DEPARTMENT OF THE INTERIOR
WAR RELOCATION AUTHORITY

APPLICATION FOR RELOCATION ASSISTANCE

DATE: Nov. 2, 1945

FAMILY NUMBER: 33062

To: Project Director (PROJECT DIRECTOR)

Heart Mt., Wyoming (RELOCATION CENTER)

I, MATSUSHITA, Yasutaro, HEREBY APPLY FOR RELOCATION ASSISTANCE FOR THE LISTED MEMBERS OF MY FAMILY.

NAMES OF PERSONS WHOM ASSIST. IS REQUESTED

(Name of applicant when included, on line 1)

(Give point of departure if other than point at which application is made)

1. Matsushita, Yasutaro, Age: 66, Sex: M, Evacuee Status: C, Destination: St. Paul, Minn., Transportation: Common Carrier: 21.11, Subsistence: Meals en route: 4.00, Relocation subsistence: 25.00, Total: 50.11.

2. Matsushita, Kiyoko, Age: 59, Sex: F, Evacuee Status: C, Destination: St. Paul, Minn., Transportation: Common Carrier: 21.11, Subsistence: Meals en route: 4.00, Relocation subsistence: 25.00, Total: 50.11.

*CODE FOR EVACUEE STATUS:

C-Center Resident

R-Relocatee (Indefinite Leave)

V-Voluntary Evacuee

X-Excludee

1. TOTAL FOR FORM 1030: $42.22

2. TOTAL FOR AUTOMOBILE TRAVEL:

3. TOTAL TRANSPORTATION GRANT: $42.22

4. TOTAL FOR MEALS EN ROUTE: $8.00

5. TOTAL FOR REL. SUBSISTENCE: $50.00

6. TOTAL SUBS. GRANT (4plus5): $58.00

7. TOTAL AMT. REQUESTED (3plus6) $100.22

8. TOTAL CASH GRANT (2plus6): $58.00

IF APPLICATION IS MADE FOR SUBSISTENCE THE APPLICANT WILL FILL IN THIS SECTION

My earnings plus those of the members of my family listed in the [illegible] the past six months have been $194.00. our resources in case [illegible] this trip include (1) currency on hand $none: (2) funds [illegible] accounts such as banks, Savings and Loan Associations, and postal savings accounts) $none: (3) income expected within next 30 days from property investments or other sources than WRA cash advances (wage payments) or grants $none. TOTAL OF SOURCES IN CASH* $none. I certify that neither I nor any member of my family listed in this application has any other resources in cash not stated herein.

*"Resources in Cash" shall not be construed to include war bonds, securities, insurance policies, trust-funds, non-revenue producing property, nor any type of property, personal or otherwise, not mentioned above as constituting "resources in cash."

I further certify that the following are the only PREVIOUS RELOCATION ASSISTANCE GRANTS received by me or listed members of my family. (If no such grant has been received, check here: X None)

I agree to report any change in destination to the Relocation Officer for the district of actual destination and to surrender to him any unused portion of railroad tickets or travel grants and a proportionate amount of any subsistence grants made as a result of this application. If this application is for assistance to return to the evacuated area, I hereby certify that neither I nor any family member listed is excluded therefrom by military order.

NOTE: Any person who knowingly and wilfully falsifies or conceals a material fact or makes a false or fraudulent statement or representation in any matter within the jurisdiction of any department or agency of the United States is liable to a fine of not more than $10,000, or ten year's imprisonment, or both.

I certify that all statements and information contained in this application are true and correct to the best of my knowledge.

Wapato, Wash. (Pre-evacuation address)

14-9-C (Present address)

DATE: 11-25-45

SIGNATURE: Yasutaro Matsushita (signed)

TO BE FILLED IN BY WRA EMPLOYEE RECEIVING APPLICATION

DESTINATION: St. Paul

STATUS: C

RELOCATION PLAN APPROVAL

GASOLINE RATION IF BY PRIVATE CAR

PROPERTY FORM 156

VISIT TO CENTER ENROUTE TO EVACUATED AREA: APPROVED

I have interviewed the applicant, examined all documents in support of this application and find that the applicant is eligible for travel grant and/or subsistence grant.

DATE: Nov. 3, 1945

SIGNATURE