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Attestation form from pearl worker Samsudin Bin Katib's service file
[Capitalised and underlined page header printed in black ink, which reads:] AUSTRALIAN MILITARY FORCES
[Capitalised heading] ATTESTATION FORM.
[Capitalised subheading] FOR SPECIAL FORCES RAISED FOR SERVICE IN AUSTRALIA OR ABROAD.
[Section:] A.
Army No. [number] [italicised] W.65780 Wx36791 [second response handwritten]
Surname [italicised] SAMSUDIN
Other names [italicised] BIN KALIB
Unit [italicised] ‘Z’ Special Unit [response handwritten]
Enlisted for service at [italicised] Claremont. [handwritten response] (Place) [italicised]
West Australia [handwritten response] (state) [italicised]
20.6.42 (Date)
[Section:] B.
[Italicised] Questions to be put to persons called out or presenting themselves for voluntary enlistment. [Asterisk]
[The following information is presented in two columns, with the question on the left and the response on the right. All responses are handwritten.]
1. What is your name?
1. Surname Samsudin (BLOCK CAPITALS)
Other names Bin Katib
2. Where were you born?
2. In or near the town of Mining Kaban
In the State or country of Sumatra
3. Are you a natural born or a naturalized [sic] British Subject? If the latter, papers are to be produced
3. Malayan
4. What is your age and date of birth?
4. Age 25 Years 7 months
Date of Birth 15. 7. 1918
5. What is your trade or occupation?
5. Pearl Diver
6. Are you married, single, widower, widow or divorcee?
6. Single
7. What are the ages of your children?
7. [Response area crossed out]
8. (a) Have you had any previous naval, military or air force service, peace or war, in Australia or elsewhere. [sic] If so, where and in what unit?
8. (a) A.M.F.– [Australian Military Forces]
No. [Response blank]
Rank [Response blank]
Unit [Response blank]
OTHER SERVICE [Response blank]
No. [Response blank]
Rank [Response blank]
Unit [Response blank]
[8.] (b) If you were discharged or dismissed from any such service, what was the reason?
(b) [Response blank]
[8.] (c) If now serving, give particulars
(c) No. W65780
Rank Pte [Private]
Unit ‘Z’ Special Unit
9. Who is your actual next of kin? (Order of relationship:– Wife, husband, eldest son, eldest daughter, father, mother, eldest brother, eldest sister, eldest half-brother, eldest half-sister.)
9. Name Timarat
Address Mining Kaban
Sumatra
Relationship Mother
10. What is your permanent address?
10. Mining Kaban
Sumatra
11. What is your religious denomination? (Answer optional.)
11. Mohammedan
12. Have you ever been convicted by a civil court? If so, for what offence?
12. [Response blank]
13. Have you any of the following Educational Qualifications? If so, which?
1. Certificate for Entry to Secondary School [Response blank]
2. Intermediate [Response blank]
3. Leaving [Response blank]
4. Leaving Honours [Response blank]
5. Technical [Response blank]
6. University Degrees [Response blank]
7. Other Diplomas [Response blank]
I, Samsudin bin Katib [name handwritten] do solemnly declare that the above answers made by me to the above questions are true and that I am willing to serve in the Australian Military Forces within or beyond the limits of the Commonwealth.
Witnessed by [handwritten signature, illegible] (Signature of Attesting or Witnessing Officer) [italicised]
[Asterisk, followed by a note that reads:] This person will be warned that should he give false answers to any of these questions he will be liable to heavy penalties under the Defence Act.
[Section:] C.
[Capitalised] OATH OF ENLISTMENT [Cross]
I, Samsudin bin Katib [name handwritten] swear that I will well and truly serve our Sovereign Lord, the King, in the Military Forces of the Commonwealth of Australia until the cessation of the present time of war and twelve months thereafter or until sooner lawfully discharged, dismissed or removed, and that I will resist His Majesty's enemies and cause His Majesty's peace to be kept and maintained, and that I will in all matters appertaining to my service faithfully discharge my duty according to law.
So Help Me God [elaborate script]
Signature of Person Enlisted [italicised] Samsudin [handwritten signature]
Subscribed at [illegible] Commando School [handwritten] in the State of Queensland
this ninth [handwritten] day of March [handwritten] 19 [illegible]
Before me –
Signature of Attending Officer [italicised] [handwritten signature, illegible]
[Cross, followed by a note that reads:] in the case of persons who object to take an oath the above form should be amended by deleting the word “swear” and inserting the words "solemnly and sincerely affirm and declare" and by deleting the words "so help me God."
[Capitalised page footer beneath horizontal line printed in black ink, which reads:] By Authority: H. E. Daw, Government Printer, Melbourne
