1. The 2nd and 3rd letters of your mothers maiden/family name
X [ ] [ ] _____________
2. The Day of the month that your mother was born [1-31]
3. The 4th and 5th letters of you fathers middle name.
If the name is shorter than five letters then wrap
around, e.g. John = "nj".
XXX[ ][ ]_______________ or XXX[ ] + [ ]XXX
4. The Day of the month that your father was born [1-31]