The full text on this page is automatically extracted from the file linked above and may contain errors and inconsistencies.
{Do.ta) T lephono: In erview: N .mo Adult: Uinor: Addre ai l.hla: Fems.lo: cit i zon hip t _....'-r__,_...._~ tJ ba ~ Ty o 1 at on ry into U11i d 3 n , ou.ry L .i.c n . n w? : ___________........_________ ________ P rs -----Tol phon Num .r: pr bl m: • _........., - -··-----------.i- N' nl • /ldul I Uinor: U«lla: X Femalo: Ci izanship: _......._.___ or la. t l:>ntry o Uni ud 3t TP Add1 Number: Pr r r bl mt I // Adul 1 llinor 1 ?Aal. : Femal : Ci t11am hip2 Da or lat n ry in rj i ......................~........~~..-...~.....,.~................... Unit d St t Op }r ting· under Tl' o.sury Lie n now? i ._........ ___..._...__~~---.-......----- Pr Addr pro r y involv d n.nd oo or ~11 Aot. on · k n • I ~~.._.""""' p·ro'pl m: (. N Adult: Addl"' lin r: Male: ~ Female: Ci izonship: D. t o ln.at on nt' und r 'I'r · nu.ry L:i.c r n ~: y in o Uni·t od .St t'\ na\'r?: nd o ~r or r bl m: ...._...._~~ Adul : I llin<'r: . A.ddr Ual : {) .~ Female: Citiz n hip: __..........,.......... 1y-p P.r Addr T ph(\nCJ Numbc r: __......._.....,..--.. _ _._ _ _ __ f f, I ( . - en roblomt Adul : llinC"ir: Ual · : Perna.lo: Ci iz · n hip 1 t 5: Op rating under 'l"r · 11'1ury L o , o Din.: tn<:Jrol ip: P:rop1~' orrhjp: on: CtJ.•por Jncli vidunl: _ _________ _,,_ I nolf?: P rs Addr El' , ..___......____ __ ......._...,.......__._.. l omo , Cl o 0 D r I Dt Telephone: Na.m. Interview: Addr l,) t, 0 l nsury Lio n .. n t? : Typ o p 'r hon · NU?nb r: -----~--------- l ~ Drs.noh ........,.-" ... Bank ot S n Franci O"> of the Unit d St o •• • Adul t {in r: Ualo: Fa.mal Ad r e : ~ Cit.iz nshi : bat of 1 s on r n n Uni Or oury I, c n·1 n w? 1 T Addr T 1 phone /\ a lj l I N .mo Adul : A d:r. v bit o lat en ry in nd 'rr Q Unit~d oury Lie n r no\'T? : __ __ T _____________....,...._ Ad Tol hon Num er : i h r bl nu , ~·; Dran~h An l e rv Bank or San Franci on nt of th Unit d St t s (Dnt ) T l phone, Int rvi w: I Addrcecu ......,_..__..._....__..,....~or-~~.......,.-.... Adul : Uin r: Unlo: v if' Fwnalo: Citizenship: ]) t~ c Op r O 1 in ntry in Q Uni )d 3t. ury Lio n s 1' now? : P rs Adclro s: ---------------- Tol phnne> Numbr r: _ _ _ _ _,_ _ _ _.........._ rlncip l 1r r· y involv d nd ...._, Bra.nob l~ y I )( ~ Ad t: Addr 1r (city) bat · o la.at on ry int • ) Uni ~d S a y Lie n Typ - 'now? ; P i· n (1) Un r: Uala: Fomal : c izonship: 0 Nm Adul Addr t llino : llal : F male: Citizon hip1 at, on ry in n undot' Tr Uni oury ic T ------------------..---------~--- h("ln Nurn •i (bat1) Telephone: Interview: Ne.met Uin(\r: Uale: Female: Citisenship: or r Adult: Addreaa1 ])ate tfa u / /. last entry into United State Operating under Treasury License ·now?: ..........~~~--;..._~_..._.___ __..,......,.....__ Type or Business: Partnership: Proprietorship: Persosa trflewed: Addre!sa Corporation: Individual: TelephonG Number: Principal property involved a.nd scope o! problem: / Act. ion t,a.k n: * *At.taoh additiono.l pag e Where nee soary Nm : Adult: Add~ Uineir: Halo: Fem.a.lo: Ci izon hip: n Opr r r" y in un ot ' tj Uni oury L c ns w?; b. Of Bl a.Lt ' M : P rtnoroh Pr0pr:1 Cor or : ........ ~ ~·i """ .phoM Numb r : or robl m: /7 r t, k n: -__ . o:ruh p+ ion : nd j vidun Ao l, 14 l -·· . N .mos Addr Dt o lot n in ry into U1i vd und r 1rr n nury L c n a: Pr Jr o1p 1 pro t1 I .C ___ ____ ...... probl m: ._ ,._...._. _____ ..._...,.. N mos A.dult1 Adch'.' Minor: ul : ' F eniale: Cltiz nship: b.t of la Op< rat ng u.nde 'I'r aury Lie · TY11 . o Bu imrno 1 n·r hp: Pro i to:rohip: Co. porn. on i ndj vid 111: ' Ac, 1 _kr 1I }. -----------------------------,....___ _..~---------------- 11 ..._, .' . ' I ... • r ~ Branch Bank o! San Franoi a l t of the Unit d St t ro Do.te Tel phono: Intervi w: Adul. : UinCtr. llale: Femal : Citiz nshipt ---------- sury ic n Y1 t no •1? : P re T 1 ph<'n N Pr n pnl p cpor y i nvolv · d o.n ~c p o.r pr r: _...__...._ _ _~.......-.-~"!""" 1 mt Adult: o O r l t ntry int" U11 ~> a t in under 'IT o.oury Lie 113 • : ........,,..,........,._ new?: P rs T Pt nv lv d nnd J\d C("I Adul , z UinClr.: ll l : F mal : {) Ci .izan hip: .,......__...._ _ N .mo: A.dul Add:ti 1 I\ w.nor: l!.'l.lo: Fama.lo: Citiz nship: b~ of not ontry in· Of ot' t n und Jni ct st au.ry Lie n now : •P i on Adu ss: Tl r y nv lv l find no~ hcmr.i Num .r pr bl ·Jtt1 b· or lo.st . ng und nt~y in " Unit~d Gtn 'rr sury Lio n · now~: A clr EH 'r l cphcn<D Pr c).p•tl pr par y c --------- -------·--·---Numbnr 1 pl obl m: ..... N .me Addr e Adult: Mino : i l!nl : Fama.lo: Citizenship: b ~· o ' lo.at, on ry in " Un tod r tn n undo , 'rr our;y I ic 11 T (.I\ now?: P rs _ _..,...,_, Tel ph 1r n 1pnl I r.,.., r r y inv l n no n~ Number: o!' pr.obl rn r .............................. --------·- ·---·----·------ 1 Branoh ot San Fra.rteiso~ 0£ th Unitod Sta a Ah l ~ ~&nk t Adul // b L 01· lo. t, ntry 'Er 1 t , llinnr: Lfol : Fem.al : Ci i2:onship: ----- nto Uni d '1t ury Lio no · now?; Pr ......._,..,___........,...........,......,.____......._ _ ___ ~....,... l o Branch ........-..;,.."' Bank o San Fr nt or th United s ci:Jo~ ea (Date' TelephonG~ o: Intervi w; Adul t MinC'r: Addr Mal · ; " Fam.ale: Citizonshi > of lnst ontry intf') Uni und r Tr 1.v ury 1-1 c n, now'?: · P rs 1 1lt A clro o: w d: ----------·------------------·------ T 1 phf'.lno Num er: r roblcm : "f -------------------- Adulti A d;re Minor: X u 101 F malo: Ci iz nship: . ·. t or lo. in ntry in " Unit cJd undo.r Tr o. ury Lio no\ r?: 1 P r 1 T l phC'no Num , : - - - - ._.........._______ r y inv 1v n l o Branoh nt"r : Jj, l : >< F malo : Citizonship: }) t of. 1 at on "!'Y in c Un Opor sury 1,ic ·n no •r?: rs TYi 1 \ ( A ddl~ To l oph~no Pr "' A Lt. r y nvolv d n p or Numbo1 : r oblom: di - I 1!'V 1 Branch Bank or San Fr&nciso~ t o the United State (Date) T lephonot ,; Interview: Adul : llinor. i ?Jal : I . Fama.lo: Citizonship: _ _ _.......,. n oury Lie n now? : Ty Adtlro 1 __ _ _._.......__.........._ _ _ _ _ _ _ __ Tol h no Numbrr: I f tA,L r h I' l N .m I Adul Addr b · of ln. n ry in " Un 'I p 'S _ __ Ad Px nc 1 filn('lr.: >< Uale: Famal : Citizon hip: nvolv d nn cop ----------------------_.;,,,-----~ .........,_.........._.................. ......... Number: r problem: ___ J. Cbata) T lophon : In orvi w: Adul · Addres : ll n r: ?.!a.lo 1 Fem.a.lo: Citiz nship: 0 or at n ry into Uni 0 oury L o '\ ( now . T pi --Nuro 0r: Prl nn 6 •I 11 ~ I ........._ Adti\t t !inor t Ua.101 r., nale: X Citizonahip: l) , · of laat on ry into Un 0 :r tin r rroo.sw7 Lie ·t1,. J.. ·: 1Jd 3t now? : Typ Adell o · o: T leph~no nnd 'cop r Numbrr: robl ms __ ______. ...._......._...,._...... Adul : Ad.cir Uinar. Ual : Female : / Citizenship: Of J., or l t n y in·· Uni ud i:o 'l'yp hCJlW Nun r: l om: I A 1 \ ,mot Addr s Adul 1 llin~r: '1 ?.!al : ,.,..... Femalo: i Ci iz nship: J or l~ot . r tin und ntry in t' rr u.r 1i od ~t Lio · . . now? : -----·------------T l phC"n y involv c p Nu.mbc'r 1 ----·--.....___.._..__..~ (Duto) Tal phonot Intcrvi w: N' .m t Adul : )< linor i Add.r l!al : ~'em.a.lo: C:i.tiz n hip: D , ., o ln.. t 0 n ry n"', ,., Uni od oury Lio ns 1Y] St n.ow?; I rs a: J\d dr ' olc hC'M Hum involv ·d n.1d A t, i n k n 0 01: 1robl mi Nam J\dulti l inert Address: Mnl : F m o: Oitiz nship: 0 1 t1ng und r 'fre su.ey 1c n 'l'J pe o ' B inos~ : I nrLn rship: novt' ; Pei· 011 nt vi wed: Proprl to ·hip:){ At Corpor· ion: In v dun. : To. ophono Nur:\ ty invo vo as: < r: --· (onto ) N - Tel6phon : Interview: Adult1: Min r: Ual 1 Ferualo: Add.res• : Citiz n hip: bt t o la.at on ry in " Uni od ur T T Li.o 1 e ·: s now?: . . ,.,.......~.......- · p r T lophono N r no 1p 1 /.1 -------- ,,.. • .. • -,..,,....._._... -.-.....--- of probl rn: I ·-----·---"""""- Nm Addr bat of laat ·n ry o Unj y Lio T ct '"'t . 11 1. new? : 0 ---·- -r1nc p o pro l ·m N Addr (I : F ru.alo: CHim nship: D yp o l s or P rs ~ i Ad T 1 phon Num r: l.V d n.t d DO p or pr blem: N A.dul Addr , l). of l at entry int u it . t 7 ntata undot 'rr o.sury L c n· · now?: T p r n Addr "' Tl nc p 1 M O'r y involv no I \'I or ........................................... l ph~n~ d: Numbnr: robl m.· JtJ m• Adul : Addr Dt Minor: l.!al : Fama.lo: Citizenship: _ _.........._.,__ l 0 Jt ontry in ,., Ut d Sa Tr n ·ury L.... c ·ns T . . ~ l'\Ol'r?: p 'S Ad T mrolv , k b t I n nc ph<"n Nlunb ri o.C oblcm1 --- ('I) 7. .~.....-.~·a-t-o)---~ T lephono: Intervi w. Adu.11~ 1 Addr rin en:· : " lfa.l : F' male : Citiz nship: __...__........,._ D· t or 11'1.ot on ry in o Jnit Op r. n. i n un Tr r.t ury :1.c nt n w. : P ~· s Addr Te r .n n' ~ph~no oi' k n wl Numb r: r obl mi Ad llinN" I u Faraal : Citiz n h Dr. · o l ( ot n ry in c Uni undor rr sur· Lio l ?r probl m1 : I) "" A , I 1 or 1 • J9h n t. Con or ·hoorn n ~ n rn • \0 h n, t r 1. rt • I () s ' L (; J•; U ·: s BI . . .c 11 CL CO PO 0 J.pril 22 , l n · U. CALIFO 2 01 co D m d to o l 1o int, r~e I 2. 1 ' 0 l --· (Dato) ·--:o--__,,_ T l phon : Intorvi vr. ~ ti' Adul Addr i ')( iinC'lr i Ual . ; )(' F mnl : Citiz n hi })~ L . o lo.st : !) n /'I y Lio n . · now?: 0 Pr p; Add.r n l'l: ---------------------------- T 1ophono Nmnb l 1 ..__ _ __,__............_..........,.'-"."-_..,. -Tn"nt) T l~phon t Interview: Adul t lti.nor; ,, Ua.10: Femal · : Cit.izonship: _ ..........._........... t1 n ry in ,., Ut1i o ury Lie n Typ o T l hC'ln Num rr: nd noo1 a o.r r 1 m.: I ,, k n t ll .. , Adul t Unor: u l -: Female: Cit.bonship: Da .. o undor 'I'roo.oury Lie ons · n w?: T Adclr ....._.;---·-------- T l phone Nu11 bl"'r : " (Dato) T lephonoi Interview: Adult: Minor 1 it.!a.l ' t) F malo: Ci izonsh:t b tc of ln. on ry int,., Unit ll sury o n , no\'t? : r ---- Adulti llin~r: U~l : X Fema.1 : Ci izonship1 l)n :i 1 ~ o la3t 1m ry nt,., Uni· od r:.ta e Opor . .n un r 'rr l oury Lie n now?: ? Tol.c hC"nr.l Ntun fr per ,y involv d n.n J ,I OCC"p Oi' probl< I CI : I Adul : )< liin~rt Addr l!ala: I} F male: Ci izonehip: _.....,_ _ b t or last ontry n United ' tat e; P rs 'l\'l Ad Tol phone numbor : .............___ __._ ,___._.._.._ _.___ involv cl nnd I 1 c p or prr.>bl m: l Ba.nk B 'anoh or San Franci o tat a t of the Unit d '"') _; u .., I -(Date) . -~ N mo: T6lephono: Interview: X.. Addr Adul : Uinor: X UA.l · : Fem.ale: Ci izonship: D . or 1 a untry 'n o Uni o " at Ad Tl nvolv ph~n Num.brr1 r blcm: ~dul : ~ in r: lll·: , / Famnl : Cit.iz nshi b. . or lo.at ontry in L c i 'l now~: Ad rj llnd noop 0 pr bl .m, ro N mo Adult.:>( Addr lli.n r: Mal : · Fem.a.lo: Ci iz nship: b of last en ry in 0 ndor I') Unit btn •. ; w·d: ·-------Nwnbox : ~ _, i ..................,.~(D~n-t-o~)-----~ T lephono: Intcrvi w: Ad Add t: llinor: ?!ale: Famal : Ci iz n·hi t. ntry ntl") Uni pt Ad Num ~ r. I 1 r inc 'r y invoJ.v d nnd ac (\ r '/ i A ti .Ot problem: I N mot D t or 1 st n Ty n ry i.n Un tJ d "ta ury Lie n .n w?: P s 1\ A T 1 ph<"n Nunb c.r: ... • •• ., '· Adult1 )< lliMt' I ..7 a.lo: 1f.. AddY. F ma.lo: Cit.bonsh.lp: __.,._ _.__,... D; t C P''r Ty o 111. t ontry in ,., Uni od ng \ln ot: '£-r m.iry c n.. now?: P :rs n Adclr T loph n · Num cm : _______..._....____ . ------·---·---~"""' ._. : :: ~ g --To~ta) T lephono· In orview: N mo: .. Adul : Addr· Mlncr : Hal · : ('D " Female: Ci iz nshi :0 t. o ln. t on ry in "' Uni 1Jd st .n unt ct' 'fr· l sury Lio n. ncn?: Ty Ad OfJO' ..........______ .,......__ _ ""_ _._........,____ T l ph"n Nurn a· : Pr:lnc tp 1 l· 01 r y nv lv Adul : Adqr Uin r: ?!al : Femal : Ci iz nship: ......-...-..........,.~ l) ~ o.f ot un ry n fi U it 1J nn-ur Lio St t e n~ · now?: T Add1 T 1 h(" ______ .,_......_ Adult.: r s A.d Un r: lf, 1 : Famal : Citiz n hip: _ _,....,,.._ n ' 0 lnst on ry in .., Uni od Sta ' .......... oury Lie ns · T 0 ? r p'1 Add T Pri pc:r y nvolv· nd 30 aphC'ln Num 1 r: p . o! probl m: Adul. : Uinor; l!al : X Add F mal : Ci izon hi D t . of lnst untry int" Unj n under 'I'r 11 ury Lie s. t C'. , now?: P r Ad w d: l f'JI ------·-----....---· Nunb r. r: robl ·m: I -----------·--------~ Angol o B~anch Lo R rv Bank o San Franc iao~ al A19nt o! the Unit d St t D N .mo t Adul I Minor: Ad re llal . : Female: Ci ,izonship: ·'lot, on 1"Y int,., Unj o . ~t11t o; bf L of ind Typ 'rr su.ry Lio on. of. 11 in P rtJn r .i} Jp: Pro pr i tor Jl ip 1 Cor porn; ion: '.Ind vid\Jo. . : I rJ n ~.pa. pr,., n now : Addl SLH Tol phonr;, .r : r y involv ') ,r, 11 i1K. ni t , .. Loe Angel n Branch R rv Bank or San Franciso~ A19nt of the Unit d St~ o 17 [Dat ) T lephono: Int rview: N.mo: Adci:r l)1 J AdUlt: o lo. X llinor 1 Ualo: X Fama.Io: Ci izonshi $ on ry in Uni u 3t U -------.-... o: P x on Ade " T le hon(\ Ntunbcr : c )(" or pr 'olom: I AoL l (') . ,, " N me: Adult :1 llincr t lla.1 I Fem.ale: Citizenship: )) · i' of t.i.at ont1ry i.n ni mdov 1rr a. ury Lio n· . now? : P rson Atldr Tol(\ph no Uurob r: rln 1 p, l prop r ·y 1nv lv l Aa , ot i ht , ch 1k n oc p o!. problem: -------·-------------~ Name: Adult: Minor : X fnl F ma.lo: Citiz nsh p: Dn.t of .!lt ont y into Unit d St t s: Opot 1n.ting undor T u.ry Lio trno now?: Typ P • on I p: Addr ~ .. ~ 'rol ph n Ntm1 'r: ('3copo o p oblomt c h ] m Adul I lliMrl T Ad Tol ph<"'n ll Prit c p 1 pr I I /\ c , i.01 / I 1 ,.,r : Lo1 Ariplt Dranoh r.ii11aNt.1.. a....,,. Bank ot San Francisco Pieoil A.-.t ot the United Statee S-1 1 {Dat.e) ,,.. Telephone: X Interview: Adult: llinor: J Uale: Female: (} Citizenship: _ __ Date of last entry into United States: Operating under Treasury License nett?: Typ . of Bu sine::; s : Par nership: Person f.ftttirftcwed: Proprietorohip: AddreBS& -----------------------------.- Corporation: Individual: X Telephone Principal property involved and scope I Act.ion t k n: ~~ I or Numb~r: I problem: 'l :; I -Tno.to) T lephono: N e. Intorviaw: X Adul : )( lli.nC'r: Ualo: Femal : Cit izonship: lJ of ·ntry int U1 l.ld ~.:ft 11' . (:) t now?: ~ I Tol h'"'n ncop o!' 1·1 Nui:nbcr: r oblem: I Nt1.m " _, 'rr ury Lie i n. T ______ _.. now? 1 p l' J\d n 00 I lcaphrno Nu.m nr: r r y involv cl nn I i ,r , r. t•. on n: , no ,o .........................,.,._,... leo B anch '-/ --Tnu-t-e)_......___ _ N.m : )1f2 T lephono : Interview: - Adult: )( Minor 1 Addr . Ul: Fem.a.lo: Oitizon~hip: D. Op~r in und ~ 'rr (), · tU'.'~' ic Typ 1 • -- no\·r?: p 1~ BIH l phon NUJt\br r, r ;\nc1 p l propo:r y ~nvolv · probl m: l o Branch d ~tatoa Adu.1 : ,, llinor: Ual : , F ru.alo: Citiz nship: _.__...,.._._....._ b L1 of lo a 0 m ry in ,., Un od 3t - . C'.l ,.J• Address: 'fol phcno Num.b0r 1 I. r i problom1 u • l 0 e/d ... Lo An, 1 Dra.nch erv- Dank or Sart 'Fr noise~ Agent o! the Unit d t tep R N mo AddrGs Adul : ~ Mint"r : Un.lo: Female : Ci Do.Lo or lo.rt on -ry in ,, Unit·1. d ''ti1.r :; : n und r r IL ury Uc l no\'T?: Tel ph~n . or At.L Numbr.r1 robl mt izon~hip: ,. CJ) N mot Adul · ! llin r: l!alc: Addr eat F'emnlo: Ci b t of 1 at en ry int Opr-:i: t ~ta: ,e : tJrd t I n. undor 'r r i ~3 now?: T p; 00 l or robl mt j zon hip: u. 1 o Branoh M' Bank of s Fr ciao A nt of th Uni od St t o (/) Adult: lliMr I ll 101 . F male: Ci b J of 1 ot on ry n ,., Unit 13 \tndo 'rr o. \rty L c nr. izan~hip: St now?: P rt; n ------------------ Tel I hC'lnc o.t' problenu 7 ---rot) T lephon Interview: Adult: llinC'r: Mal ; F ma.lo: C izonship: ..__.___ _ l) l of lo.at ontry intr:> Uni Typ a Du. Ln Rn t rt,n rsMp: Propd1 toroh:lp1 on : Corpor ln vidun.l: I T l .ph no Mumb r.r: _ _ _ _...___._,..._.___........, or ) It, 0 \ t obl m: _,, Adult: il.n<'.'r i l!F .l : Add.r er i F ma.lo: C iz nsh p: ,;.....;..........,_""""-"' D, OJ Pr. Of 1 t ·n ry in sury Lie l 1. n w?: w : rt.nor s Propi"i Co11 por n JncUvid fr 0I T l hem Nurn t l~: pr bl mt ~ m : dd 9r Adul I in<='r: tfal . : t . F roa.l · : Clt izon hip: . st ontry in· ting undor 1 . rr 1 Unit<.;d "tn nsury Li.c n .. c- now?: P r n T l phon · Nu.rn 0r : or rob nu -------~-----·--------- l Ba.nk ~! Br neh or s n Frs.nc so the Unit d Stat - (Date ) I TelephoM: ntorv1.ew: Adul 1 hlint1r: llal 2 Fe.mal : Oi bonship1 )) t~ Op r o:r lo. in. und · nt y n o Uni a ury io n l'\ r? : T es1 Ad 'r r y 1nvolv d l'\ 1 phC'no NUl?lb r : noop f probl mt ( N .rn : Adul : Addr J\ Minor 1 ld l : '>( F nial · : A J t· _ ·t _ · -~-Ci iz nah:ip: "" On, o aot undor 'rr a.om y Lie t ~ n ·r?: ('m d: d t..J • ~ o~ t --......----...-.·---------------------- ol ph('lno Nuinbcr : r Q o! problem: Add:r. Dai, or lo.at en ry int,., Un:lt od Gtn ne und ot' 'I'r o oury 1 c e1 l 'ly of nu in rl' : P r tn r- ,, 1 i p : Propd ,orahi1 i Corpo:rnt on: P rs Addr cs a: Jnriividunl: f rJ 1 c1 pal pr~ . :r y now? : ____________ ____ .......... , ro1 phono Num rr 1 1 i.nv v d n OCC"ll o.r problcmt 1,, r o y N nt 1 Adult I Minor 1 U.'lla1 F emnlo: I Ci izonship: Da. J of laat1 ont ry in TJni 1,, Opo:re. 1.ng undor 'rr noury L c n ' yp : n '''?: Partn rnhip! P:ropri tor nhip t Corporni:.ion: A ell" __ ____ Individun.J.: T 1 hon Nt.un or : . Of 81 , in tlO I Pr ncipnl p. ~por y inv lv d I ~tat P x· n ......................... ..-..--.-... ___ .......... ,,_....,.; Loe ~le Branch R rv Blink or San Frtanciso~ A nt or the Unitod St s ' <1l r~ me: Adult: Addre X lliMr l ?.!a.lo: Female! Ci izonship: na ~ of lo.st untry into Uni od Stats ng undot· 'rr aaury Lio ns Ty}• o usln As: now?: P rs artn rol p: Pl'op.rio ,oral ip: Corpor 1 on : 1nd.i vidun.l: r .n Add.roe ' 'fol· phoM Nurn r : nn ncop o!' prc'o em1 L/ I .l/ (Date) Telephone: Interview: K Adult: '/(. llinor: Uale: X Female: /. Citizsnship: c._--<',_(..... . ___~ l>ate of la.st "ntry into United States: .._.._............,... Opera.ting under Treasury Lie ense now?: ~.-..---~~~-...-...----~~------ Typ or Business: Partnershi : Proprietor ~ hip: Addross i Corporation: Individual: Telephone Number: Principal pr perty involved and scope or problem: I Atta.ch additional pa s whe nee 3&17 1( t