CONFIDENTIAL.
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Appendix 4.
SHANGHAI REFUGEES COMMITTEE
1.
Name in full
2.
Married or Single
3.
Birth place
4. Nationality (by birth)
QUESTIONNAIRE
(by marriage)
5. Accompanied by:
NAME.
AGE.
PARTICULARS (Relationship, etc.).
*$5 per day
for adults *$3 per day
for children.
6. *Ability to pay maintenance rate
Full
Proportionate
*Not required by those able to pay full rate
7. *Statement of means:
(a) Cash in hand
(b) Own and/or husband's salary
(c) Investments
(d) Property
(e) Other sources
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