[104-10194-10014.pdf — page 211]
SECRET(When Filled In)SECTION V CONTINUED FROM PAGE 24.  HAVE YOU EVER BEEN IN, OR PETITIONED FOR, BANKRUPTCY?![checkbox no] NO5.  IF YOUR ANSWER IS "YES" TO THE ABOVE QUESTION, GIVE PARTICULARS, INCLUDING COURT AND DATE(S)6.  DO YOU RECEIVE AN ANNUITY FROM THE UNITED STATES OR DISTRICT OF COLUMBIA GOVERNMENT UNDER ANY RETIREMENT ACT, PENSION, OR COMPENSATION FOR MILITARY OR NAVAL SERVICE?    ![checkbox no] NO7.  IF YOUR ANSWER IS "YES" TO THE ABOVE QUESTION, GIVE COMPLETE DETAILS8.  DO YOU HAVE ANY FINANCIAL INTEREST IN, OR OFFICIAL CONNECTION WITH, NON-U.S. CORPORATIONS OR BUSINESSES OR IN OR WITH U.S. CORPORATIONS OR BUSINESSES HAVING SUBSTANTIAL FOREIGN INTERESTS?    ![checkbox no] NO    IF YOU HAVE ANSWERED "YES", GIVE COMPLETE DETAILS ON A SEPARATE SHEET AND ATTACH IN A SEALED ENVELOPE.SECTION VI1. PRESENT CITIZENSHIP (Country)2. CITIZENSHIP ACQUIRED BY - CHECK (X) ONE:   BIRTH   MARRIAGE   OTHER (Specify):3. HAVE YOU TAKEN STEPS TO CHANGE YOUR PRESENT CITIZENSHIP?   YES   NO4. GIVE PARTICULARS5. IF YOU HAVE APPLIED FOR U.S. CITIZENSHIP, INDICATE PRESENT STATUS OF YOUR APPLICATION (First papers, etc.)SECTION VIIEDUCATION1. CHECK (X) HIGHEST LEVEL OF EDUCATION ATTAINEDLESS THAN HIGH SCHOOL GRADUATETWO YEARS OF COLLEGE - NO DEGREEHIGH SCHOOL GRADUATEBACHELOR'S DEGREETRADE, BUSINESS, OR COMMERCIAL SCHOOL GRADUATEGRADUATE STUDY LEADING TO HIGHER DEGREETWO YEARS COLLEGE OR LESSDOCTOR'S DEGREE2. COLLEGE OR UNIVERSITY STUDY| NAME AND LOCATION OF COLLEGE OR UNIVERSITY | SUBJECT MAJOR/MINOR | DATES ATTENDED FROM | DATES ATTENDED TO | DEGREE REC'D | DATE REC D | SEM/QTR. HOURS SPECIFY || ------------------------------------------ | ------------------- | ------------------- | ----------------- | ------------ | ---------- | ---------------------- ||                                            |                     |                     |                   |              |            |                        ||                                            |                     |                     |                   |              |            |                        ||                                            |                     |                     |                   |              |            |                        |3. TRADE, COMMERCIAL AND SPECIALIZED SCHOOLS| NAME OF SCHOOL | STUDY OR SPECIALIZATION | DATES ATTENDED FROM | DATES ATTENDED TO | TOTAL MONTHS || -------------- | ----------------------- | ------------------- | ----------------- | ------------ ||                |                         |                     |                   |              ||                |                         |                     |                   |              ||                |                         |                     |                   |              |4. MILITARY TRAINING (Full time duty in specialized schools such as Ordnance, Intelligence, Communications, etc.)| NAME OF SCHOOL | STUDY OR SPECIALIZATION | DATES ATTENDED FROM | DATES ATTENDED TO | TOTAL MONTHS || -------------- | ----------------------- | ------------------- | ----------------- | ------------ ||                |                         |                     |                   |              ||                |                         |                     |                   |              ||                |                         |                     |                   |              |5. OTHER EDUCATIONAL TRAINING NOT INDICATED ABOVESECRET3