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the date and pless of your birth,

30 1932,

duties and obligations of citizenakip

D. Country

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we been employed by another during the last five years sites at of your gent and the

Boyer or employers and his or their addomson is Corenity,

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7. If you claim that you are a bona fide resident of the State of Alabams, give the date on which you cinim to have i (a) When did you become a bona fide resident at

bona fide resident

County 1937

& If you intend to e

8. Have you seer qualy applied for and bean denied registration

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10. Has your name been previously stricked from the list of persons registered:

11. Are you now or have you ever been a dopo addict or an habitual drunkand: addict or an habitual drunkard, explain as fully as you can...

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give the facts

18. Have you ever served in the Armed Foress of the United Biniss Government: mately how long:

16. Have you ever been expelled or dishonorably discharged from any sch

lage or from any

of the United States, or

other country...

(a) i sa

17. Will you support and

and the Constitution of the United States and the Constitution of

18. Are you now or have you ever been affiliated with any group or organization which advocated the States Government the goverment of any State of the United States by unlawful mens

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20. Do you believe in free elections and rule by the majority:..

Will you give aid and comfort

To Swell

yes

Yes

-1964 ferme

1952-1964

; APPLICATION FOR REGISTRATION, QUESTIONNAIRE AND OATH

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do hereby apply to the Board of Registras of

County. State of Alabama, to register as an elector under the Constitution and laws of the

> herewith submit answers to the interrogatories propound to me by said Board.

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Mamie R. Sil

QUESTIONNAIRE

1, the date and place of your birth, and your present address:

Philhat this southblo Wilcox County

tement of the extent of your education and-be

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1. If you claim that you g

bona fide resident

County 1937

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"Spell as highing led diploma, JBS Degree in
hold
Luandary
Education

14. Have you ever been charged with or convicted of a felony or crime or offense involving moral turpite to

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17. Will you support and defend the Constitution of the United States and the Constitution of the State of Alber

Yes

18. Are you now or have you ever been affiliated with any group or organization which adrested the overthrow of the States Government or the goverment of any State of the United States by uniewiel meena

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10. Will you bear arms for your country when called upon by i

(a) if you angu

38. Do you believe in tree elections and rule by the majority:

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-1964 ferme

1952-1964

; APPLICATION FOR REGISTRATION, QUESTIONNAIRE AND OATH

L

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hereby apply to the E 1 of Registrass of

County, State of Alabama, to register as an elector under the Co titution and lows of the

› berewith submit answers to the interrogatories propoun

to me by said Board.

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