-----t bX6);(b)(7)(CJ 3. Homo Telephone Number (Area Code , Number) ~- Aliases/Nickna~e: 5 . Citizenship (List the country you are a citizen of) : {j /i I' 10/rt , 6. Soci al Security Number: llbX6' (b)(7;(Cl I 7. Date of Birth (Month, day, year): ( ·6); (b)t7)(C) I Sa. Sex: MALe- Sb. Race: