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REGISTRATION CARD--(Men born on or after April 28th, 1877 and on or before February 16, 1897)

[[3 column table]]
| SERIAL NUMBER | 1. Name (Print) | ORDER NUMBER |
| U ... | (First) Rasuo (Middle) (Last) Kuniyoshi | ... |

2. Place of Residence (Print)
(Number and street) 30 E. 14th St. (Town, township, village, or city) N. Y. C. (County) N. Y. (State) N. Y.

3. Mailing Address
(Mailing address if other than place indicated on line 2. If same insert word same) Same

[[3 column table]]
| 4. Telephone | 5. Age in Years | 6. Place of Birth |
| | 52 | (Town or county) Okayama |
| (Exchange) Orchard 4. (Number) 3096 | DATE OF BIRTH (Mo.) Sep. (Day) 1 (Yr.) 1890 | (State or country) Japan |

7. Name and Address of Person Who Will Always Know Your Address
Mrs. Edith Halpert, 43 #. 51st St. N. Y. C.

8. Employer's Name and Address
New School for Social Research 66 W. 12 St. NYC

9. Place of Employment or Business
Art Students League 215 W. 57 St., N. Y. C.
(Number and street or R. F. D. number) (Town) (County) (State)

I AFFIRM THAT I HAVE VERIFIED ABOVE ANSWERS AND THAT THEY ARE TRUE

14-31630-3  ...
(Registrant's signature)

D. S. S. Form 1
(Revised 4-1-42)

(over)

Man who are required to enroll tomorrow and Sunday between 1 and 6 P.M. or Monday between 7 A.M.
McDermott, director of Selective Service of New York City,