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| Datasheet File OCR Text: |
| U.S. Department of Justice Immigration and Naturalization Service FORM G-325A OMB No. 1115-0066 BIOGRAPHIC INFORMATION (Middle name) MALE FEMALE BIRTHDATE (Mo.-Day-Yr.) NATIONALITY FILE NUMBER ASOCIAL SECURITY NO. (If any) CITY AND COUNTRY OF RESIDENCE (Family name) (First name) ALL OTHER NAMES USED (Including names by previous marriages) CITY AND COUNTRY OF BIRTH FAMILY NAME FATHER MOTHER (Maiden name) HUSBAND(If none, so state) OR WIFE FIRST NAME DATE, CITY AND COUNTRY OF BIRTH (If known) FAMILY NAME (For wife, give maiden name) FIRST NAME BIRTHDATE CITY & COUNTRY OF BIRTH DATE OF MARRIAGE PLACE OF MARRIAGE FORMER HUSBANDS OR WIVES (If none, so state) FAMILY NAME (For wife, give maiden name) FIRST NAME BIRTHDATE DATE & PLACE OF MARRIAGE DATE AND PLACE OF TERMINATION OF MARRIAGE APPLICANT'S RESIDENCE LAST FIVE YEARS, LIST PRESENT ADDRESS FIRST STREET AND NUMBER CITY PROVINCE OR STATE COUNTRY FROM MONTH YEAR MONTH TO YEAR PRESENT TIME APPLICANT'S LAST ADDRESS OUTSIDE THE UNITED STATES OF MORE THAN ONE YEAR STREET AND NUMBER CITY PROVINCE OR STATE COUNTRY FROM MONTH YEAR MONTH TO YEAR APPLICANT'S EMPLOYMENT LAST FIVE YEARS. (IF NONE, SO STATE.) LIST PRESENT EMPLOYMENT FIRST FULL NAME AND ADDRESS OF EMPLOYER OCCUPATION (SPECIFY) FROM MONTH YEAR MONTH TO YEAR PRESENT TIME Show below last occupation abroad if not shown above. (Include all information requested above.) THIS FORM IS SUBMITTED IN CONNECTION WITH APPLICATION FOR: NATURALIZATION OTHER (SPECIFY): If your native alphabet is other than roman letters, write your name in your native alphabet here: SIGNATURE OF APPLICANT DATE $ STATUS AS PERMANENT RESIDENT Are all copies legible? X $ Yes PENALTIES: SEVERE PENALTIES ARE PROVIDED BY LAW FOR KNOWINGLY AND WILLFULLY FALSIFYING OR CONCEALING A MATERIAL FACT. APPLICANT: COMPLETE THIS BOX (Family Name) BE SURE TO PUT YOUR NAME AND ALIEN REGISTRATION NUMBER IN THE BOX OUTLINED BY HEAVY BORDER BELOW. (Given name) (Middle name) (Alien registration number) Form G-325 A (Rev. 10-1-82) (1) Ident. U.S. Department of Justice Immigration and Naturalization Service FORM G-325A OMB No. 1115-0066 BIOGRAPHIC INFORMATION (Middle name) MALE FEMALE BIRTHDATE (Mo.-Day-Yr.) NATIONALITY FILE NUMBER ASOCIAL SECURITY NO. (If any) CITY AND COUNTRY OF RESIDENCE (Family name) (First name) ALL OTHER NAMES USED (Including names by previous marriages) CITY AND COUNTRY OF BIRTH FAMILY NAME FATHER MOTHER (Maiden name) HUSBAND(If none, so state) OR WIFE FIRST NAME DATE, CITY AND COUNTRY OF BIRTH (If known) FAMILY NAME (For wife, give maiden name) FIRST NAME BIRTHDATE CITY & COUNTRY OF BIRTH DATE OF MARRIAGE PLACE OF MARRIAGE FORMER HUSBANDS OR WIVES (If none, so state) FAMILY NAME (For wife, give maiden name) FIRST NAME BIRTHDATE DATE & PLACE OF MARRIAGE DATE AND PLACE OF TERMINATION OF MARRIAGE APPLICANT'S RESIDENCE LAST FIVE YEARS, LIST PRESENT ADDRESS FIRST STREET AND NUMBER CITY PROVINCE OR STATE COUNTRY FROM MONTH YEAR MONTH TO YEAR PRESENT TIME APPLICANT'S LAST ADDRESS OUTSIDE THE UNITED STATES OF MORE THAN ONE YEAR STREET AND NUMBER CITY PROVINCE OR STATE COUNTRY FROM MONTH YEAR MONTH TO YEAR APPLICANT'S EMPLOYMENT LAST FIVE YEARS. (IF NONE, SO STATE.) LIST PRESENT EMPLOYMENT FIRST FULL NAME AND ADDRESS OF EMPLOYER OCCUPATION (SPECIFY) FROM MONTH YEAR MONTH TO YEAR PRESENT TIME Show below last occupation abroad if not shown above. (Include all information requested above.) THIS FORM IS SUBMITTED IN CONNECTION WITH APPLICATION FOR: NATURALIZATION OTHER (SPECIFY): If your native alphabet is other than roman letters, write your name in your native alphabet here: SIGNATURE OF APPLICANT DATE $ STATUS AS PERMANENT RESIDENT Are all copies legible? X $ Yes PENALTIES: SEVERE PENALTIES ARE PROVIDED BY LAW FOR KNOWINGLY AND WILLFULLY FALSIFYING OR CONCEALING A MATERIAL FACT. APPLICANT: COMPLETE THIS BOX (Family Name) BE SURE TO PUT YOUR NAME AND ALIEN REGISTRATION NUMBER IN THE BOX OUTLINED BY HEAVY BORDER BELOW. (Given name) (Middle name) (Alien registration number) (OTHER AGENCY USE) INS USE (Office of Origin) OFFICE CODE: TYPE OF CASE: DATE: Form G-325 A (Rev. 10-1-82) (2) Rec Br. U.S. Department of Justice Immigration and Naturalization Service FORM G-325A OMB No. 1115-0066 BIOGRAPHIC INFORMATION (Middle name) MALE FEMALE BIRTHDATE (Mo.-Day-Yr.) NATIONALITY FILE NUMBER ASOCIAL SECURITY NO. (If any) CITY AND COUNTRY OF RESIDENCE (Family name) (First name) ALL OTHER NAMES USED (Including names by previous marriages) CITY AND COUNTRY OF BIRTH FAMILY NAME FATHER MOTHER (Maiden name) HUSBAND(If none, so state) OR WIFE FIRST NAME DATE, CITY AND COUNTRY OF BIRTH (If known) FAMILY NAME (For wife, give maiden name) FIRST NAME BIRTHDATE CITY & COUNTRY OF BIRTH DATE OF MARRIAGE PLACE OF MARRIAGE FORMER HUSBANDS OR WIVES (If none, so state) FAMILY NAME (For wife, give maiden name) FIRST NAME BIRTHDATE DATE & PLACE OF MARRIAGE DATE AND PLACE OF TERMINATION OF MARRIAGE APPLICANT'S RESIDENCE LAST FIVE YEARS, LIST PRESENT ADDRESS FIRST STREET AND NUMBER CITY PROVINCE OR STATE COUNTRY FROM MONTH YEAR MONTH TO YEAR PRESENT TIME APPLICANT'S LAST ADDRESS OUTSIDE THE UNITED STATES OF MORE THAN ONE YEAR STREET AND NUMBER CITY PROVINCE OR STATE COUNTRY FROM MONTH YEAR MONTH TO YEAR APPLICANT'S EMPLOYMENT LAST FIVE YEARS. (IF NONE, SO STATE.) LIST PRESENT EMPLOYMENT FIRST FULL NAME AND ADDRESS OF EMPLOYER OCCUPATION (SPECIFY) FROM MONTH YEAR MONTH TO YEAR PRESENT TIME Show below last occupation abroad if not shown above. (Include all information requested above.) THIS FORM IS SUBMITTED IN CONNECTION WITH APPLICATION FOR: NATURALIZATION OTHER (SPECIFY): If your native alphabet is other than roman letters, write your name in your native alphabet here: SIGNATURE OF APPLICANT DATE $ STATUS AS PERMANENT RESIDENT Are all copies legible? X $ Yes PENALTIES: SEVERE PENALTIES ARE PROVIDED BY LAW FOR KNOWINGLY AND WILLFULLY FALSIFYING OR CONCEALING A MATERIAL FACT. APPLICANT: COMPLETE THIS BOX (Family Name) BE SURE TO PUT YOUR NAME AND ALIEN REGISTRATION NUMBER IN THE BOX OUTLINED BY HEAVY BORDER BELOW. (Given name) (Middle name) (Alien registration number) (OTHER AGENCY USE) INS USE (Office of Origin) OFFICE CODE: TYPE OF CASE: DATE: Form G-325 A (Rev. 10-1-82) (3) C. U.S. Department of Justice Immigration and Naturalization Service FORM G-325A OMB No. 1115-0066 BIOGRAPHIC INFORMATION (Middle name) MALE FEMALE BIRTHDATE (Mo.-Day-Yr.) NATIONALITY FILE NUMBER ASOCIAL SECURITY NO. (If any) CITY AND COUNTRY OF RESIDENCE (Family name) (First name) ALL OTHER NAMES USED (Including names by previous marriages) CITY AND COUNTRY OF BIRTH FAMILY NAME FATHER MOTHER (Maiden name) HUSBAND(If none, so state) OR WIFE FIRST NAME DATE, CITY AND COUNTRY OF BIRTH (If known) FAMILY NAME (For wife, give maiden name) FIRST NAME BIRTHDATE CITY & COUNTRY OF BIRTH DATE OF MARRIAGE PLACE OF MARRIAGE FORMER HUSBANDS OR WIVES (If none, so state) FAMILY NAME (For wife, give maiden name) FIRST NAME BIRTHDATE DATE & PLACE OF MARRIAGE DATE AND PLACE OF TERMINATION OF MARRIAGE APPLICANT'S RESIDENCE LAST FIVE YEARS, LIST PRESENT ADDRESS FIRST STREET AND NUMBER CITY PROVINCE OR STATE COUNTRY FROM MONTH YEAR MONTH TO YEAR PRESENT TIME APPLICANT'S LAST ADDRESS OUTSIDE THE UNITED STATES OF MORE THAN ONE YEAR STREET AND NUMBER CITY PROVINCE OR STATE COUNTRY FROM MONTH YEAR MONTH TO YEAR APPLICANT'S EMPLOYMENT LAST FIVE YEARS. (IF NONE, SO STATE.) LIST PRESENT EMPLOYMENT FIRST FULL NAME AND ADDRESS OF EMPLOYER OCCUPATION (SPECIFY) FROM MONTH YEAR MONTH TO YEAR PRESENT TIME Show below last occupation abroad if not shown above. (Include all information requested above.) THIS FORM IS SUBMITTED IN CONNECTION WITH APPLICATION FOR: NATURALIZATION OTHER (SPECIFY): If your native alphabet is other than roman letters, write your name in your native alphabet here: SIGNATURE OF APPLICANT DATE $ STATUS AS PERMANENT RESIDENT Are all copies legible? X $ Yes PENALTIES: SEVERE PENALTIES ARE PROVIDED BY LAW FOR KNOWINGLY AND WILLFULLY FALSIFYING OR CONCEALING A MATERIAL FACT. APPLICANT: COMPLETE THIS BOX (Family Name) BE SURE TO PUT YOUR NAME AND ALIEN REGISTRATION NUMBER IN THE BOX OUTLINED BY HEAVY BORDER BELOW. (Given name) (Middle name) (Alien registration number) (OTHER AGENCY USE) INS USE (Office of Origin) OFFICE CODE: TYPE OF CASE: DATE: Form G-325 A (Rev. 10-1-82) (4) Consul |
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