First name:

Last name (if known):

Nickname:

Birthdate (yours): //

Address (where you live):

CB Handle:

Daddy (If unknown, list three suspects):

Mama (list also relation, i.e., sister):

Wife's name:

Children:

Number of original teeth:

Information on pickup owned:

Make:

Year:

Name:

Size of tires:

Height:

Number of empty beer cans on floorboard or in bed:

Number of Weeks Unemployed:

Number of Welfare Checks Received:

Medical Information:

Number of Testicles Shot Off in 'Nam:

Number of Testicles Left:

How far can you throw cow pies?

Where was your last Elvis sighting?
When? //

Length of Right leg:
Length of Left leg:

How many cars do you have on blocks in your front yard?

How many kitchen appliances do you keep on your porch?