Annex ‘Ancestors’

to the application for naturalization VA

pursuant to Article 116 (2), first sentence, of the
Basic Law for the Federal Republic of Germany (GG)

by:

 The applicant’s surname, given name, and date of birth

Surname, given name Date of birth

Information concerning my ancestor’s
1
parents 

Father of  Mother of 

1.1 Family name:

Name at birth and/or
1.2
former names:
1.3
Given name(s):
- Enter all given names, please. -

1.4 Date of birth:

Place of birth, adminis-
1.5
trative district, country:
1.6 Religious affiliation: Jewish other/none Jewish other/none

This ancestor was a natural This ancestor was an This ancestor was a natural This ancestor was an
1.7 Descent:
child of his parents. adopted child. child of his parents. adopted child .
Date of acquisition Date of acquisition

Citizenship German German

1.8
(current/last citizenship): other:  other: 

from ... to ... (year) from ... to ... (year)

Citizenship German German

1.9
(former citizenship): other:  other: 

The ancestors were married: Place of marriage from ... (date of marriage) ... to (date)
1.10
Marriage:
 of the ancestors to each other no yes 

never resided in Germany never resided in Germany

Name of the city/town/village Name of the city/town/village
Last place of residence in
1.11
Germany: yes  yes 
left Germany on: left Germany on:

no no
1.12 deceased: deceased on (date) deceased on (date)
yes  yes 

2 My ancestors’ places of residence since birth (Provide more detailed or additional information, if necessary, on a separate sheet.)

Father of  Mother of 
from to in (city or town / country) from to in (city or town / country)

2.1

Bundesverwaltungsamt as at January 2019