[104-10194-10001.pdf — page 49]
# SECRET(When Filled In)MHC: 5 JUNE 63NOTIFICATION OF PERSONNEL ACTIONOEF1. SERIAL NUMBER 2. NAME (LAST-FIRST-MIDDLE)019477 TARASOFF BORIS D3. NATURE OF PERSONNEL ACTIONRESIGNATION4. EFFECTIVE DATE 5. CATEGORY OF EMPLOYMENT| MO. | DA  | YR  || --- | --- | --- || 06  | 04  | 63  |REGULAR6. FUNDS 7. COST CENTER NO. CHARGEABLE 8. CSC OR OTHER LEGAL AUTHORITY| V TO V  | V TO CF  || ------- | -------- || CF TO V | CF TO OF |3235 1990 10009. ORGANIZATIONAL DESIGNATIONS10. LOCATION OF OFFICIAL STATIONDDP WHCS/CS DEVELOPMENT COMPLEMENTWASH., D. C.11. POSITION TITLE 12. POSITION NUMBER 13. SERVICE DESIGNATIONI O FOREIGN DOC 9997 D14. CLASSIFICATION SCHEDULE (GS, LB, etc.) 15. OCCUPATIONAL SERIES 16. GRADE AND STEP 17. SALARY OR RATEGS 0132.62 11 3 857518. REMARKSSPACE BELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL| 19. ACTION Code | 20. Employ. CODE | 21. OFFICE CODING NUMERIC ALPHABETIC | 22. STATION CODE | 23. INTEGREE CODE | 24. Hdqtes. Code | 25 DATE OF BIRTH MO. DA. YR | 26. DATE OF GRADE MO. DA YR | 27. DATE OF LEI MO. DA YR || --------------- | ---------------- | ------------------------------------ | ---------------- | ----------------- | ---------------- | --------------------------- | --------------------------- | ------------------------- || 45              | 18               |                                      |                  |                   |                  | 11 02 08                    |                             |                           |28. NTE EXPIRES| NO. | DA  | YR  || --- | --- | --- ||     |     |     |29. SPECIAL REFERENCE30. RETIREMENT DATA 31. SEPARATION 32. CORRECTION/CANCELLATION DATA| ICSC | 3-FICA E-NONE |     || ---- | ------------- | --- |DATA CODE TYPE NO. DA. YREOD DATA33. SECURITY 34. SEX REQD1BD009135. VET. PREFERENCE 36. SERV. COMP. DATE 37. LONG. COMP. DATE 38. CAREER CATEGORY 39. FEGLI/HEALTH INSURANCE 40 SOCIAL SECURITY NO.| CODE                     | MO. DA. YR | MO DA YR | CODE               | CODE             | HEALTH INS CODE || ------------------------ | ---------- | -------- | ------------------ | ---------------- | --------------- || 0. NONE 1. APT. 2. 10 PT |            |          | CAN AESY PROV TEMP | 0. WAIVER 1. YES |                 |41. PREVIOUS GOVERNMENT SERVICE DATA 42. LEAVE CAT. 43. FEDERAL TAR DATA 44. STATE TAX DATA| CODE                                                                                                                   | FORM EAECUTED: CODE | NO TAR EREMPTIONS CODE | FORM EXECUTED CODE | NO TAR EXEMPT CODE || ---------------------------------------------------------------------------------------------------------------------- | ------------------- | ---------------------- | ------------------ | ------------------ || 0 NO PREVIOUS SERVICE 1 - NO BREAK IN SERVICE 2-BREAK IN SERVICE RESS THAN 1 VRS 3- BREAK IN SERVICE (MORE THAN 1 VAS) | 1. YES 2. NO        |                        | 1.YES 2.NO         |                    |SIGNATURE OR OTHER AUTHENTICATION![Signature]FORM Use Previous 11-62 EditionSECRET 5 JUN 1963![POSTED 06/06/63]> [Figure] GROUP I> Excluded from automatic downgrading and declassification(14-51)(When Filled In)