Ragnar Benson by Acquiring New ID

Author:Acquiring New ID
Language: eng
Format: epub

UNITED STATES DEPARTMENT OF STATE

APPLICATION FOR PASSPORT BY MAIL

TYPE CR PRINT IN

E A R E A S ONLY

U S E B L O C K L E T T E R S / N U M B E R S

MAIL PASSPORT TO

IN CARE C* OF APPLICABLE)

PLACE Of BIRTH

City 4 Stai» o« Cry i Country

I I I I I

1 I I I I

HOME TELEPHONE

BUSINESS TELEPHONE

NOTE: M o s t recent p a s s p o r t M U S T b e e n c t o s e d l

PASSPORT NUMBER

OCCUPATION (Hot UarxMarri |

!l I I I I I

DEPARTURE DATE

TRAVEL PLANS fWOC ¡ ¡ g g w l

LENGTH Of STAY (Not Utnôtlortf
COUNTRIES TOSE Vi;

PERMANENT AOORE8S |Po not Hit PQ-BaiQ

STREET/R FO «

NOT MANDATORY

N CASE OF EMEROENÇV WHEN TRAVELING ABROAO, NOTIFY (PRRR

pnlicant the ponion which applies should be lined o

should be attached, signed, and made a pan of (his application.)

I have not. since acquiring United Stales citizenship, been naturalized as a citizen of a foreign state: laken an oath. •

SUBMIT TWO RECENT C

WTH LCHT 1 BACKGPQUNO

diplomatic or consular officer of the United Stales in a foreign nate: or been convicted hy¿ a cour

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t or court martial of competen

,

t jurisdiction of i

ithnjanyac-

o| treason against

against., o

,> r

r .litemptin

.mcmpiin g

g I

b "

y ' "

force lo

* :

overthrow, or

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bearing -irmi against the " —

United Slates, or conspirin *

g lo

- —

overthrow, p -

u •

t —

do» -

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or destroy by force ir.

(Government

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t f

o th

f e

th Unite

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Unite Slates

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Slates

WARSlilC; False statements made knowingly and willfullv in Kinport applications or affidavits or other supporting documents arc punishahle by fine and imprisonment

imprisonmen

t u

n

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