Application Form

Application

Date: ______________

Applicant's Name:

Address:

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Relationship of Applicant to Owner:

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Name of Original Owner:

Current Address:

Address of Property in Poland including Plot number:

Description of Property:

Owner's Father's name: 

Owner's Mother's name: 

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The property was in the owner's possession until: (date)

Citizenship of Applicant:

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Applicant's telephone numbers: