1066E730Q-MRF
 
                        MUTANT REGISTRATION FORM
 
                         Department of Justice
                      Office of ParaHuman Affairs
                           Mutant Task Force
 
 
 
Please fill in the following spaces with the correct infomation
Please print clearly in ink or type
 
FULL NAME:_____________________________________________________________
                last name/first name/middle
 
BIRTHDATE:_____________________         SEX:  MALE[]     FEMALE[]
 
ADDRESS:  Street:_______________________________________________
          City  :_______________________________________________
          State :_______________________________________________
          Zip Code:________________
 
CODE NAME(name use while you are using your powers):
 
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NATURE OF POWER:
Give a brief discription of its uses and limitations.  Please include any
special uses of the power.
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CLASSIFICATION OF POWER: CLASS 1 [ ]   CLASS 2 [ ]    CLASS 3 [ ]
 
CLASSIFICATIONS
Pursuant to the Mutant Regstation Act of 1987, ParaHuman Abilities have
been classified  according to the following scale: 
               
CLASS 1 :         EXTRAPHYSICAL
        A) Extreme strength (ex. COLOSSUS)
        B) Focused energy release (ex. CYCLOPS)
        C) Telkinetic (ex. MARVEL GIRL)
 
CLASS 2 :      EXTRASENSORY/PSYCHIC
        A) Astral/image projection (ex. MIRAGE)
        B) Telpathic (ex. PSYLOCKE)
        C) Extrasensory (ex. CALIBAN)
 
CLASS 3 :   HEIGHTENED NORMAL ABILITIES
        A) Cerebral (ex. CYPHER)
        B) Physical (ex.BEAST)
           
 
 
                              WARNING!
                      THIS IS A FEDERAL DOCUMENT
Under the terms of the Mutant Registration Act of 1987, all residents of
the United States who possess Mutant ParaHuman Abilities must register these
powers with the Federal Government.  This is defined as those born with
ParaHuman Abilities and the genetic potential in their offspring.  Failure
to file this application is a felony punishable by fine and imprisonment.
 
 
        I __________________________________ do hereby state that the above
information is correct and do hereby agree to the terms put down under future
legislation of this sort concerning ParaHuman Abilities.
 
Signature:________________________________________________
Date:__________________________