Questionnaire Text

Questionnaire form view entire document:  text  image
6. Your citizenship
[] 1 Russian Federation
[] 2 Other State (indicate name of State) ________
[] 3 Stateless
Questionnaire instructions view entire document:  text  image
Question 6. Your citizenship
Russian citizens should be identified by the "Russia" prompt.
In the proper field (box) indicate the citizenship (name of the state) of a foreign respondent (e.g., Italy, Ukraine, Moldavia).
If a Russian citizen also has citizenship of another country, you should mark the "Russia" option and indicate his/her other citizenship (name of the state).
If a respondent is a citizen of two foreign states, indicate one foreign citizenship only - at his/her choice.
Persons without citizenship are identified by the "stateless" option.
Citizenship of children under 14 years is identified by their parents.
Do not complete the field for digits located after the entry of the name of the state made in writing.