Citizenship and Alien Status - Statement of Hmong/Highland Lao Tribal Membership

Revised March 25, 2011

APPENDIX III

Statement of Hmong/Highland Lao Tribal Membership

I declare, under penalty of perjury, that I was a Hmong or Highland Laotian tribe member when the tribe assisted the U.S. military during the Vietnam era (8/5/64 to 5/7/75).

 

Signature

 

Date