i 
v- 
** r 
^ iQtoi iiii^a il w i 11 ■■ «mi, mm&mpiimitKMimKiv* 
S 
■ 
Loss of this card must be reported 
immediately to the office of issue. 
»• l 
This card must be returned to 
office of issue for cancellation up 1 ' 
transfer or termination of employment. 
* Grade or Title 
AQ.~Z.S91 
* ASK, IC No., or Cedul 
* Organization or Emplo 
Re8idenc 
Nat ionality ^*^ 
mplexi 
Date of Bir 
Ey 
Other Identifying Dat 
Occupation 
applicable 
