Passport ID:                    

Court/Consulate Location:       
Passport Type:                  
Application Number:             
Oath Date:                      




Name:                           
Immigrant ID:                   ASIA-10OCT1922-2-U6-0008 

Age:                             years 
Birth Date:                     
Birth Place:                    

Occupation:                     
Height:                         
Eye Color / Hair Color:          / 



Other Relationship:             

Name:                           
Immigrant ID:                   MERI-15MAY1911-3-S-0022 LEVI-02SEP1929-3-29-0006 

Occupation:                     

Current Residence / Purpose:     / 

Emigrated From (Date):          
Resided in USA:                 

Witness Name / Occupation / Residence / Time Known Applicant:
                                 /  /  / 

Comments: