Elwynn, Amokolia, and Hurmu (Alondor Ellion, Amokôliar, o Erimôon)
(§2 Act on the Nationality within the Union)
Section 1 — Personal details
(As on Micras)
Full name:
Carl Jackson Miller
Place or country of birth:
Aňira, Safiria
Current nationality/citizenship:
Republic of Ashkenatza; Safirian Empire; Imperial Republic of Shireroth
Section 2 — Electronic details
Bastion Union account:
Carl Jackson / HM Amane VIII
Means of private contact:
Bastion Union PM; others available on request
Section 3 — Voluntary provisions
(This section is voluntary to fill in)
Place of preferred residence:
Amokolia
Section 4 — Declaration
By signing this application for naturalization, I confirm that:
- 1. I apply for naturalization into Elwynn, Amokolia, and Hurmu (Alondor Ellion, Amokôliar, o Erimôon); and that
2. the details provided in this application are true as far as I can attest.
I hereby sign this application and affix my name hereto:
/s/ Carl Jackson Miller