[104-10194-10026.pdf — page 214]
SECRET(When Filled in)# REPORT OF SERVICE ABROADTO:Office of Personnel, Transactions and Records Branch, Status Section| SERIAL NO. | LAST     | FIRST | NAME || ---------- | -------- | ----- | ---- || 024345     | PHILLIPS | DAVID | A.   |INSTRUCTIONSUSE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TDY. 'NSERT APPROPRIATE CODE NUMBER IN "CODE" COLUMNTO DESIGNATE WHETHER SUBMISSION IS OF DASIC DATA, CORRECTION, OR CANCELLATION (One only). REPORT DATES BY USINGTHE NUMBER-FOR THE MONTH. AND LAST TWO DIGITS ONLY FOR YEAR, REFER TO OFI NO. 58. REVISED.PCS DATES OF SERVICE|       | ARRIVAL O/S |       | DEPARTURE O/S |       | TYPE OF DATA |     | O/P USE ONLY | COUNTRY | CODE || ----- | ----------- | ----- | ------------- | ----- | ------------ | --- | ------------ | ------- | ---- || MONTH | DAY         | YEAR  | MONTH         | DAY   | YEAR         |     |              |         |      || 25-26 | 27-28       | 29-30 | 31-32         | 33-34 | 35-36        |     | 38 39        | 40-42   |      ||       |             |       |               |       |              | 1   | PCS (Basic)  |         |      ||       |             |       |               |       |              | 3   | CORPECTION   |         |      ||       |             |       |               |       |              | 6   | CANCELLATION |         |      |TDY DATES OF SERVICE|        | ARRIVAL O/S |       | DEPARTURE O/S |       | TYPE OF DATA |     | O/P USE ONLY | AREA(S) | CODE || ------ | ----------- | ----- | ------------- | ----- | ------------ | --- | ------------ | ------- | ---- || MONTH  | DAY         | YEAR  | MONTH         | DAY   | YEAR         |     |              |         |      || 25-26. | 27-28       | 29-30 | 31-32         | 33-34 | 35-36        |     | 38 39        | 40-42   |      || 05     | 19          | 69    | 05            | 21    | 69           | 2   | TOY (Basic)  | WH      | 120  ||        |             |       |               |       |              | 4   | CORRECTION   |         |      ||        |             |       |               |       |              | 6   | CANCELLATION |         |      |OFFICE OF PERSONNEL USE ONLY - PUNCH AREASOURCE DOCUMENT AND CERTIFICATION| TRAVEL VOUCHER  | DISPATCH                                  || --------------- | ----------------------------------------- || X               |                                           || CABLE           | DUTY STATUS OR TIME AND ATTENDANCE REPORT || OTHER (Specify) |                                           |DOCUMENT IDENTIFICATION NU.DOCUMENT DATE/PERIOD5 thru 21 May 1969REMARKS| PREPARED BY          | REPORT ANNOTATED ON CONTBOL DOCUMENT | ABOVE DATA CERTIFIED CORRECT, BASED UPON SOURCE DOCUMENT CITED || -------------------- | ------------------------------------ | -------------------------------------------------------------- || DCO                  |                                      |                                                                || X                    |                                      |                                                                || C @ L DIVISION. CTA. | DATE                                 | SIGNATURE                                                      || C @ Y @lvision       | 28 May 1969                          |                                                                |THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNELIN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDERFORM 1451a OBSOLETE PREVIOUS3-67 EDITIONSSECRET(4-10)