dress: Telephone: Name of Second Hotel or Private Host: Address: Telephone: EFTA00310408 0 Did you participate in combat? Name of Conflict: Location of Conflict: Name of Third Hotel or Private Host: Address: Telephone: VISA QUESTIONNAIRE RUSSIA MISCELLANEOUS QUESTIONS: Have you ever been refused a Russ

No K Yes (complete details below) Dates of Active Service: to -Br - Moor - - Y7sar - Fear Did you participate in combat? Name of Conflict: Location of Conflict: O No O Yes (complete details below) Date of Conflict: -ref --- .Ton—fr YOUR EDUCATION: Provide the details of the highest degree or diploma you

Yes (complete details below) Dates of Active Service: to -- MootTer— — Y7sar - Dry- — Fear Did you participate in combat? Name of Conflict: Location of Conflict: O No O Yes (complete details below) Date of Conflict: - zajr- YOUR EDUCATION: Provide the details of the highest degree or diploma you have obta

Yes (complete details below) Dates of Active Service: to -- MootTer— — Y7sar - Dry- — Fear Did you participate in combat? Name of Conflict: Location of Conflict: O No O Yes (complete details below) Date of Conflict: - zajr- YOUR EDUCATION: Provide the details of the highest degree or diploma you have obta