Present Address:

Full Name:      
Street:         
City:           
State:          
Zip:            
E-mail:         
Home telephone: 
Work telephone: 
Fax:            

Owners Name:     
Street:          
City:            
Judet/Sect.:     

Property Description:


How was the property confiscated?


Were you forced to receive the so-called "compensation"?


Was any action taken to reclaim the property? Any results?


Who is occupying your property now?


Were you an American citizen when your property was confiscated?
YESNO

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