0031-0330 irl.qxd 2.3.2009 14:20 Page 157 ANNEX IV 1. Front B. CAPTURE CARD (See Article 70) PRISONER OF WAR MAIL Postage free CAPTURE CARD FOR PRISONER OF WAR IMPORTANT 2. Reverse side This card must be completed by each prisoner immediately after being taken prisoner and each time his address is changed (by reason of transfer to a hospital or to another camp). This card is distinct from the special card which each prisoner is allowed to send to his relatives. Write legibly and in block letters 2. Name CENTRAL PRISONERS OF WAR AGENCY International Committee of the Red Cross GENEVA (Switzerland) 1. Power on which the prisoner depends .............................................. 3. First names (in full) 4. First name of father .................................................................................................................................... 5. Date of birth .................…................ 6. Place of birth .............................................. 7. Rank ........................................................................................................................... 8. Service number.......................................................................................................... 9. Address of next of kin ............................................................................................... *10. Taken prisoner on: (or) Coming from (Camp No., hospital, etc.) ................................................................. *11. a) Good health—b) Not wounded—c) Recovered—d) Convalescent—e) Sick— f) Slightly wounded—g) Seriously wounded. 12. My present address is: Prisoner No. ......................................................................... Name of camp............................................................................................................ 13. Date.....................…........................ 14. Signature ..................................................... * Strike out what is not applicable—Do not add any remarks—See explanations overleaf. Remarks. — This form should be made out in two or three languages, particularly in the prisoner’s own language and in that of the Detaining Power. Actual size of the form: 15 by 10.5 centimetres.