Civil record questionnaire

CIVIL RECORD

CIVIL RECORD

To be filled to the best of your knowlege. This not a legal document, it used in all of our cases to draft the powers of attorney and to submit a full family tree to the notary.

YOURSELF

DISABILITY (Are you crippled ?)
DISABLED EX SERVICE MAN (Are you disabled ex-serviceman at leat 50% ?)
MARITAL STATUS

SPOUSE

EX-SPOUSE (If applicable)

0
(Drag the cursor)

EX-SPOUSE 1

EX-SPOUSE 2

EX-SPOUSE 3

YOUR FATHER

YOUR MOTHER

CHILDREN

(Drag the cursor)
0

CHILDREN 1

CHILDREN 2

CHILDREN 3

CHILDREN 4

CHILDREN 5

CHILDREN 6

CHILDREN 7

CHILDREN 8

CHILDREN 9

CHILDREN 10

DO YOU HAVE BROTHER(S) AND SISTER(S)

BROTHERS & SISTERS (Half-brothers ans sisters included)

1
(Drag the cursor)

BROTHER OR SISTER 1

(If applicable)

BROTHER OR SISTER 2

(If applicable)

BROTHER OR SISTER 3

(If applicable)

BROTHER OR SISTER 4

(If applicable)

BROTHER OR SISTER 5

(If applicable)

BROTHER OR SISTER 6

(If applicable)

BROTHER OR SISTER 7

(If applicable)

BROTHER OR SISTER 8

(If applicable)

BROTHER OR SISTER 9

(If applicable)

BROTHER OR SISTER 10

(If applicable)

REMARKS

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