Vital Statistics
Basic Vital Statistic Information First Name * Middle Name Last Name * Dr. Social Security No. - - Date of Birth Place of Birth (City and State or Foreign Country) United States Armed Forces ( for either Spouse) Yes No Marital Status Married Never Married Widowed Divorced Most Recent Spouse (If wife, give maiden name)    Are they Living? Yes No Education High School Two years college Four years college What is your usual occupation? (even if retired) Residence State Country City or Town Street and Number Your Parents Father's First Name Middle Name Last Name Your Parents Mother's First Name Middle Name Last Name Contact Person Mailing Address Telephone Number