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Instructions as to Application for Certificate of Identification

Item 1. Name. - Write or print your present legal name.

Item 2. Registered name. -This refers to the name (not aliases) under which you registered in accordance with the Alien Registration Act. If your present legal name is the same, write "Same." If different, give the name under which you registered and explain the reason for the difference, which as marriage, divorce, adoption, court proceedings, etc. 
Item 3. Present residence. - (a) Give the location of your present residence, that is, your usual dwelling place. If you live in an apartment house or tenement, give the number. (b) Give your post-office address. If same as 3 (a), write "Same." (c)Give the location of other places at which you resided since January 1, 1941, and indicate after each the length of time, such as (3 months). 

Item 4. Employment.- The names of employers you have had since January 1, 1941 must be stated ; give in each case the address of the employer, the approximate dates of employment. and the capacity in which you were employed. The last -named employer must, of course, be your present employer and the last entry under "Dates"  must be "to date." If unemployed at present, so state. If you operated your own shop, business, or profession at any time since January 1, 1941, write the word "self," your business address the period covered, and the business in which you were or are engaged. 

Item 5. Birth and citizenship. - (a) Give your birth date in full. (b) Name the country of which you are a citizen or subject. If you have list all foreign citizenship, write "None - last a citizen of ---------------------------------------," and name the country of which you were las t citizen or subject. If you wish to give any further explanations of your citizenship or subject status, write "See answer 15" and explain under item 15.

Item 6. Relatives in the United States. - Give the names, state the relationship, and give the address only of living parents, brothers, sisters, husband or wife, or children in the United States. 

Item 7. Answer the question "Yes" or "No" as to weather 
you have any children acctually serving in the military,
naval, or other service in the armed forces of the United States, including the auxiliary arms of service. If the answer is "Yes," give their names and branch of service. It is not necessary to give address. 

Item 8. Relatives outside of the United States. - (a) Give the names, state the relationship. and give the last known addresses only of living parents, brothers, sisters, husband or wife, or children outside the United States. (b) If any of the relatives mentioned in (a) above are, or when last known to the applicant were, serving in the armed forces of a foreign nation, state this fact in the space reserved for "Address" - as "Serving in (army, navy, air corps, etc) of ----------------------," naming the country.

Item 9. United States citizenship.- (a) If you have applied for first citizenship papers or received them or petitioned for naturalization since August 27, 1940, write "Yes" and state which and when and where. Otherwise write "No." (b) Answer "Yes"
 or "No" whether you have ever been refused or denied naturalization in the United States. If "Yes," state the court, place, and reasons or cause given, and whether said reasons or cases have been since removed. 

Item 10. Foreign naturalization. - If you have ever taken any steps towards naturalization in a country other than the United States, answer "Yes" and state the time and place and country. Otherwise, answer "No."

Item 11. Oath of allegiance. - If you, at any time have ever taken an oath or allegiance to any state or country other than the United States, write "Yes" and state the time, place, and country. Otherwise, answer "No."

Item 12.Presidential Proclamations, and Regulations.- A summery of the provisions of Presidential Proclamations, and Regulations concerning the conduct of aliens of enemy nationalities is available at post offices and may be obtained there. You should read such summery or have it read to you, and then state whether you have complied. If you have been granted any kind of exemption, you should so note.


Item 13.Selective service.- If you were registered for selective service, write "Yes," and state where and your number. Otherwise, answer "No.'
Item 14. Organization affiliations.-You must state the clubs, organizations, or societies of which you have been a member or with which you have been affiliated at any time during the past 5 years, either in the United States or abroad. If any listen membership or affiliation has ceased, state the approximate date. If you spent any part of said 5-years period outside the United States, include a statement of your foreign political party or national organization affiliation during such time. 
Item 15. Additional information.-You are not obliged to write in any information under this item, and no penalty or prejudice attaches to your failure to do so. This item merely give you an opportunity to make any voluntary, additional statement concerning yourself. These are suggested topics: (a) How you acquired your present foreign citizenship status (by birth, naturalization, decree, etc.); (b) brief history of your citizenship, whether you lost it by expatriation or decree; (c) whether you left your country of origin because of racial, religious, or political persecution or restriction, and, if so, when and under what circumstances; (d) names and addresses of not more than two persons, now living in the United States, who knew you in your country of origin or who know you here and will vouch for your loyalty. If you give any such names, however, you much accompany them with a written statement, under oath, substantially as follows: "I have neither given anything of value nor obligated myself in any manner whatsoever to obtain permission to use the above names." This must be so stated and must be the fact. If anyone attempts to influence you in any manner with respect to use of his name as a reference, it should be reported to the Identification Official. 
(The above instructions indicate the information you will need to fill out the Application for Certificate of Identification. See other side for instructions as to where and how, and what you will need, to submit you application)
U.S. GOVERNMENT PRINTING OFFICE 16-26142-1