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AMANSIATION.
INFORMATION TO BE SUPPLIED BY APPLICANTS FOR DENATIONALISATION
CERTIFICATES
Hame of applicant
Age of Applicant
Address of Applicant
Place of birth of applicant province
district
locality
village
Name of great grandfather
Name of graffather
Mame of father
Maiden nam, of mother
Maiden name of wife
Kames of sons
Names of daughters
Locality of immovable property
Business in the interior
Business connections and assets in treaty ports
Kame of country nationality of which it is desired to adopt
whether living or dead
whether married or single---- ages
occupations
whether in treaty ports or in the interior, position should be des- oribed in detail,
name of --- shore conducted --- when established ... whether or not part- ners exist.
Reasons for changing nationality
Signature and seal of applicant
Date