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Show Consumers Declaration Form Form Approved. BuHcet Bureau No. 08 -R 126-42 1 OPA Form No. R-1301 One copy of this Declaration most be filed with the Office of Price Administration by each person applying for War Ration Book UNITED STATES OF AMERICA wo mcmters of a family unit, and by each person who is not a member of a family unit. File at the site designated. OFFICE OF Coupons will be deducted for excess supplies PRICE AQMINktditiam f n food listed below according to the rK1U ADMINISTRATION schedules announced by the Office of Price ; Administration. - CONSUMER DECLARATION Processed Foods and Coffee I HEREBY CERTIFY that I am authorized to apply for and receive I a War Ration Book Two for each person listed below who is a member of my family unit, or the other person or persons for whom I am acting whose War Ration Book One I have submitted to the Board; That the name of each person and number of his or her War Ration Book One are accurately listed below; That none of these persons is confined or resident in an institution, institu-tion, or is a member of the Armed Forces receiving subsistence subsist-ence in kind or eating in separate messes under an officer's command; That no other application for War Ration Book Two for these persons has been made; That the following inventory statements are true and include all indicated foods owned by all persons included in this Declaration: Coffee 1. Pounds of coffee owned on November 28, 1942, minus 1 pound for each person included in this Declaration whose age as stated on War Ration Book One is 14 years or older - 2. dumber of persons included in this Declaration whose age as stated , on War Ration Book One is 14 years or older Canned foods Include all commercially canned fruits (including spiced) ; canned vegetables; canned fruit and vegetable juices; canned soups, chili sauce, and catsup. Do not include canned olives; canned meat and fish; pickles, relish; jellies, jams, and preserves; spaghetti, macaroni, and noodles; or home-canned foods. 3. Number of cans, bottles, and jars (8-ounce size or larger) of commercially packed fruils, vegeta- bles, juices and soups, chili sauce and catsup owned on February 21, 1943, minus 5 for each person included in this Declaration. . 4. Number of persons included in this Declaration The name of each person included in this Declaration and the number of his or her War Ration Book One is: Print Name Number 1 2 3 5 6...: -- - -- - j 7. j 8 - ' additional space is needed, attach separate sheet I I (Siffnature of applicant or authorized . NOTICE. Section S5 (A) of the agent) United States Criminal Code makes it a criminal offense, punishable br ""VIVj" a maximum of II Tears' imprison- (Address) ment, 10,000 line, or both, to make a falso statement or repieeeiitation as to ar matter within the Jurisdlc- tion of any department or Money of (Oily and State) the United States. i j' 1 'J'i This is the official declaration which yon will b required to fill out before receiving War Ration Book No. J, the point rationing ration-ing book. To save time at registration, all applicants should clip this declaration out, fill in the answers, and bring it with them to the regiseration site: |