[104-10193-10079.pdf — page 273]
48. Do you hold any position or office under any State, Territory,    county or municipality?........................................................................................................ Yes [X] No    If so, give details under item 45.40. Do you receive any pension or other benefit (exclusive of Adjusted    Service Certificate) by military or naval service, or civil annuity    from the U.S. Government under any Retirement Act?...........................................Yes No [X]    If so, give details under item 45.40. Show name and address of wife's (or husband's) employer (if none, write    "None").NONE4l: (a) Were any of the following members of your family born out-side Continental U. S. A.?.............................................................................................................Yes No [X]Wife Husband Father MotherIf yes, indicate which by marking the appropriate space, and show under item45 for each: (1) full name, including maiden name of wife or mother, (2)birthplace, (3) native citizenship, and (4) if U.S. naturalized, date of naturalization.(b) Have you any relatives, by blood or by marriage (excludingpersons in the U. S. armed forces); now living in a foreigncountry?....................................................................................................................................................Yes No [X]If so for each relative show under item 45 the, (1) name, (2) relationship,(3) place of residence, (4) birthplace, (5) present citizenship, and (6) whethertransient or resident.42. List any special skills not shown in Question 37--such as operation of short    wave radio, multilith, key-punch, turret lathe, or scientific or professional    devices.SKILLSKILLSKILLWords per minute in typing 60-65; stenography ............Do you have a license to operate an automobile?....................................................................................Yes [X] No43. State what kind of work you prefer................................................................................................................44. Give any special qualifications not covered elsewhere in your application,    such as (a) your more important publications (do NOT submit copies unless re-    quested), (b) your patents or inventions (c) hobbies, construction of instruments, etc.45. Space for detailed answers to other questions:| Item No. | Write in left column numbers of items to which detailed answers apply. || -------- | ---------------------------------------------------------------------- ||          |                                                                        ||          |                                                                        ||          |                                                                        ||          |                                                                        ||          |                                                                        ||          |                                                                        ||          |                                                                        ||          |                                                                        ||          |                                                                        ||          |                                                                        |If more space is required, use a sheet of THIN, paper, size 8 x 10½ inches.Write on each sheet your name, full address, date of birth, and examination title(if any). Use one side only. Enclose, unattached, with application.If you claim preference for the Indian Service as an Indian, you must file with this application a certificate from the superintendent of the Indianagency where you are registered, or from the Commissioner, Bureau of Indian Affairs, showing that you have at least one-fourth Indian blood.JURAT (OR OATH).--This jurat (or oath) must be executed.The following oath must be taken before a notary public, the secretary of a United States civil service board of examiners, or otherofficer authorized to administer oaths, before whom the applicant must appear in person. The following are among those not authorizedto administer this oath: Postmasters (except in Alaska), Army officers, post-office inspectors, and chief clerks and assistant chief clerksin the Railway Mail Service.The composition and work in connection with any material required to be submitted for this examination are entirely myown, except where I have given full credit for quoted matter or the collaboration of others by quotation marks and references,and in the composition of the same I have received no assistance except as indicated fully in my explanatory statement.I, the undersigned, DO SOLEMNLY SWEAR (OR AFFIRM) that the statements made by me in answer to the foregoingquestions are full and true to the best of my knowledge and belief, SO HELP ME GOD.If female prefix "Miss" or "Mrs." and if marrieduse your own given name as "Mrs. Mary L. Doe."Ann R. Goodpastur(Signature of applicant)[Sign with PEN AND INK your name--give given name, initial or initials, and surname.]Subscribed and duly sworn to before me according to law by the above-named applicant this 25 dayof Jan 1944, at [city or town] of W. Coalcounty of and State (or Territory or District) of Okla.[Signature of officer](Official title) olan Omblic.U. S. GOVERNMENT PRINTING OFFICE 0--29004--1