Registration Form CSLL-446B
1.FULL LEGAL NAME: Llewellyn Grimm.
2. ALL KNOWN ALIASES: El.
3. BIOLOGICAL AGE: 45.
4.BIOLOGICAL SEX: Male.
5.LONGEVITY:
-NATURAL IMMORTALITY (IMMORTALITY GRANTED VIA BIRTH, SPECIES, BREED OR SEX): [✔]
6. BIRTH DATE : 21st February, 1975.
7. BIRTH LOCATION: Sparta, Lakonia.
8. APPARENT SPECIES:
Human.
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IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
9. BIOLOGICAL SPECIES:
Werewolf.
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____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
10. ARE YOU AN ALTERED ENTITY: YES [✔] NO [__]
10A. SELECT ONE (1) IDENTIFIER:
-GOVERNMENTAL SERVICES (GSR) [✔]
-VETERAN MILITARY (VET) [✔]
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF PERSONAL IDENTIFIER CHANGES.
11. ARE YOU A MAGICAL ENTITY (CHECK ONE): YES [__] NO [✔]
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF MAGICAL STATUS CHANGES.
11B: SELECT ONE (1) IDENTIFIER:
-MAGICAL-ENTITY-S (ME7) [✔]
--HIGH MAGICAL ABILITY. LETHAL OR NON-LETHAL MAGICS. SPECIALLY TRAINED OR MASTER OF MAGICAL SUBJECT
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF MAGICAL IDENTIFIER CHANGES.
12. LEGAL RESIDENCE: [With Liam]
13. REGISTERED PROFESSION: Politician.
Retired General of the Lupus Division for the Greek Army (Honorable discharge).
13A. PROFESSIONAL ADDRESS: [Some political building somewhere]
14. LEGAL FAMILY MEMBERS:
No known living family members.
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF FAMILY DYNAMIC CHANGEs.
15. BLOOD TYPE: O+.
16. LEFT THUMB FINGERPRINT:
17: IDENTIFYING PHOTOGRAPH:
SIGNATURE AND DATE:
__________L. GRIMM________________________ ____________25/01/2020___________
BY SIGNING THIS DOCUMENT I (THE APPLICANT OF THIS DOCUMENT AND/OR THEIR GUARDIANS) HEREBY ACKNOWLEDGE THAT ANY AND ALL INFORMATION SUBMITTED ON DOCUMENT CSLL-446B IS COMPLETE AND TRUTHFUL TO THE BEST OF MY ABILITY. ANY FALSIFYING OF INFORMATION OR DOCUMENTS WILL BE PERSECUTED TO THE FULLEST EXTENT OF THE LAW. BY SIGNING THIS DOCUMENT I (THE APPLICANT OF THIS DOCUMENT AND/OR THEIR GUARDIANS) HEREBY AGREE TO BE ADDED TO THE CITY OF LOWER LIGHT'S GOVERNMENTAL CENSUS AND AGREE THAT ANY FALSIFIED INFORMATION OR DOCUMENTS WILL TERMINATE YOUR CITIZENSHIP OR APPLICATION OF CITIZENSHIP OF LOWER LIGHT AND WILL RESULT IN IMMEDIATE DEPORTATION.
1.FULL LEGAL NAME: Llewellyn Grimm.
2. ALL KNOWN ALIASES: El.
3. BIOLOGICAL AGE: 45.
4.BIOLOGICAL SEX: Male.
5.LONGEVITY:
-NATURAL IMMORTALITY (IMMORTALITY GRANTED VIA BIRTH, SPECIES, BREED OR SEX): [✔]
6. BIRTH DATE : 21st February, 1975.
7. BIRTH LOCATION: Sparta, Lakonia.
8. APPARENT SPECIES:
Human.
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
9. BIOLOGICAL SPECIES:
Werewolf.
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
10. ARE YOU AN ALTERED ENTITY: YES [✔] NO [__]
10A. SELECT ONE (1) IDENTIFIER:
-GOVERNMENTAL SERVICES (GSR) [✔]
-VETERAN MILITARY (VET) [✔]
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF PERSONAL IDENTIFIER CHANGES.
11. ARE YOU A MAGICAL ENTITY (CHECK ONE): YES [__] NO [✔]
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF MAGICAL STATUS CHANGES.
11B: SELECT ONE (1) IDENTIFIER:
-MAGICAL-ENTITY-S (ME7) [✔]
--HIGH MAGICAL ABILITY. LETHAL OR NON-LETHAL MAGICS. SPECIALLY TRAINED OR MASTER OF MAGICAL SUBJECT
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF MAGICAL IDENTIFIER CHANGES.
12. LEGAL RESIDENCE: [With Liam]
13. REGISTERED PROFESSION: Politician.
Retired General of the Lupus Division for the Greek Army (Honorable discharge).
13A. PROFESSIONAL ADDRESS: [Some political building somewhere]
14. LEGAL FAMILY MEMBERS:
No known living family members.
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF FAMILY DYNAMIC CHANGEs.
15. BLOOD TYPE: O+.
16. LEFT THUMB FINGERPRINT:
17: IDENTIFYING PHOTOGRAPH:
SIGNATURE AND DATE:
__________L. GRIMM________________________ ____________25/01/2020___________
BY SIGNING THIS DOCUMENT I (THE APPLICANT OF THIS DOCUMENT AND/OR THEIR GUARDIANS) HEREBY ACKNOWLEDGE THAT ANY AND ALL INFORMATION SUBMITTED ON DOCUMENT CSLL-446B IS COMPLETE AND TRUTHFUL TO THE BEST OF MY ABILITY. ANY FALSIFYING OF INFORMATION OR DOCUMENTS WILL BE PERSECUTED TO THE FULLEST EXTENT OF THE LAW. BY SIGNING THIS DOCUMENT I (THE APPLICANT OF THIS DOCUMENT AND/OR THEIR GUARDIANS) HEREBY AGREE TO BE ADDED TO THE CITY OF LOWER LIGHT'S GOVERNMENTAL CENSUS AND AGREE THAT ANY FALSIFIED INFORMATION OR DOCUMENTS WILL TERMINATE YOUR CITIZENSHIP OR APPLICATION OF CITIZENSHIP OF LOWER LIGHT AND WILL RESULT IN IMMEDIATE DEPORTATION.
Moderators: Postey