Person sought
Surname(s)....................................................................................................................................
( also maiden name for married women )
Name(s).........................................................................................................................................
Parents’ names..............................................................................................................................
(mother’s maiden name)
Date of birth.......................................Place of birth......................................................................
Occupation...................................Military range and assignment................................................
Citizenship and nationality............................................................................................................
Last place of residence..................................................................................................................
(phone number)
Date and place of last news...........................................................................................................
Other information concerning the person sought (circumstances leading to loss of contact, for military men - Army Postal Service number, surnames and addresses of people who may provide information on person sought, employment place, information on family members of person sought, etc.)
.................................................................................................................................
Enquirer
Surname...........................................................................Name....................................................
(also maiden name for married women)
Date and place of birth..................................................................................................................
Parents’ names..............................................Kinship range..........................................................
to the person sought
Address..........................................................................................................................................
(phone number, e-mail)
I authorize the release of my address to the person sought, the next of kin and National Societies of the Red Cross, Red Crescent and International Tracing Service through which this tracing will be conducted.
I grant consent to have my personal data enclosed in the following form processed by Polish Red Cross Tracing Service (ul. Mokotowska 14, 00-561 Warszawa) for the purposes of the conducted tracing endeavours (in accordance with the provisions of the Personal Data Protection Act of 29 August 1997 (Journal of Laws for 2002 No. 101, item 926, as amended).I have been informed that I have the right to access and correct my data.
Date........................................................Signature........................................................................
Personal data should be printed.
wyprana