148
8. Possibility of repatriation
9. Remarks
CONFIDENTIAL.
་
Appendix 5.
SHANGHAI REFUGEES COMMITTEE
1. Name in full
2. Married or Single
QUESTIONNAIRE
3.
Birth place
4.
Nationality (by birth)
*$3 per day.
5.
Ability to pay maintenance rate*
Full
Proportionate
*Not required by those able to pay full rate.
6. *Statement of means:
(a) Cash in hand
(b) Salary
(c) Investments
(d) Property
(e) Other sources
7. Possibility of repatriation
8. Remarks