Form AR-11 (Revised)
Form approved
BUDGET BUREAU NO. 43-R038-42
Approval expires 12-31-44 ADDRESS RECORD CARD - ALIEN REGISTRATION
(This card may be used for both types of reports mentioned on the face of this card)
Registration No. (COPY FROM REGISTRATION RECEIPT)
Name (print or type) Miriam Grossman
My last address was 1719 E 3rd St. c/o Elson (STREET ADDRESS OR RURAL ROUTE)
New York (POST OFFICE) (COUNTY) N.Y. (STATE)
My present address is (print or type) 1806 No. 19th St. (STREET ADDRESS OR RURAL ROUTE)
Omaha (POST OFFICE) Douglas (COUNTY) Nebraska (STATE)
I work for Housewife (EMPLOYER'S NAME)
Whose address is 1806 No. 19th St. (STREET ADDRESS OR RURAL ROUTE)
Omaha (POST OFFICE) Douglas (COUNTY) Nebraska (STATE)
Date 6-1-1949 Signature sig Miriam Grossmann
DEPARTMENT OF JUSTICE,
IMMIGRATION AND NATURALIZATION SERVICE,
PHILADELPHIA, P.A.
WASHINGTON 25, D.C.
ALIEN REGISTRATION
ADDRESS REPORTS
The Alien Registration Act, 1940, requires that all resident aliens to report each change
of address within 5 days of such change. Other aliens, for example: Visitors, students,
and others not admitted for permanent residence in the United States, must report their
address every three months whether they change their address or not. A penalty of fine and
imprisonment is provided by law for failure to make the required reports. When reporting,
give both your number and name.
16-16437-1
