XIII. COTENANTS List all individuals with whom you have resided in the last 5 for a period of 30 days or more. Do not include relatives listed in section XII above (Attach additional sheets if necessary.) 1. 2. Name (Last, First, Middle) (Maiden) Name (Last, Middle) (Maiden) Current Address (City, State, Zip Code) Current Address (City, Zip Code) Home Telephone Number Home Telephone Number Name of Firm or Employer Name of Firm or Employer Address of Employer (City, State, Zip Code) Address of Employer (City, State, Zip Code) Work Telephone Number Work Telephone Number Date of Birth Place of Birth Date of Birth Place of Birth Dates of Residence From: (Month, Day, Year) To: (Month, Day, Year) Dates of Residence From: (Month, Day, Year) To: (Month, Day, Year) XIV. CITIZENSHIP OF RELATIVES/COTENANTS Are any close relatives or cotenants naturalized or non-United States citizens? Yes No If yes, provide the information below. (You do not need to list this information for in-laws unless they currently reside with you). Attach additional pages, if necessary. Name Used When Relationship Registration Naturalization Number, Date, and Full Name to Applicant Entering U.S. Number Place of Naturalization (City, State, Zip Code) XV. FRIENDS OR ACQUAINTANCES EMPLOYED BY THE SOUTH CHICAGO HEIGHTS POLICE Location Length of Acquaintance Full Name XVI. PHYSICAL DATA 1. Height Without Shoes 3. Persons with a disability who require an accommodation to complete the application process are required to notify the South Chicago Heights Police of their need for the accommodation. 2. Weight Without Clothes
XIII. COTENANTS List all individuals with whom you have resided in the last 5 for a period of 30 days or more. Do not include relatives listed in section XII above (Attach additional sheets if necessary.) 1. Name (Last, First, Middle) (Maiden) 2. Name (Last, Middle) (Maiden) Current Address (City, State, Zip Code) Current Address (City, Zip Code) Home Telephone Number Home Telephone Number Name of Firm or Employer Name of Firm or Employer Address of Employer (City, State, Zip Code) Address of Employer (City, State, Zip Code) Work Telephone Number Work Telephone Number Date of Birth Place of Birth Date of Birth Place of Birth Dates of Residence From: (Month, Day, Year) To: (Month, Day, Year) Dates of Residence From: (Month, Day, Year) To: (Month, Day, Year) XIV. CITIZENSHIP OF RELATIVES/COTENANTS Are any close relatives or cotenants naturalized or non-United States citizens? Yes No If yes, provide the information below. (You do not need to list this information for in-laws unless they currently reside with you). Attach additional pages, if necessary. Full Name Name Used When Entering U.S. Relationship to Applicant Registration Naturalization Number, Date, and Number Place of Naturalization (City, State, Zip Code) XV. FRIENDS OR ACQUAINTANCES EMPLOYED BY THE SOUTH CHICAGO HEIGHTS POLICE Full Name Location Length of Acquaintance 1. Height Without Shoes XVI. PHYSICAL DATA 3. Persons with a disability who require an accommodation to complete the application process are required to notify the South Chicago Heights Police of their need for the accommodation. 2. Weight Without Clothes
application-police-document.docx