1. House address: 2. Is this house on a farm (or ranch)? 3. If no in item 2: Is this house on a place of three or more acres?
For All Persons:
4. Name (last name first): Defoe, Magdalene
· What is the name of the head of household? Nathan Wallace · What are the names of all other persons who live here? · List in this order: - The head: Nathan Wallace - His wife: Magdalene Defoe - Unmarried sons and daughters and their families (in order of age): Shilo Wallace - Married sons and daughters and their families: N/A - Your least favorite color:
Anything too saturated, particularly red and orange.
5. Species (underline applicable):
Human (H) Animal (A) Communist (☭) Wizard (W) Catgirl (CG) God/Goddess (G) Other (please specify)
6. Sex (underline applicable):
Male (M) Female (F)
7. Are you now married, widowed, divorced, separated, or never married? (Mar, Wd, D, Sep, Nev) Nev
8. What State (or foreign country) were you born in? England
9. What is your deepest secret? That I fully expected to die at the opera after my final performance...and that I had accepted it.
10. If foreign born: Are you naturalized? (Yes, No, or AP for born abroad of American parents) Yes
11. What are you most ashamed about? Not being able to attend by best friend's funeral.
For Persons 14 Years of Age and Over:
12. What were you doing most of last week: working, keeping house, or something else? (Wk, H, Ot, or U for unable to work) Wk
13. If H or Ot in Item 12: Did you do any work at all last week, not counting work around the house? (Include work for pay, in own business, profession, on farm, or unpaid family work) (Yes or No)
14. If No in Item 13: Were you looking for work? (Yes or No)
15. If No in Item 14: Even though you didn't work last week, do you have a job or business? (Yes or No)
16. If No in Item 15: Do you have a good explanation for why you are being so utterly useless to the prosperity of our great town? (Yes, Female, or No, elaborate. Yes is not a valid answer.)
For All Persons:
17. What country were your father and mother born in? (Enter US or name of Territory, possession, or foreign country)
Father: France Mother: England
18. If anything but America in Item 17, justify your right to be here (maximum 100 words): I was raised in America from a young age.
19. What is your most embarrassing memory? Being so nervous before my first concert that I vomited on Nathan and Marni's shoes.
20. What is more important- laughter (L) or medicine (M)? M
21. Please list all of the following diseases you have been afflicted by, if any: Measles (M), Mumps (U), Chicken-Pox (C), Polio (P), Tuberculosis (T), Smallpox (S), Communism (R) U, C
For All Males in the Household:
22. Did you ever serve in the U.S. Armed Forces during (specify Y or N):
22a. World War II
22b. World War I
22c. Any other time, including present service
23. If No to any question in Item 22, justify your reasons for being so reprehensibly unpatriotic (maximum 100 words):
24. Are you a Communist? Are you? No.
For All Persons:
25. Is there an afterlife and how do you know this isn't it? (maximum 100 words) I'd like to think so.
And if this was the afterlife Marni would be here.
no subject
For Head of Household:
1. House address:
2. Is this house on a farm (or ranch)?
3. If no in item 2: Is this house on a place of three or more acres?
For All Persons:
4. Name (last name first): Defoe, Magdalene
Anything too saturated, particularly red and orange.
5. Species (underline applicable):
6. Sex (underline applicable):
7. Are you now married, widowed, divorced, separated, or never married? (Mar, Wd, D, Sep, Nev) Nev
8. What State (or foreign country) were you born in? England
9. What is your deepest secret? That I fully expected to die at the opera after my final performance...and that I had accepted it.
10. If foreign born: Are you naturalized? (Yes, No, or AP for born abroad of American parents) Yes
11. What are you most ashamed about? Not being able to attend by best friend's funeral.
For Persons 14 Years of Age and Over:
12. What were you doing most of last week: working, keeping house, or something else? (Wk, H, Ot, or U for unable to work) Wk
13. If H or Ot in Item 12: Did you do any work at all last week, not counting work around the house? (Include work for pay, in own business, profession, on farm, or unpaid family work) (Yes or No)
14. If No in Item 13: Were you looking for work? (Yes or No)
15. If No in Item 14: Even though you didn't work last week, do you have a job or business? (Yes or No)
16. If No in Item 15: Do you have a good explanation for why you are being so utterly useless to the prosperity of our great town? (Yes, Female, or No, elaborate. Yes is not a valid answer.)
For All Persons:
17. What country were your father and mother born in? (Enter US or name of Territory, possession, or foreign country)
18. If anything but America in Item 17, justify your right to be here (maximum 100 words): I was raised in America from a young age.
19. What is your most embarrassing memory? Being so nervous before my first concert that I vomited on Nathan and Marni's shoes.
20. What is more important- laughter (L) or medicine (M)? M
21. Please list all of the following diseases you have been afflicted by, if any: Measles (M), Mumps (U), Chicken-Pox (C), Polio (P), Tuberculosis (T), Smallpox (S), Communism (R) U, C
For All Males in the Household:
22. Did you ever serve in the U.S. Armed Forces during (specify Y or N):
23. If No to any question in Item 22, justify your reasons for being so reprehensibly unpatriotic (maximum 100 words):
24. Are you a Communist? Are you? No.
For All Persons:
25. Is there an afterlife and how do you know this isn't it? (maximum 100 words) I'd like to think so.
And if this was the afterlife Marni would be here.