Annex No. 1

Tracing Form
(Part A)

Ref. No._________________

I. Information about person(s) requesting services:

1. Name:______________________________________
Sex:___ Age:___ Religion: ________________________
2. Place of Birth: ________________________________
3. Ethnic origin/nationality: ______________________
4. Marital status: ________________________________
5. Present location: ______________________________
6. Permanent residence: __________________________
7. Contact address: ______________________________
8. Relationship to person being traced: ______________
9. Enquirer's signature: ___________________________
10. Date and place of enquiry: _____________________

II. Information about the person(s) to be traced:*

(* For unaccompanied children/minors, complete annex no. 2.)

11. Name:________________________________________________
Age: ___ Sex: ___ Religion:__________________________________
12. Father's name:_________________________________________
13. Mother's name:________________________________________
14. Place of birth:__________________________________________
15. Ethnic origin/nationality:________________________________
16. Marital status:_________________________________________
17. Profession:____________________________________________
18. Any distinguishing physical characteristics:_________________
19. Last location if known:__________________________________
20. Date of last contact:_____________________________________
21. Date and kind of last news: _______________________________
23. Circumstances of separation:______________________________
24. Family members accompanying the person to be traced:_________

1 Name__________________________________________________
Sex ___ Relationship _________ Date of birth___________________
2 Name__________________________________________________
Sex ___ Relationship _________ Date of birth___________________
3 Name__________________________________________________
Sex ___ Relationship _________ Date of birth___________________

29. Additional information: (Please give all information that may assist investigation, such as duration and address of former residences, business address or that of present employer...) _________________________________________________

30. Name and address of persons able to supply information: (family, friends, business relations, etc.)_______________________________________________

31. Action taken:_____________________________________________

32. Name of interviewer:______________________________________

Date: ___ Place:___________________________________________

Tracing Form
(Part B)

Ref. No._________________

1. Feedback:___________________________________________________
2. Follow-up action:_____________________________________________
3. Feedback:___________________________________________________
4. Follow-up action:_____________________________________________
5. Outcome of tracing:___________________________________________

Name of case worker:___________________________________________
Date: _____ Place:______________________________________________
Case closed: ________ Ongoing: __________________________________