Reference and Information Services

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Directions for filling out the form properly:

Please fill out detailed information on victim. If a detail is unknown / unavailable, please enter "unknown".
A * denotes a required field.
In most fields it is possible to enter more than one item per victim, e.g., more than one first name.
Please fill out one form per victim.

Is the request for judicial purposes (e.g. reparation, restitution of property, etc.)? yes no

Family name: *

First name: *

Address:

City:

Country: *

Zip Code:

E-mail: *

Fax:

Telephone:

Relationship to the victim:

Family name: *

First name: *

Maiden name:

Date of birth:

If exact date unknown, please enter aproximate age or date of birth:

Sex:

Place of birth:

Father's name:

Mother's name:

Place of residence before war: *

Marital status during war:

First name of spouse:

Maiden name of spouse:

Place of residence during war:

Incarceration places (Ghettos, Concentration Camps):

Prisoner number:

Family name:

First name:

Places of residence immediately after War:

Date of Aliya/immigration:

Place of residence in country of immigration: