Scanned Document Collection

Scanned Document Collection Page 1 of 7 U.S. DeD-4,11^tOt 0/ Sta -, APPLICATION FOR U.S. PASSPORT BY MAY 0/4•1111- N tr.“ NAME FN. r LAST . Max:. _ _ 0 STREET : RFD a APT. if OR P.O BOX ITY STATE ZIP CODE New York NY 10021 /N CARE OF SF APPLICABLE) III Data 03100, D S D OP t..) ,z6tmit6 SEX PLACE OF MIRTH ity & Stale or Oly b Counuyr -...N. Feet Inc 'HEIGHThes 5 8 I - NOTE: Most recent r T be enclosed! Dark Br . Brown vu t.tt ISSUE DATE PLACE OF IS51. NCE Ye _31 t NAIR COLOR -/CE COLOR Day Year 1r Month DATE BIRTH 0 /101•14 /A An NOICII PS •ILVD14; wee. I „ I SOCIAL SECURITY NUMBER HOME TELEPHONE BUSINESS TELEPHONE DEPARTURE DAR - I IF AWL PLAI• Woe On/.:art, S At A m -NA , March 16, 2003 I rt tiligiete st si<ii -dan, Saudi Arat ia caw AIN PERMANENT ADDRESS (Do not Itt P.O. Boll STREET / R.F D. • OCCUPATION /Not Mandsterw to Al )r STAY War Mandatory, Raw TWO Mena 0•AiTiCAL PHOTOS WITH LIGHT. Plate BACXGROuNO