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Get NY Personal History Statement Form

Ided is not sufficient. The correctness of all statements made will be verified. Any delibirate omission Or distortion of facts will be sufficient cause for the disapproval of application. PHOTO 2x2 PERSONAL DATA Surname First Name Middle Name First Name Middle Name If Chinese, Fokien/Mandarin equivalent: Surname Date of Birth: Place of Birth Sex: Height: Weight: Build: Eyes: Hair:__________ Complexion: ______________________ Visible marks or tattoos: Citizenship : _____________.

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