Form 1-131 No*
v. b. mpabSSS? of justice     APPLICATION FOR REENTRY PERMIT
Immigration and Naturalization Service
(Edition January 1941) ^     .
Reviewer _.__._	
To the Honorable Commissioner of Immigration and Naturalization ;
The undersigned, being an alien, hereby makes application for a reentry permit, as provided for in Section 10 of the
Immigration Act of 1924, and submits the following data in support thereof:
The name I now use is (Print full name)	
(First) (Middle) (Last)
( Name of steamship —  ——	
I (First, second, or third class)
LAST arrived in the United States < Port of arrival   — —-
, Date of arrival  _ _	
(Excluding reentries before July 1, 1940, after absence of less than 6 months in Canada and Mexico.)
Name under which admitted	
Father's name —_— - --—~     Mother's maiden name	
At time of entry my age was  _„; I was /Sngl? , V-     M^ occupation was
(Yrs.)   (Mos.)                 \MarriedJ
Place of birth »-..—   ~   Date .	
a
■s
« Last permanent residence before date of entry ———----. _ r___ _____
>g ^ (Country) (City or town)
^ Name and complete address of nearest relative or friend at time of entry in country whence came -,.
Name and address of person to whom destined at time of last entry
f
j_f Personal description as of date of application:
''S Age  _   Height ~ ft  inches.    Weight lbs,
■g Complexion _..____„ _ -    Color of hair  __ ——   Color of eyes ——	
Q Marks of identification _ _ — —- 	
u
«g   By whom accompanied at time of last entry	
%   Applicant's present residence in the United States
(Street and number) __„_„___—
>g (City or town)  -     (State) —__ —__ 	
" Resided at the above address years „———- —- months.
^   My temporary address abroad will be _ 	
p   Single    Wame an(j address of nearest relative (give name of husband or wife if married) -.
g     	
*£   My business or employment is — .   —	
•»§   Place of business or employment ___ ________  	
0*
g< Name of employer ,_„____—_- -  	
jg   Port and date of proposed departure from the United States  — ^-t-z	
"g _-     _r                                                                                                                       (Port)                                                               (Date)
eS Name of vessel on which sailing ——    Length of proposed absence _ ,_,. 	
^ Countries to be visited _ ——— 	
Reasons for going abroad ___- —
(State fully)
My last application for reentry permit was filed     Application number 	
Have you registered under the Alien Registration Act of 1940 ? ______ 	
If so, give receipt card number _ ~ —	
Money Order No. _— - - , in the sum of three dollars, payable to the Commissioner of Immigration and
(Postal or express)
Naturalization, together with two unmounted, unretouched, and signed photographs of myself, accompany this appli-
cation.
If you are the holder of a certificate of registry or of lawful entry, give number of the certificate _.	
1 i hive not! declared ^ ^tenti011 to becoKle a citize* <first PaPer> on (S-So (Day)-" T-i-T "
numbered ._ in the Court of. at ___„.__.- -(«3_)—-
(Full signature of applicant as now used)
(Note: Jurat and other side of this application must be executed)