1) your Portuguese ancestor is:
a) born in Portugal (Continental and islands);
b) born outside Portugal; He/She is a bearer of double nationality

2) your Portuguese ancestor is:
a) dead
b) alive

3) your Portuguese ancestor is:
a) your grand-grandfather / grand-grandmother
b) your grandfather/ grandmother
c) your father / mother
d) Other options

4) In case the answer to item 3 above is letter “a”, please inform if:

5) In case the answer to item 3 has been letter “b”, please inform
if your father/mother (son (daughter) of the Portuguese ancestor):
a) is alive
b) is dead, but applied for Portuguese Nationality before his/her death
c) is dead, but never applied for Portuguese Nationality

6) You, the descendant are:
a) older than 18 years old
b) younger than 18 years old

7) Please declare your marital status:
a) Single
b) Married
c) Widow/Widower
d) Divorced, in the process of separation or separated

8) Marriage:

How many times have you got married?
Place and date of Marriage:

Is the marriage dissolved?
a) Yes
b) No

How:
a) Divorce
b) Death

Where do you reside:

Other information that you consider relevant:

With respect to the documentation, you declare the following:
a) I am in possession of a birth certificate of my Portuguese ancestor.
b) I am not in possession of a birth certificate of my Portuguese ancestor, but I may indicate the place where he/she was born in Portugal
c) Other declarations