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( notaliases) under which you registered in accordance withthe Alien Registration Act. If your present legal name isthe same, write" Same." If different, give the name underwhich you registered and explain the reason for the differ-ence, such as marriage, divorce, adoption, court proceed-ings, etc.
Item 3. Present residence.-( a) Give the location of yourpresent residence, that is, your usual dwelling place. Ifyou live in an apartment house or tenement, give the num-ber.( b) Give your post- office address. If same as 3( a),write" Same."( c) Give the location of other places atwhich you resided since January 1, 1941, and indicate aftereach the length of time, such as( 3 months).
Item 4. Employment. - The names of employers you havehad since January 1, 1941 must be stated; give in each casethe address of the employer, the approximate dates of em-ployment, and the capacity in which you were employed.The last- named employer must, of course, be your presentemployer, and the last entry under" Dates" must be" todate." If unemployed at present, so state. If you operatedyour own shop, business, or profession at any time sinceJanuary 1, 1941, write the word" self," your business ad-dress, the period covered, and the business in which youwere or are engaged.
Item 5. Birth and citizenship.-( a) Give your birth datein full.( b) Name the country of which you are a citizen orsubject. If you have lost all foreign citizenship, write" None- last a citizen of
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and name the country of which you were last a citizen orsubject. If you wish to give any further explanations ofyour 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 addresses only of livingparents, brothers or sisters, husband or wife, or childrenin the United States .
Item 7. Answer the question" Yes" or" No" as to whetheryou have any children actually serving in the military,naval, or other service in the armed forces of the United States , including the auxiliary arms of service. If theanswer is" Yes," give their names and branch of service.It is not necessary to give addresses.
Item 8. Relatives outside of the United States. -( a) Givethe names, state the relationship, and give the last knownaddresses only of living parents, brothers or sisters, hus-band or wife, or children outside the United States. ( b) Ifany of the relatives mentioned in( a) above are, or whenlast known to applicant were, serving in the armed forcesof 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 ap-plied for first citizenship papers or received them or peti-tioned 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 everbeen refused or denied naturalization in the United States .If" Yes," state the court, place, and reasons or causes given,and whether said reasons or causes have since been removed.
Item 10. Foreign naturalization.- If you have ever takenany steps toward naturalization in a country other than theUnited States , answer" Yes" and state the time and placeand country. Otherwise, answer" No."
Item 11. Oath of allegiance.- If you, at any time, haveever taken an oath of allegiance to any country, state, ornation other than the United States , write" Yes" and statethe time, place, and country. Otherwise, write" No."
Item 12. Presidential Proclamations, and Regulations.-A summary of the provisions of Presidential Proclamations,and Regulations concerning the conduct of aliens of enemynationalities is available at post offices and may be obtainedthere. You should read such summary or have it read toyou, and then state whether you have complied. If you havebeen granted any kind of exemption, you should so note.
Item 13. Selective service.- If you were registered forselective service, write" Yes," and state where and yournumber. Otherwise, write" No."
Item 14. Organization affiliations.- You must state theclubs, organizations, or societies of which you have beena member or with which you have been affiliated at anytime during the past 5 years, either in the United States orabroad. If any listed membership or affiliation has ceased,state the approximate date. If you spent any part of said5- year period outside the United States , include a statementof your foreign political party or national organizationaffiliation during such time.
Item 15. Additional information.- You are not obligedto write in any information under this item, and no pen-alty or prejudice attaches to your failure to do so. Thisitem merely gives you an opportunity to make any volun-tary, additional statement concerning yourself. These aresuggested topics:( a) How you acquired your present for-eign citizenship status( by birth, naturalization, decree,etc.);( b) brief history of your citizenship, whether you lostit by expatriation or decree;( c) whether you left yourcountry of origin because of racial, religious, or politicalpersecution or restriction, and, if so, when and under whatcircumstances;( d) names and addresses of not more thantwo persons, now living in the United States , who knew youin your country of origin or who know you here and willvouch for your loyalty. If you give any such names, how-ever, you must accompany them with a written statement,under oath, substantially as follows:" I have neither givenanything of value nor obligated myself in any manner what-soever to obtain permission to use the above names." Thismust be so stated and must be the fact. If anyone attemptsto influence you in any manner with respect to the use ofhis name as a reference, it should be reported to the Identi-fication 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 your application)