Bundesamt für zentrale Dienste und offene Vermögensfragen DGZ-Ring 12 13086 Berlin Application in accordance with the German Federal Ministry of Finance guidelines on one-time payments to former Soviet prisoners of war in recognition of their treatment in German detention (Anerkennungsrichtlinie) How to complete the application form: In order to allow us to reach the right decision regarding your application, we require some important details and documents from you. We therefore kindly ask you to answer all the following questions and to enclose any relevant documents that you have. Submitting documents in German may shorten the processing time for your application. Otherwise, we would need to have the documents translated. Before you return the questionnaire, we kindly ask you to have your personal details confirmed on page 1 by an official authority. Please enclose a copy of the identification document (e.g. passport or identity card) you presented to this authority. A fact sheet is included as an annex to this application form. Please read the fact sheet carefully. Please sign the application form and declaration of consent.
-1-1. Applicant s personal information Mr. (Please use the Latin alphabet) Mrs. Last Name First name Date of birth Birth name Place of birth (country) Father's last name / patronymic Previous names Divergent spellings, if applicable Address (street, postal code, town/city, country) Nationality Only for persons currently residing in the US: What is your social security number (SSN)? Only for persons who currently reside or have resided in the past in Israel: What is the number of your Israeli identity card (ID)? Confirmation by an official authority (e.g. all authorities of the country of residence, banks, hospitals, Red Cross/Red Crescent and embassies and consulates of the Federal Republic of Germany) The applicant is alive. His or her personal information was confirmed on the basis of: Identification document Number Identity card Passport Other documents (birth certificate, marriage certificate or certificate of parentage) Place, date Official stamp and signature
-2-2. Third-party application The application is submitted on behalf of the applicant by Last name First name Official agency (file no., where applicable) Address (street, postal code, town/city, country) In the capacity of Legal representative 3. Please enclose authorisation or order of the guardianship court Guardian Carer Authorised representative Information on applicant's spouse / children I am married to Last name First name Date of birth Address, if different (street, postal code, town/city, country) Should you have living children, please fill in information for one of your children here Last name First name Date of birth Address (street, postal code, town/city, country) 4. Information on war-time imprisonment and activities between 22 June 1941 and 8 May 1945 4.1 During the Second World War, did you belong to the Soviet armed forces and were you at any point between 22 June 1941 and 8 May 1945 a prisoner of war detained in a German prisoner-of-war camp? Yes Please give details, on an extra sheet of paper if necessary. No
-3-4.2 Please specify the prisoner-of-war camp(s) in which you were interned: Time period 4.3 Number of the dulag, stalag, oflag or other prisoner-of-war camp (if known) Identity tag number (if known) Location of the prisoner-of-war camp Do you have documentary evidence of your internment in the prisoner-of-war camp(s) (e.g. military passport, identity tags, certificates)? Yes Please specify the type(s) of evidence and enclose a copy: No 5. Bank details (Please provide the details of your own account. No payments will be made to third parties.) Account holder: BIC / SWIFT code: Account no.: Bank code: IBAN: Name and address of bank: Bank stamp and signature of the bank officer confirming that this is your bank account Note: Fees resulting from failed transfers and returned transfers due to incorrect/incomplete or illegible account information are to be paid by the applicant.
-4-6. Declaration: I am aware that there is no legal entitlement to payment. I have taken note of item 3 on the fact sheet (explanation of section 5 subsection (4) of the guidelines) and hereby affirm that none of the listed reasons for excluding payment apply. I hereby swear and affirm that all the above statements and the statements in the enclosed documents are correct. I understand that my application will be rejected, or any amounts already paid recovered, should I knowingly provide incorrect information. Place / date 7. Signature Declaration of consent: During the process of checking whether you are entitled to the requested assistance payment, it may be necessary to obtain additional information from, for example, military archives, residents registration offices, international search organisations, the foundation Remembrance, Responsibility and the Future, the foundation for Saxon Memorials (Stiftung Sächsische Gedenkstätten) and other institutions and public or private organisations. I agree that the Federal Office for Central Services and Unresolved Property Issues (BADV) may request the necessary information, to this end and to the extent that is necessary to process my application, from the institutions listed above and that it may where necessary obtain access to the files. If you are not in agreement with this and do not sign this declaration of consent, it is not possible to check whether you are entitled to a payment. This can lead to your application being rejected. I am aware that the information collected will be stored in electronic form in accordance with data protection provisions. Place / date Enclosures: Signature I am enclosing the following documents with this application form a copy of a valid identity card and/or notarised documents documents regarding imprisonment a power of attorney document or order of the guardianship court (if applicable) other documents (please specify): Print Save Reverse
-5- Fact sheet regarding one-time assistance payments to former Soviet prisoners of war (annex to application form) 1. Who is entitled to payment? In order to qualify for payment, you must have belonged to the Soviet armed forces and have been in custody as a prisoner of war in a German prisoner-of-war camp at any point in the time period between 22 June 1941 and 8 May 1945. Eligible persons may receive a one-time payment of 2,500 in recognition of their time in German detention. 2. How and where to apply Before the one-off recognition payment can be made, a written application must be submitted. Please make your application by the deadline of 30 September 2017 at the latest. The application may be made in German, English or Russian and should be sent to the following address: Bundesamt für zentrale Dienste und offene Vermögensfragen (BADV) DGZ-Ring 12 13086 Berlin Germany A special form must be used for the application. You can request it by writing to the address above or by downloading it from the following websites: German version of the application form: http://www.badv.bund.de/antrag/antragsformular_ask_dt.pdf English version of the application form: http://www.badv.bund.de/antrag/antragsformular_ask_en.pdf Russian version of the application form: http://www.badv.bund.de/antrag/antragsformular_ask_ru.pdf An information hotline has been set up in Germany. You can contact it at the following telephone number: +49 30 187030 1550
-6-3. Who does not qualify for a one-time recognition payment? Applicants who are undeserving of assistance are not entitled to an assistance payment. Pursuant to section 5 subsection (4) of the guidelines, individuals who committed war crimes or crimes against humanity or who participated in such crimes, are in particular considered undeserving of assistance. This also includes individuals who, during the period between 22 June 1941 and 8 May 1945, following their imprisonment or following their release from imprisonment, placed themselves at the service of the German police, the Sicherheitspolizei (SIPO), the Geheime Staatspolizei (Gestapo), the Sicherheitsdienst (SD), the Schutzstaffel (SS) including the Waffen-SS or the Sturmabteilung (SA). In addition, individuals who collaborated with the German Reich during the period between 22 June 1941 and 8 May 1945 (e.g. through service in the German Wehrmacht or another military or paramilitary unit on the side of, or under the control of, the German Reich or its allies) and in the process committed or participated in war crimes or crimes against humanity are also included in this category. 4. What is the deadline for applications? The application deadline is 30 September 2017. 5. What do legal successors need to be aware of in the event of a succession? If a valid application has already been submitted and none of the persons entitled to be legal successors as defined in the guidelines on one-time payments to former Soviet prisoners of war in recognition of their treatment in German detention (ASK-Anerkennungsrichtlinie) have notified the Federal Office for Central Services and Unresolved Property Issues (BADV) of the legal succession within six months following the death of the person eligible for a payment, the entitlement to a payment expires.
-7- Information on filling out the application: Unfortunately, if your application documents are not complete, no assistance payment can be made. Therefore, please pay attention to the following information. Section 1.: Only you as the entitled person or a person authorised by you (copy of a power-ofattorney must be provided, see number 2 below) may make an application. Any assistance payment can only be made to you as an entitled person. Please request an official authority (e.g. all authorities of the country of residence, banks, hospitals, Red Cross, Red Crescent, embassies and consulates of the Federal Republic of Germany) to fill out the life certificate on page 1 of the application. Section 2.: If the application is made by a third person authorised by you, please provide their personal information and attach a power of attorney document or an order from the Guardianship Court. Section 3.: If the entitled person passes away after his/her application has been made and the Federal Office for Central Services and Unresolved Property Issues is notified, the assistance payment will be made to the entitled person's surviving spouse or surviving children. Entitlement to an assistance payment expires after six months, if the surviving spouse or children fail to notify the office of their legal successorship. Section 4.: Please provide information about war-time imprisonment (4.1), the prisoner-of-war camp (4.2) and documentary evidence thereof (4.3) in this section. Section 5.: In order to facilitate the smooth transfer of any assistance payment, please provide bank account details, a complete bank address and international codes such as the BIC / SWIFT codes and IBAN. Section 6.: Please confirm the correctness of all of the information you have provided. Without a signature confirming correctness, the application will be considered incomplete and cannot be processed. Incorrect information provided by you or under your authorisation can result in the rejection of your application or a request for return of the assistance payment. Section 7.: A declaration of consent is required so that information can be obtained from the listed bodies, if necessary. For this reason, please sign the declaration of consent. Before you send off your application, please complete the application form in full and sign section 6 and section 7.