36) I 0 -have [7 - have not been previously married: (Ifpreviously married, list the name of eachprior spouse, the dates on
I Date marriage began: ]Place marriage ended:] Description or manner of how marriage
which each marriage began and ended, the place where the marriage terminated, and describe how each marriage ended.)
I Name ofprior spouse: ( h t , First, Middle)
I
Date marriage ended: I (city and Countty) was terminated or ended:
I
I
Name ofprior spouse: (Last, First, Middle)
37) Have you been ordered by any court, or are otherwise under any legal obligation, to provide child support and/or spousal maintenanc
as a result of a separation and/or divorce? 0 - Yes
- NO
I'
Date marriage began: Place marriage ended: Description or manner of how marriage
Date marriage ended:
(City and Country) was terminated or ended:
38) Since my arrival into the United States, I have been employed by the following named persons or firms: (Please begin withpresent
employment and work back in time. Anyperiods of unemployment or school attendance should be specij7ed.)
Employed From:
(Month. Day. Year)
Full Name and Address of Employer
Employed To:
(Month, DqV. year)
Earnings Per Week Type of Work
(Approximate)
I Performed.
$
$
$
PRESENT
39) If self-employed, describe the nature of the business, the name of the business, its address, and net income derived therefrom:
r-
40) My assets (and ifmanied, my spouse's assets) in the United States andother countries, not including clothing and householdnecessities, are:
Self
Jointly Owned with Spouse
Cash, Stocks, and Bonds - - - - - - - '
Automobile (value minus amount owed) - - $
Other (describe on line below) - - - - - $
Cash, Stocks, and Bonds - - - - - - $
RealEstate - - - - - - - - - - $
Automobile (value minus amount owed) - - $ s
Other(describeonlinebe1ow) - - - -
Real Estate. - - - - - - - - - - - $
TOTAL
$
TOTAL
I
~
41) I [7 - h a v e n -have not received public or private relief or assistance (e.g. Welfare, Unemployment Benefits,