Questionnaire Text

Questionnaire form view entire document: text image

Questions to be answered by all persons

10. What is his/her nationality?

[] Dutch
[] Belgian
[] German
[] Italian
[] None (stateless)

If he/she has another nationality please turn to question 10 at the back of this page.

Questionnaire instructions view entire document: text image

Question 10 [Nationality]
Mention, if the party involved has more than one nationality, every nationality of the person.