Please give the name of the country of your birth on the basis of international boundaries existing at the time of the census

[] 1 Poland
[] 2 Other country (specify)

Name of country ____

1. For person born in Poland answer 1. Poland should be indicated.

2. For person born outside Poland answer 2. other country should be indicated. The name of the country of birth should be written in.

3. The country of birth should be given according to present country/territory the place is located at (e.g. a person born in Lvov should be classified as born in Ukraine regardless the date of birth).

4. In case the person can not specify the country his/her place of birth is located in, the name of the city of birth and the name of the closes big city should be written in.