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Story: The Mailahn Family Massacre
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| # |
Question |
Answer |
|
Serial Number |
|
|
Order Number |
|
| 1 |
Name |
|
| 2 |
Place of Residence |
|
| 3 |
Mailing Address |
|
| 4 |
Telephone |
|
| 5 |
Age in Years, Date of Birth |
|
| 6 |
Place of Birth |
|
| 7 |
Name and Address of Person who will know your address. |
|
| 8 |
Employers Name and Address |
|
| 9 |
Place of Employment or Business |
|
|
(signature) |
|
| R1 |
Race |
|
| R2 |
Height |
|
| R3 |
Weight |
|
| R4 |
Complexion |
|
| R5 |
Eyes |
|
| R6 |
Hair |
|
| R7 |
Other obvious physical characteristic that will aid in identification: |
|
| R8 |
I certify that my answers are true; that the person registered has read or has had read to him his own answers; that I have witnessed his signature or mark and that all of his answers of which I have knowledge are true, except as follows: |
|
|
(signature of registrar) |
|
| |
Registrar for Local Board: |
|
| |
Date of Registration |
|
| |
Stamp of Local Board (No and address) |
|
