Strunk Response 1

1 AMEND TO IHCLUDE (EXCLWOEI tWIFEI(HUSBAND)
NAME BIRTHPLACE BlRTHOATE
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"REVIOYSLV MARRIED TO 1 PREVIOUI MARRIAGE TERMINATED 81
DIVORCE: DEATH
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DISPOSITION OF MY SPOUSE'S PREVIOUS PaS5DORT
ATT*CHED
Cj CAHCELED
LnATFI
I AMEND TO INCLUDE IEXCLUOE! CHILDREN I
AMEND TO AEAO IN MARRIED HAME
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DATE MARRIED
PLACE MARRIED
MARRIED TO
CITIZENSHIP OF HUleANO
[7 U. 9. CITIZEN a ALIEN-CITIZEN OF
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OTHER RMENDMENT~S~ (DESCRIBE IN DETAlL ACTION REQUE5TEDl
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DOCUMENTARY EVIDEYCP SUBMIT TED Y a DEP&RTIAEhlT BY CDHIU LAR OFFICER
DOCUMEHTARY EVIDENCE SEEN AND RETURNED T 0 APPLICANT BY C13HSULAROFFICER
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STATEMENT OF ACTION BY POST UPOH DEPARTMENT'S AUTHOR1 ZATIOH (70 h eaecwtd only In conncdon 4th costs r efad to Dcpt.)
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THE PAS SPORT RENEWEO TO 09TE
AUTHOR1 TY
C4RD OF IOENTITY WAS [3 AMENDED 45 REQUESTED 1
(Y born ?e~'?cd /ot irarlmiensJ
STAPLE ONE PHOW HERE
DO NOT MAR FACE
Thc passpon photos requifcd must
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bc approxirmtdy 2% by 2% inches in riic;
1 -
* bc on thin unglazed papcr, sbw lull front
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view of applicant with a plain, lidht back-
2 ground: and haw been taken within 2 years FJ
3:
n: of &tc submirtd. When dependents asc in- 3
k cldrd they should be shown inaproup pho-
- -
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tograph. The consul will nor accept photos
rhnr ere nor z gmd likeness. Color photographs
arc acccptablc.
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OPINlQN OF CONSULAR OFFICER
(Consul *I the Unid St~es of Arnrrltff)
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(Consul of ihe Unitmd Stales ef Arnericol
FORM ,.,oa In certain cases specific auihorizatiom by the lllepaltmcnt will bc rcquized. In chcse rases an extra copy of rhe form should I
be prcpnrcd. L'pon receipt of ihc Pepnnmcnt's rcplp the txrrn copy should bc rtaasmittcd mith a nota'ien of ihc scrion inken+
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