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efta-efta00151144DOJ Data Set 9Other

PRISM Scanned Document

PRISM Scanned Document Page I of 1 U S. Deportment State APPUCATION FOR 0 U. Onl gyro Or prat all capital Wan in blue tack Ink M whil• era. 1. NAME Inca sad Mid 11 CITY I— 6 1 cowmen*/ CARE OF resapholork..._ cie s 1t4. t.Lt k_ a..s tact "Y lA t oizr 1 1_1 6.0 TE OfAIRTH L itipaL N IT ,,T ZT„tiottint. Sur C, Co. ' MOTHER'S PULL INLO DATE re. • -4 . mare te HAVE YOU EVEN KEN ISSUED A U.S. PASSPORT/ — US in M.COMPUITS NW tall ASO NAM 0445•001IPIVellaaat ISSPOST/ON NAME Ito WHCH GSVED _irrr ut „ not moms isis onotrxhiaTt ISSIA Dan ni HIT :ri Elore as a004••• inn...Minya .we ~an end or p•Inn•Pir w. 4— r rusiet Ile lannel Yen • dela Inn Ihrinunn paean asp In __._- Ina PO MN OCCUPATION pl ts...WAS IIIIMMENCY COMM, • nuns nu win ntlur ••• Urn .W.•. N •••••••••• "Int. er• ppm.% lior Inning — nu es In ienuane t M on•Snel NAME I STREET M. Tsaves PLANS trotnensom.r mue Os. rren irr,„ 4-scsals• COuNfIlqST fl SE_YLSTED. CAA Mn. 15-

Date
Unknown
Source
DOJ Data Set 9
Reference
EFTA 00151144
Pages
1
Persons
0
Integrity

Summary

PRISM Scanned Document Page I of 1 U S. Deportment State APPUCATION FOR 0 U. Onl gyro Or prat all capital Wan in blue tack Ink M whil• era. 1. NAME Inca sad Mid 11 CITY I— 6 1 cowmen*/ CARE OF resapholork..._ cie s 1t4. t.Lt k_ a..s tact "Y lA t oizr 1 1_1 6.0 TE OfAIRTH L itipaL N IT ,,T ZT„tiottint. Sur C, Co. ' MOTHER'S PULL INLO DATE re. • -4 . mare te HAVE YOU EVEN KEN ISSUED A U.S. PASSPORT/ — US in M.COMPUITS NW tall ASO NAM 0445•001IPIVellaaat ISSPOST/ON NAME Ito WHCH GSVED _irrr ut „ not moms isis onotrxhiaTt ISSIA Dan ni HIT :ri Elore as a004••• inn...Minya .we ~an end or p•Inn•Pir w. 4— r rusiet Ile lannel Yen • dela Inn Ihrinunn paean asp In __._- Ina PO MN OCCUPATION pl ts...WAS IIIIMMENCY COMM, • nuns nu win ntlur ••• Urn .W.•. N •••••••••• "Int. er• ppm.% lior Inning — nu es In ienuane t M on•Snel NAME I STREET M. Tsaves PLANS trotnensom.r mue Os. rren irr,„ 4-scsals• COuNfIlqST fl SE_YLSTED. CAA Mn. 15-

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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
PRISM Scanned Document Page I of 1 U S. Deportment State APPUCATION FOR 0 U. Onl gyro Or prat all capital Wan in blue tack Ink M whil• era. 1. NAME Inca sad Mid 11 CITY I— 6 1 cowmen*/ CARE OF resapholork..._ cie s 1t4. t.Lt k_ a..s tact "Y lA t oizr 1 1_1 6.0 TE OfAIRTH L itipaL N IT ,,T ZT„tiottint. Sur C, Co. ' MOTHER'S PULL INLO DATE re. • -4 . mare te HAVE YOU EVEN KEN ISSUED A U.S. PASSPORT/ — US in M.COMPUITS NW tall ASO NAM 0445•001IPIVellaaat ISSPOST/ON NAME Ito WHCH GSVED _irrr ut „ not moms isis onotrxhiaTt ISSIA Dan ni HIT :ri Elore as a004••• inn...Minya .we ~an end or p•Inn•Pir w. 4— r rusiet Ile lannel Yen • dela Inn Ihrinunn paean asp In __._- Ina PO MN OCCUPATION pl ts...WAS IIIIMMENCY COMM, • nuns nu win ntlur ••• Urn .W.•. N •••••••••• "Int. er• ppm.% lior Inning — nu es In ienuane t M on•Snel NAME I STREET M. Tsaves PLANS trotnensom.r mue Os. rren irr,„ 4-scsals• COuNfIlqST fl SE_YLSTED. CAA Mn. 15-44-fi elCars% StAn 21. CODE TELEPHONE La SKr APPLICa NON mitt ISFaUESss0 TO DO SO BY PERSON AONNIVISTERSIO OATH. rodo .air t; ljeLlir4 St.:,. ... lumiC.p. stripodsd oily of IM ,,,, Ls lulad s t •Asa, en Conukinno•••• IlititrentS . Mini SOPIIC a4 Ma Altul aioN40.mailt •Sto el 00 **NW of mo. "A f I sic0I0‘ tIOITIarg IMPainKitlIVINInt4II ClChneti I Iy swim la allinnfl" "X wets au. sae 14 of older Wmr tl clfattakku&a___ Myrna 23.. API/lama of Fames la ntltang DocurvenIS ono, .watt le accost losscaten, Altar 0.14*•• Otaadisn's SJgaatw. II/ Meal!/ywy minor Muth • /1. agal Guarclaa's SI¢tNere (N Warn% new.; K cs.• ass. )21:304asoat ass. 0 p.a. 0 w..., 23b. Nleteen sonefeino Documents ;vs,. D.A., El ors tnsrow =Li _Lb_LLIJ 24. FOR ISSUING OFFICE LIS. ...el: S. IADDIKEwil a evuSancs of Gnus -h 2 7 „,...t Lt cs...., i .._,E,IIIns Careficsa 0 5a [i CA r . , : ... sa Friss/4c Maw Nano -s r• p-' r - E, Peat *I Eton ----_ , 2 I.,Y. I j Pao Csosp* c-sr 110 } /Si ` Or.: • Ilesaarl Mahal 25 OS If i i4ittgiaV 6.5"A Rios " ' CP° Wall No 1405 0004 (•,. Hunan r :0 tanitin Pip., 3 of 4 https://ccdi.state.osis.gov/p1s/PPT/rpt_passport_images.display_doc?p_hash—22EF4329... 2/24/2020 ASSPORT ElREGISTRATION EFTA00151144

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Phone1405 0004
URLhttps://ccdi.state.osis.gov/p1s/PPT/rpt_passport_images.display_doc?p_hash—22EF4329

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