ame Ate aetna tlie AR eee terest Sn dg Retin et neeenerm cemennnnmanttetnaae an ameter t sclehenememumineneanaentea ramamaian admins ea ere ear + A ea ROOTS eR NENA APES aA RD reac A CIR ETS PREV Tw . ee ASHE AEE hy . aoe Ree Fee es $id BeK Tr e L at ite . Rae Ce IRAE ce Sade PUTER Pca em, arenes coe rested MT net A TERR NY Oe SETA SOE NR SO TAPCO 83k AIP ROCIRDPO RS TDD ACE PASE St ICR a Meare“ MARAT hones en ven ets amen meee = IIE RA OHA TNS SNE, Te ee ME I AA eT renege mn ATEL ARONA NAY OE AEN LA RETEE SETS
eR ree ger ey ote ES Me ae ok Me BE TO INSTRUCTIONS: inert VASSIGN™ after 201. if number needed, SEVEN Ae AK WIRELESS ASK i SU TV AME by: Gir gn MAME SIO, Ff aS BIDENCE e Gi 20t- 163226 Van or gem SURNAME SURNAME GIVEN MAME MIDOLR MA Me rte ere et etree EEE en a 20t- WN OF GIRTH Cx GIVEN NAME MIDOLE NAME Gtyit HAMS MIU E WARE : ‘ OWN OF BIRTH ~ ! ¢ MoE ~ ~ i —— — a a — wee t 4 pee arene one erence ne ene 3 & : i Fa $04 COBOL ETE PREVIOUS SEAGREAIT AT IVT : Pav We Set ae “ te oa ; SRCRET ' 3 CONTEND 56 i vO pen opto Pes ESM hten ae SEES, sear TI Saetneteti meters ESSENCE AEROS “EY yearn enneb dette SERA aI AAS gh RS EONS ESN TLR Ite EID NORE ISEIRS CRORE ME REI RIPE 8 TE BEL! TREN At SLI ETO + RTE SERS ComponZe ERAT kee rence & : 201- Reebines
oe verted INSTRUCTIONS: Insert “ASSIGN” affor 209. if number needed. a ed a pcan ron Yeon neta tyre ce vivre wert L Att Petndi Ba 8 ae ns i i i H i | j | 8 | Ji ¢ i | a | GIVEN NAME » MIDOLE NAME 2 SURNAME 20t- rf 7 TOWN OF GIRTH ic q a , é a ‘ RRAME GI siN MAME MICDLE NAME t 3 201- 4+? * TOWN OF BIRTH | CU ANAME Gis Ess WARE MIDOLE NAME i 14 ! - t d . es 1 q ; ! q saan saan : q ; t i ot . : Al : t ' H t f H oa 5 nuane Biv 3 MIDDLE NALS : J § i anne i : : i : i : Pome OBsor le Pegvioug CARDO ICA THORS A i FAGE ND roan BIC foros i j muse : Core Tr Pee : SECRET : &) 57  onteaniahtaiaieamieaticmiaenemerntne rameter a _ SOAS IINT 8 LAE PAIN EBL RN AE ERIE EOE die a TENTED AE ARRON E RIL cE metnrmns nak A ae . SPRATT PNET T! PLONE EOE, erm et vienes ster a a
{ Re MrOW Ue Leer? . poss 4 5 { INDEXING INGOSMATION SECRET ANCL = LODL i | QUCTIONS: laser? "ASSIGN" aftoe 201. if number needed. SL UeARE GIVEN NAME MOC MAME | 201- Civ / TOWN OF BIRTH | INST : i t \ i Give MAME WIA AME i ; j | i 208- 3 Clev yown oF giate TT t ene a i | = ‘nesibence i t tJ — a : boys ; a a ne ; | | | | | DATE OF BIRTH COUNTRY CATISEMSHIP OCCUPATION RESIDENCE OTMER NAMES - STATE TYPE (AKA, ALIAS, MAIDEN) ADEITIONAL INFORMATION: SURNAME GIVEN NAME BICKLS MAME | 201- SEX DATE OF SIRTH COUNTRY OF BIRTH | CITY/TOWN OF BIRTH emer eanersntgn-eseeereeenteetteeesteientnanpninit | vec en att newer gee ner en prt erent RESIDEMCE , Sted cit:ZENSHIP OCCUPATION OTHER NAMES - STATE TYPE UARA, ALIAS, MAIDEN) ences EE AOpen ad h e E ADDNTIONAL INFORMATION:  edeacmeneerianatinenmememe nt ee wMWibme NAME SURRAME GIVEN MAME 4 201- Sex DATE OF BIRTH COUNTRY OF BIRTH | CITY/TOWN OF BIRTH ClCUPATION CUTZ ESP ~ | RESIOENCE ee eeerterern ene A ES ih AE FEE ‘OTHER NAMES - GTATE TYPE (AKA. ALIAS. MAIDEND ADGITIONAL INFORMATION: Wiles MOE { SURMARE GIVEN NAME | 201- ! a — Teiry/ Town OF giatee re ttre sateen serene wna Sie OATE OF Miatnw \ COUNTRY OF OIRTH = j CHTlsgnsniP } GCEUPATION RS SENCR i ‘ / a an btn RA : OTMER KRAMES - STATE PwRE (AKA. ALLA®, MAIDEN : i i AQSIONAL INFORMATION: CRABSIFICAT ICN BECRET &? Cun TINUED aon enepinee~ atssestl tretittentrerennmeetttr tere iomncemateger-ititat eA re CHBGLETE PARWICUS $34 trons rn ne ne FR cern rel AA A ee
Se eten wreewey cnmepatenerntenea ni © are ns ust rteth meer eet erie mene ence oon cree teen oe tence cipaiengenan pare | Pree Ree Ferman 8 IT INSTRUCTIONS: Insert “ASSIGN” atter NUL. if number needed. Se Se ry Ad @ LOZ SURNAME GIMED A a BE, MIL EIN bb U rrerw werd 20i- TOWN OF BIRTH ENcEe ~ . s ) 6URNAME GIVEN SAME MIDDLE NAME | | 201- CITY/TOWN OF BIRTH — “RESIDENCE — | rete are TTT menus - Ppane CHGOM TE PREV ICUS { CRAG HIPC AREA {PAGk mR toa 53d awutions i BECRE? i fc] comtimuce 139 beeaeiemtemnahatineernimtimiernten te autem orate UAB CSApe pn tie ante meme ge ne pre Mein md crest mae ee oe ae
Praca eren erage patna maemo Ft eee te re neem oe meena ey en catenin ger Meee Ma eT BEM GN A ONE THE AMRY - 169) CONTIAC ATION OF DGPATCA "Stee INDEX Si Ge INFORMATION ; BRCRE INSTRUCTIONS: Insert "ASSIGN" 4 fer 231. if number needed. ' 201. r OWN OF BIRT “d a enn no neem - ee 4 enero neta eat teeter SURNAME SVEN NAME MICOLE NAME 201- 3 FOWN OF BIRTH c ENCE ° & 201- $s [v7 Town GF BIRTH ¢ Esioence — a nents aa ree A SURNAME GIVEN NAME MIDOLE NAME j 7 te eet cae ec rerenannnnett S ro | en o A “ RN Sete Solves aw s MIDOLE NAME i ort the ttre Pe eth EY ee AE En EE 0 A TIO “ F omar CRACLATY FARVIOUG CRASBIFICATION : ACH Peas. tees S3d formons ‘ &] CONTINUED 8 SECRET i 60 * tise emacs} cthseaveertnrvnenentaotn teres ene:
| | | | | | | I } J } 3 | CONTINUATION UF BPP atrces sginee oan arts Pet MEM BMD. AN NL wae AMNW = 1691 Wh Sater SECRET INDEXING INFORMATION INSTRUCTIONS: Insort “ASSIGN” after 201. if number neoded. SUANMAME GIVEN NAME MIDDLE NAME DATE OF GINTH COUNTRY OF BIRTH CEIZENSHIP OCCUPATION RESIDENCE “GINGA NAMES - GTATE TVPE (AKA, ALIAS, MAIDEN) ADUITIONAL INFORMATION: SURNAME GIVEN NAME re remnee, ner RENN rere eer een ott, ornnpyanevianucetare reeveanunnagaauerrsvsravecartuehanshen nen itenert Sa4 | DATE OF BIATH COUNTRY OF GIRTM | _ wo orn come tn errata CITSZENGHIF OCCUPATION RESIDENCE ern rer eee eee dora GYHER MAMESD - BYATE TYPE (AKA, ALIAS. MAIDEN) ADUITIONAL INFORMATION: GIVEN NAME MIDOLE MAME SURNAME | 201- COUNTRY OF BIRTH CITY/TOWN OF BIRTH SER OATE OF BIRTH Se pw oe LT CEES tte merrier? jammy ntnteahenn 2, np nn eerste nL ER Pe REE EEE Pt RA rere EEL ECELS OEE CGE PE NOE CiVtiZEMSH iP OCCUPATION | RESIOENCE on entra etter et ett et re ca merge eee net ene ee GTMER NAMES - STATE TYPE (AMA, ALIAS, MAIDEN) ADDITIONAL INFORMATION® MIDCLE NAME SU eRMAME GIVEN NAME i i 201+ et er tee ee nent pe seen ree cn nee ne Sex DATE OF BIRTH | COUNTRY OF BIRTH City,’ TOWN OF BIRTH a i ee ence |e eee cae peer eee ent 9 aro ar orn teenie an ne ee semen roe enenn p r y CITIZENGMEP OCCUPATION RESOENCR OTHER HAWES - GATE TYPE TAKAL ALIAS, MA TOE» “ADDITIONAL INFORMATION: ees gen es eT Ee) Ca ABE Ft AT ACR 4 J ah F BECRE®? a CONTINUED & sence Att ASAE eNOS oD 5 serrerarmtcc oe OBBOLETR PREVIOUS i 2 33d BO TtONe ' | eee eS AREAS Heiter. ranted stettoe rt SHFTEST CAG. ~cRASSIEIASECper weet erecta. aeniaisliaenpemiaindibatd emesmnne eee ae MIL ates meee
“INUEAING INFORMATION SECRET ; BOW ~ Los) i i & : a . we wep ee ee | INSTRUCTIONS: Insert “ASSIGN” after 201. if number neaded. TS TT ETT TTI I | 20. (Peel town oF pier 7 Sn eRCrrmemee te =e teal men ae eerie a 2 BURNAMK GIVEN NAME MIDDLE NAME “SEX | GATE OF GIATH | COUNTRY OF BIRTH aceon ertnnnainnnie tenet antettene CiViAEN BOP OCCUPATION | 201- CITY/TOWN OF GIRTH RESIDENCE OTHER NAMEG - GTATE TYPE (AKA, ALIAG, MAIDEN) ree or errr ce ee geen te et ee theese eeteerrebwererstesensehthsne nth SSPE | | ADDITIONAL INFORMATION: * BURNAME GIVEN NAME MIDDLE NAME 3 201- DATE OF BIRTH COUNTRY OF BIRTH CITY/TOWN OF BIRTH RESIDENCE “SiTaENGHMIP OCCUPATION ce “remanent tte satay tn ttt torrente rareermre Santee OTHER NAMEN - STATE TYPE (AKA, ALIA, MAIDRN) ADDITIONAL INFORMATION: GIVEN NAME MIDOLE MAME | 201 | = SURNAME [ CITY/TOWN OF BiATH BEX | DATE GF BIRTH “CliziNeHe SURAT COUNTRY OF GIRTN "RESIDENCE OCCUPATION A Sratinemineemmery geet weutneninitnrereat + cnmamdgamgeartun “OTHER NAMES - GTATE TYPE (AKA, ALIAS. MAIDEN) Z sadn candasnsnnfarnaesgahyeist-ransgnvnneanasnanmannaaanensasnd ényiar-ne WenipansSAASeRECRE fear? str OEP trer tne erent tha nEDAS RN SAS CE Ter ACCP LN LEC, IS ADBITIONAL INFORMATION: SURNAME Givin NAME MIODLE NAME | 201 eax [eitv7 tows OF BinTH sree ee m8 terete atten eee rr ero tant creer ne aaa DATS OF BIRTH | COUNTRY OF BIRTH cent ae enna nce eases aetna eenetnini ee ee ne nan net ne CiViZENBHIP | GCCUPATION RESIOBNCE ee OTHER NAMES - OVATE TYPE (AKA, ALIAR. WAIDENT “ADOITIONAL INFORMATION: ‘ OSSOLEIE PREVIOUS GL ABER C ATION wes 53d Fortions SECRET | {f] comrmure i 62 neice. Ome nore ee $c tec Se ESSEC EET neA SERRE etcrbitee hat net tier terre st
14-00000 vee EO ae PAL . INDE GN ENO IA TL one # *, (po ema eR Blew ad Ee HNSTRUCTIONS: fasart “ASSIGN” after 201. if aomber needed, SIV EM Baume [ores] oo re as | MG © Lvl MIDOLE SAME Y aneaeeel teeta ey ‘ad 201-5463 CIUPY. Toma OF Bite Tangier “RESIDENCE A teenem pomsaritna © OmROret se ney nearttmtgtnt tet, 4 enna yon 4 SURNAME GIVEN NAME BRIDOLE MARE 1 { i s P "e 4 | : = LS . FS | a Ff aan ~ ae BSB iS Bilin BE WYVT-T-e eee n fa GIVEN NAME MIODLE NAME BURNAME OATE OF BIRTA | {EA NAMEG - STATE TYPE (AKA, ALIAS. MAIDENS ODITIONAL INFORMATION, OSPR FRAY NIUE oom wea 53d coho ec ne oe ok ae, oe nena GIVEN NAME ‘ | OCCUPATION COUNTRY CF OIRTR CU AOE CATH eD MIDUOLE NAME i 201i- Citys TOWN OF BIRTH “aesiOeNcE secre merece t= mete sega “Sauk wo va] COMTI Eee ‘ 63 ee ae RTO A a re ate, OF me A cacti cent ES Re eet Mig mse ny Sut geen nd