Francesco/who-killed-jfk huggingface dataset:
[104-10194-10001.pdf — page 111]
# SECRETCONTRACT INFORMATION AND CHECK LISTCASE OFFICERTELEPHONE EXTENSIONGENERAL24. PROJECT3. ALLOTMENT NO.   3135-5700-10004. SLOT NO.5. PREVIOUS CIA PSEUDONYM OR ALIASESNone6. INDIVIDUAL HAS BEEN ENGAGED BY CIA OR ITS ALLIED ACTIVITIES IN SOME CAPACITY PRIOR TO THIS CONTRACT.(If yes, describe and include dates and salary)7. SECURITY CLEARANCE (Type and date)StaffStaff employee 20 Feb 1956 - Present CC-11MEDICAL CLEARANCECONTRACT IS TO BE OFITTEN IN STERILE FORM i.e., "U.S. GOVERNMENT"10. PROPOSED LIAISON (Contract agent, contract employee)SECTION 11 PERSONAL DATA13. AGE14. DATE OF BIRTH (Month, day, year)15. LEGAL RESIDENCE (City and state or country)Washington, D.C.16. CURRENT RESIDENCE (City and state or country)5109 35th St. N.W. Washington, D.C.17. MARITAL STATUS (Check as appropriate)18. NUMBER OF DEPENDENTS (Not including individual) RELATIONSHIP AND AGEWife, 40Son, 14Dau, 1719. INDIVIDUAL IS RELATED TO A STAFF EMPLOYEE, STAFF AGENT OF AN INDIVIDUAL CURRENTLY WORKING FOR THE AGENCY IN SOME CAPACITY RELATIONSHIPBrotherWiteSECTION 111 U.S. MILITARY STATUS20. RESERVENo21. VETERANYes22. IF RETIRED, INDICATE CATEGORY (Longevity, combat disability, service disability non-combat) N.A.23. BRANCH OF SERVICEU.S. Army24. BANK OR GRADEEnt.25. DRAFT ELIGIBLE26. DRAFT DEFERMENT OBTAINED BY CIASECTION IV COMPENSATION27. BASIC SALARYCS-113$857528. POST DIFFERENTIAL29. COVER (Breakdown, if any)30. FEDERAL TAX WITHHOLDING COVERCIASECTION V ALLOWANCES (NORMALLY GRANTED ONLY TO RESIDENTS OF THE UNITED STATES)31. QUARTERS W/utilities    $3,00032. POST33. OTHERAllowances applicable to staff agent under non-official cover.34. COVER (Breakdown, if any)SECTION VI TRAVEL35. TYPES36. WITH DEPENDENTS37. HME TO BE SHIPPED37A. HME TO BE STORED38. PERSONAL VEHICLE TO BE SHIPPED39. TRANSPORTED VEHICLE TO BE USED FOR OPERATIONAL TRAVEL40. IF WITH DEPENDENTS STATE RELATIONSHIP, CITIZENSHIP, AGE AND DATE OF BIRTHWife, U.S., 40, 5 May 1923Son, U.S., 14, 20 Mar 1949Dau, U.S., 17, 22 Dec 1945[Figure: Handwritten text with names and date]41. PAYMENT AND ACCOUNTABILITY WILL BE IN CONFORMANCE WITHC1A REGULATIONSCOVER POLICIES AND PROCEDURESSECTION VII OPERATIONAL EXPENSES42. PURCHASE OF INFORMATIONYes43. ENTERTAINMENTYes44. OTHER45. PAYMENT AND ACCOUNTABILITY WILL BE IN CONFORMANCE WITH
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PART 111.-DETERMINING CREDITABLE SERVICEAND SERVICE COMPUTATION DATE FORLEAVE PURPOSES|                                            | YEARS | MONTHS | CAYS || ------------------------------------------ | ----- | ------ | ---- || TOTAL SERVICE (Item 12)                    |       |        |      || NONCREDITABLE SERVICE (Item 13).           |       |        |      || CREDITABLE SERVICE (Leave purposes)        |       |        |      || ENTRANCE ON DUTY DATE (Present agency).    | 6     | 02     | 20   || LESS CREDITABLE SERVICE (Loave purposes)   | 4     | 05     | 18   || SERVICE COMPUTATION DATE (Leavo purposes). | 5     | 06     | 02   |verified4/4/57PART IV.-DETERMINING CREDITABLE SERVICEAND SERVICE COMPUTATION DATE FORREDUCTION IN FORCE PURPOSES(To be completed only in those cases when the amount of creditable service for reductionin force purposes differs from the amount creditable for leave purposes)|                                                                                                                                  | YEARS | MONTHS | DAYS || -------------------------------------------------------------------------------------------------------------------------------- | ----- | ------ | ---- || TOTAL SERVICE (Item 12).                                                                                                         |       |        |      || NONCREDITABLE SERVICE (Item 14).                                                                                                 |       |        |      || CREDITABLE SERVICE (RIF purposes)                                                                                                |       |        |      || ENTRANCE ON DUTY DATE (Present agency)                                                                                           |       |        |      || LESS CREDITABLE SERVICE (RIP purposes).                                                                                          |       |        |      || SERVICE COMPUTATION DATE (RIF purposes). (Enter as the "service computation date" on the employer's "Service Record Card," SP-7) |       |        |      |REMARKS
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CONFIDENTIAL(when Filled In)Complete in duplicate. The data recorded on this formis essential in determining travel expenses allowable in connection with leaveof government expense, overseas duty, return to residence upon separation, and for providing current residence and dependency infor-mation required in the event of an employee emergency. The original of this form will be filed in the employee's official personnel folder1. NAME OF EMPLOYEE   (Last)   TARASOFF   (First)   BORIS   (Middle) SOCIAL SECURITY NUMBER   DIMITRI 079-05-1624   RESIDENCE DATA   PLACE OF RESIDENCE WHEN INITIALLY APPOINTED   5104-45 Str. N. W., Wash D.C.   LAST PLACE OF RESIDENCE IN CONTINENTAL U.S. (If approibited   abroad)   5104- 45 Str. N. W., Wash. D.C.   PLACE IN CONTINENTAL U.S. DESIGNATED AS PERMANENT RESIDENCE   as above   HOME LEAVE RESIDENCE   as above2. MARITAL STATUS (Check one)   SINGLE   MARRIED   SEPARATED   DIVORCED   WIDOWED   ANNULLED   IF MARRIED, PLACE OF MARRIAGE   DATE OF MARRIAGE   Cleveland, Ohio   IF DIVORCED, PLACE OF DIVORCE DECREE   DATE OF DECREE   na   IF WIDOWED, PLACE SPOUSE DIED   DATE SPOUSE DIED   na   IF PREVIOUSLY MARRIED, INDICATE NAME(S) OF SPOUSE, REASONIS) FOR TERMINATION, AND DATEIS)   na3. MEMBERS OF FAMILY   NAME OF SPOUSE   ADDRESS (NO., Street, City, Zune, State)   TELEPHONE NO.   Anna   5104-45 Str., N. W. Wash. D.C. 363-1944   NAMES OF CHILDREN   ADDRESS   SEX   DATE OF BIRTH   Barbara   as above   f 22 Dic 45   Raymond   m 20 Mar 49   NAME OF FATHER(Or male guardian)   ADDRESS   TELEPHONE NO.   Tarasoff, Dimitri   NAME OF MOTHER(Or female guardian)   ADDRESS   TELEPHONE NO.   Tarasoff, DonnaWHAT MEMBER(S) OF YOUR FAMILY IF ANY, HAS BEEN TOLD OF YOUR AFFILIATION WITH THE ORGANIZATION IF CONTACT IS RE-QUIRED IN AN EMERGENCY. Mrs. C. C. Comella4. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY   NAME (Mr., Mrs., Miss)   (Last-First-Middle)   RELATIONSHIP   Comella, Henry   Sister-in-Law   HOME ADDRESS (No., Street, City, Zone, State)   HOME TELEPHONE NUMBER   31599 Gatesville Club, Pepper Pike, Ohio   BUSINESS ADDRESS (No., Street, City, Zone, State) AND NAME OF EMPLOYER, IF APPLICABLE   BUSINESS TELEPHONE & EXTENSIONIS THE INDIVIDUAL NAMED ABOVE WITTING OF YOUR AGENCY AFFILIATION? (If "No" give name and address of organiza-tion he believes you work for.)YESNOIS THIS INDIVIDUAL AUTHORIZED TO MAKE DECISIONS ON YOUR BEHALF? (If "No" give name and address of person, ifany, who can make such decisions in case of amergency.)YESNODOES THIS INDIVIDUAL KNOW THAT HE HAS BEEN DESIGNATED AS YOUR EMERGENCY ADDRESSEE? (If answer is "No"explets why in item 6.)YESNOThe persons named in item 3 above may also be notified in case of emergency. If such notitication is not desirable because ofhealth or other reasons, please so state in item 6 on the reverse side of this form.CONTINUED ON REVERSE SIDECURRENT RESIDENCE AND DEPENDENCY REPORTCONFIDENTIALFORM 61 USE PREVIOUS4-60 EDITIONS.(4)
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CONFIDENTIAL(To Be Filled In)VOLUNTARY ENTRIESExperience in the handling of employer… estates… including the disclosure of certain personal data affecting care and control;concerns the settlement of estate and financial matters. The information requested in this section may prove very useful to your familyor attorney in the event of your disability or death and will be disclosed only when circumstances warrant.NAME AND ADDRESS OF ANY BANKING INSTITUTIONS WITH WHICH YOU HAVE ACCOUNTS AND THE NAMES IN WHICH THE ACCOUNTS ARE CARRIED.UNION TRUST COMPANY District of ColumbiaKOIS S. & ANNA TANSKYHAVE YOU COMPLETED A LAST WILL AND TESTAMENT? YES NO. (If "Yes" where is document located")in our own possessionHAVE YOU PREPLANNED AN ARRANGED GUARDIANSHIP OF YOUR CHILDREN IN CASE OF COMMON DISASTER TO BOTH PARENTS?YES NO. (If "Yes" give name(s) and address)3637 N. military RoadHAVE YOU EXECUTED A POWER OF ATTORNEY? YES NO. (If "Yes", who possess the power of attorney)ADDITIONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMSSIGNED ATDATESIGNATUREWashington DC. 29. May 1963 Boris D TanskyCONFIDENTIAL
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CERTIFICATE OF ATTENDANCEI certify that on MAR 15 1956 I have attended the Induction Course specified by Regulation 25-110.BORIS DIMITRI TARASOFF(NAME) - Please printCLERICAL STENOGRAPHIC OTHEROFFICE DDP/FIGS. 7 (Grade)FORM NO. 487 REPLACES FORM 31-1211 FEB 55 WHICH MAY BE USED.(6)
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# APPOINTMENT AFFIDAVITSIMPORTANT.--Before swearing to these appointment affidavits, you should read and understand the attached information for appointeeCENTRAL INTELLIGENCS AGENCYBoris Dimitri Tarasoff, do solemnly swear (or affirm) that-## A. OATH OF OFFICEI will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; that I take this obligation freely without any mental reservation or purpose of evasion; that I will well and faithfully discharge the duties of the office on which I am about to enter, SO HELP ME GOD.## B. AFFIDAVIT AS TO SUBVERSIVE ACTIVITY AND AFFILIATIONI am not a Communist or Fascist. I do not advocate nor am I a member of any organization that advocates the overthrow of the Government of the United States by force or violence or other unconstitutional means or seeking by force or violence to deny other persons their rights under the Constitution of the United States. I do further swear (or affirm) I will not so advocate, nor will I become a member of such organization during the period that I am an employee of the Federal Government.## C. AFFIDAVIT AS TO STRIKING AGAINST THE FEDERAL GOVERNMENTI am not engaged in any strike against the Govertunent of the United States and that I will not so engage while an employee of the Government of the United States; that I am not a member of an organization of Government employees that asserts the right to strike against the Government of the United States, and that I will not, while a Government employee, become a member of such an organization.## D. AFFIDAVIT AS TO PURCHASE AND SALE OF OFFICEI have not paid, or offered or promised to pay, any money or other thing of value to any person, firm or corporation for the use of influence to procure my appointment.## E. AFFIDAVIT AS TO DECLARATION OF APPOINTEEThe answers given in the Declaration of Appointee on the reverse of this form are true and correct.20 Feb. 1956Erin D. TarasoffSubscribed and sworn before me this 20th day of Feb., A. D. 1956at Washington, D. C.[SEAL]![Signature of officer]NOTE.-Il the oath is taken before a Notary Public the date of expiration of his commission should be shown.
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019477 EMP# NAME GS 12 0 ORG A40810500310 AA-ITEMAE0100014936 AB0020200023 EC06ZUZ1845 VF061ZUXXX45ECO0G99HRK45 VJ0609948X45 VR00G99HAF23 TA06G99MAU26TCO0G99HAK94 FM00SAUXA56 PM206SYXJK51 FLOOSSYKAAGOBK5070000467 802110111459 BQ2740304457 BQ301 60BQ361 59 B05111111459 BQ5455555357 BC5733433257BQ6033433257 ZYP169090000 ZM5 XXXXXX69S-E-C-R-E-T![stamp of Retined Nov 1974 "ader Re-cdo For Rercave"]71 F(F)
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# SECRET14-000001 FEB119477PERIODIC SUPPLEMENTPERSONAL HISTORY STATEMEReturn toTHIS DATE1191157INSTRUCTIONSThis form provides the means whereby your official personnel are kept current. Even though it duplicates information you have furnished previously, it will be necessary for you to complete Sections in their entirety. You need complete Sections VII through XIII only if there have been since you entered on duty with the organization or if you believe the item requires coverage.QABK04 CurieDATE 25 OCT 1957## SECTION I1. FULL NAME (Last-First-Middle)TARASOFF, BORIS DIMITRI2. CURRENT ADDRESS (No., Street, City, Zone, State)2819 - Gainsville Str. S.E.Washington, D.C.3. PERMANENT ADDRESS (No., Street, City, Zone, State)2819 - Gainsville Str. S.E.Washington, D.C.4. HOME TELEPHONE NUMBERLudlow 4-13805. STATE, TERRITORY, POSSESSION OR COUNTRY IN WHICH YOU NOW CLAIM RESIDENCEWashington, D.C., U.S.A.## SECTION IIPERSON TO BE NOTIFIED IN CASE OF EMERGENCY1. NAME (Last-First-Middle) PREFERABLY RESIDING IN U.S.2. RELATIONSHIPTarasoff, Annawife3. HOME ADDRESS (No., Street, City, Zone, State, Country).2819 - Gainsville Str. Washington, D.C., U.S.A.4. BUSINESS ADDRESS (No., Street, City, Zone, State, Country). INDICATE NAME OF FIRM OR EMPLOYER, IF APPLICABLE2430 E Street, Washington, D.C.5. HOME TELEPHONE NUMBERLudlow 4-13806. BUSINESS TELEPHONE NUMBERExecutive 3 - 61157. BUSINESS TELEPHONE EXTENSION84918. IN CASE OF EMERGENCY, OTHER CLOSE RELATIVES (Spouse, Mother, Father) MAY ALSO BE NOTIFIED. IF SUCH NOTIFICATION IS NOT DESIRABLE BECAUSE OF HEALTH OR OTHER REASONS, PLEASE SO STATE.## SECTION III1. CHECK (X) ONE:SINGLE x MARRIED WIDOWED SEPARATED DIVORCED ANNULLED2. FURNISH DATE, PLACE AND REASON FOR ALL SEPARATIONS, DIVORCES OR ANNULMENTSWIFE OR HUSBAND: If you have been married more than once, including annulments, use a separate sheet for former wife or husband giving data below for all previous marriages. If marriage is contemplated, provide same data for fiance.3. NAME(First) Anna (Middle) Adamoviez (Maiden) Tarasoff (Last)4. DATE OF MARRIAGE10 March 19455. PLACE OF MARRIAGE (City, State, Country)Cleveland, Ohio6. HIS (or her) ADDRESS BEFORE MARRIAGE (No., Street, City, State, Country)13610 - Benwood Ave., Cleveland, Ohio, U.S.A.7. LIVINGX YES8. DATE OF DEATH9. CAUSE OF DEATH10. CURRENT ADDRESS (Give last address, if deceased)2819 - Gainsville Str., S.E., Washington, D.C.11. DATE OF BIRTH5 May 192312. PLACE OF BIRTH (City, State, Country)Cleveland, Ohio, U.S.A.13. IF BORN OUTSIDE U.S. DATE OF ENTRY14. PLACE OF ENTRY15. CITIZENSHIP (Country)U.S.A.16. DATE ACQUIREDAt birth17. WHERE ACQUIRED (City, State, Country)Cleveland, Ohio, U.S.A.18. OCCUPATIONTemporary clerical position19. PRESENT EMPLOYER (Also gave former employer, or if spouse is deceased or unemployed, last two employers)CIA20. EMPLOYER'S OR BUSINESS ADDRESS (No., Street, City, State, Country)2430 - E Street, Washington, D.C.SECTION III CONTINUED TO PAGE 2FORM NO. 4446 USE PREVIOUS EDITIONS.1 DEC 56SECRET1(4)
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SECRETSECTION 111 CONTINUED FROM PAGE 121. DATES OF MILITARY SERVICE (Pros. and Tor) BY MONTH AND YEAR    3 Feb 1941 - 20 Oct 194522. BRANCH OF SERVICE    Army23. COUNTRY IN MILITARY SERVICE AFFILIATED    USofA.24. DETAILS OTHER GOVERNMENT SERVICE. U.S. OR FOREIGNSECTION IV RELATIVES BY BLOOD, MARRIAGE OR ADOPTION LIVING ABROAD OR WHO ARE NOT U.S. CITIZENS1. FULL NAME (Last-First-Middle)2. RELATIONSHIP3. AGE4. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES5. CITIZENSHIP (Country)6. FREQUENCY OF CON PACT7. DATE OF LAS CONTACT1. FULL NAME (Last-First-Middle)2. RELATIONSHIP3. AGL4. ADDRESS 09 PSY IN WHICH RELATIVE RESIDES5. CITIZENSHIP (Vuntry)6. FREQUENCY OF CONTACT7. PATE OF LAST CONTACT1. FULL NAME (Last-First-Middle)2. RELATIONSHIP3. AGE4. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES5. CITIZENSHIP (Country)6. FREQUENCY OF CONTACT7. DATE OF LAST CONTACT1. FULL NAME (Last-First-Middle)2. RELATIONSHIP3. AGE4. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES5. CITIZENSHIP (funtry)6. FREQUENCY OF CONTACT7. DATE OF LAST CONTACT9. SPECIAL REMARAS. IF awy. CONCERNING THESE RELATIVESSECTION V FINANCIAL STATUS1. ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY ?   Yes   No2. IF YOUR ANSWER IS "NO" TO THE ABOVE, STATE SOURCES OF OTHER INCOME3. BANKING INSTITUTIONS WITH WHICH YOU HAVE ACCOUNTSNAME OF INSTITUTIONADDRESS (City, State, Country)Anacostia National Bank2844 - Alabama Ave, S.E., Washington, D.CSECTION V CONTINUED TO PAGE 3SECRET2
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SECRETSECTION V. CONTINUED FROM PAGE 24. HAVE YOU EVER DEIN IN, OR PETITIONED FOR BANKRUPTCY?I had been adjudged bankrupt by the U.S. District Court of New York on 29 Oct 1940 in the case of Orel Delicatessen, 1456 Lexington Ave. N.Y.C.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 SERVICE8. 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!SECTION VI1. PRESENT CITIZENSHIP (Country)U.S.A.2. CITIZENSHIP ACQUIRED AY* Naturalized3. HAVE YOU TAKEN STEPS TO CHANGE YOUR PRESENT CITIZENSHIPT5. IF YOU HAVE APPLIED FOR U.S. CITIZENSHIP, INDICATE PRESENT STATUS OF YOUR APPLICATION (First papers, etc.)SECTION VII1. CHECK (X) HIGHEST LEVEL OF EDUCATION ATTAINED* TWO YEARS COLLEGE OR LESS2. COLLEGE OR UNIVERSITY STUDY| NAME AND LOCATION OF COLLEGE OR UNIVERSITY | SUBJECT | DATES ATTENDED | DEGREE REC'D | DATE REC'D | SEM/QTR. HOURS SPECIFY || ------------------------------------------ | ------- | -------------- | ------------ | ---------- | ---------------------- || Russian University of N.Y., N.Y.C.         | General | 1924 - 1926    |              |            |                        |3. TRADE, COMMERCIAL AND SPECIALIZED SCHOOLS| NAME OF SCHOOL                           | STUDY OR SPECIALIZATION | DATES ATTENDED | TOTAL MONTHS || ---------------------------------------- | ----------------------- | -------------- | ------------ || Cooper Union Art School in New York City | Fine Arts               | 1927 - 1927    | 10           || Cooper School of Art in Cleveland, Ohio  | Commercial Art          | 1950 - 1951    | 21           |4. MILITARY TRAINING (Full time duty in specialised schools such as Ordnance, Intelligence, Communications, etc.)| NAME OF SCHOOL                                        | STUDY OR SPECIALIZATION | DATES ATTENDED | TOTAL MONTHS || ----------------------------------------------------- | ----------------------- | -------------- | ------------ || MITC Camp Richie, Md                                  | CIC Course              | 1944 - 1945    | 2            || University of Penn. Philad. Pa., German Language, CIC | April - 1945            |                | 1            |5. OTHER EDUCATIONAL TRAINING NOT INDICATED ABOVEAdvanced CIC Course, Oberursel, Germany, in July 1945
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SECRETSECTION XI CONTINUED FROM PAGE7. LIST ANY SIGNIFICANT PUBLISHED MATERIAL OF WHICH YOU ARE THE AUTHOR   INDICATE TITLE, PUBLICATION DATE, AND TYPE OF WRITING (Non-fiction, scientific articles, general interest subjects, novels, short stories, etc.)8. INDICATE ANY DEVICES WHICH YOU HAVE INVENTED AND STATE WHETHER OR NOT THEY ARE PATENTED9. LIST ANY PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCEPublic Speaking and public relations experience on the Executive Board of Greater Alameda County C.I.O. Council10. LIST ANY PROFESSIONAL, ACADEMIC OR HONORARY ASSOCIATIONS OR SOCIETIES IN WHICH YOU ARE NOW OR WERE FORMERLY A MEMBER. LIST ACADEMIC HONORS YOU HAVE RECEIVED.Chairman of the Circle of Youth "Russian Culture", New York, N.Y. 1937 - 1940The National CIC Association, 1956 - presentSECTION XII ORGANIZATION WORK EXPERIENCE - SINCE LAST COMPLETION OF A PERSONNEL QUALIFICATIONS QUESTIONNAIRE1. INCLUSIVE DATES   2 Mar 1956 to 27 Jun 19562. GRADE   73. OFFICE/DIVISION/BRANCH OF ASSIGNMENT   DDP/FI/CI/ICD4. NO. OF EMPLOYEES UNDER YOUR DIRECT SUPERVISION   none5. OFFICIAL POSITION TITLE   Intelligence Assistant6. DESCRIPTION OF DUTIES   Research, analysis, and translation of materials in the Russian Language, including extensive work with microfilmed materials.1. INCLUSIVE DATES   27 Jun 1956 - 9 Sep 19562. GRADE   73. OFFICE/DIVISION/BRANCH OF ASSIGNMENT   OO/FDD/BU4. NO. OF EMPLOYEES UNDER YOUR DIRECT SUPERVISION   none5. OFFICIAL POSITION TITLE   Intelligence Assistant6. DESCRIPTION OF DUTIES   Reading newspapers and periodicals, abstracting information of intelligence value and compiling it into reports.1. INCLUSIVE DATES   9 Sep 1956 - present2. GRADE   73. OFFICE/DIVISION/BRANCH OF ASSIGNMENT   OO/FDD/BU4. NO. OF EMPLOYEES UNDER YOUR DIRECT SUPERVISION   none5. OFFICIAL POSITION TITLE   Foreign Documents Officer6. DESCRIPTION OF DUTIES   Abstraction of intelligence information from Soviet newspapers and periodicals and compiling it into reports.1. INCLUSIVE DATES2. GRADE3. OFFICE/DIVISION/BRANCH OF ASSIGNMENT4. NO. OF EMPLOYEES UNDER YOUR DIRECT SUPERVISION5. OFFICIAL POSITION TITLE6. DESCRIPTION OF DUTIES1. INCLUSIVE DATES2. GRADE3. OFFICE/DIVISION/BRANCH OF ASSIGNMENT4. NO. OF EMPLOYEES UNDER YOUR DIRECT SUPERVISION5. OFFICIAL POSITION TITLE6. DESCRIPTION OF DUTIESSECRET
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## SECTION XIII**SECRET**(When Filled In)CHILDREN AND OTHER DEPENDENTS1. NUMBER OF CHILDREN (Including stepchildren and adopted children) WHO ARE UNMARRIED, UNDER 21 YEARS OF AGE, AND ARE NOT SELF-SUPPORTING.22. NUMBER OF OTHER DEPENDENTS (Including parents, stepparents, etc.) WHO DEPEND ON YOU FOR AT LEAST 50% OF THEIR SUPPORT, OR, CHILDREN OVER 21 YEARS OF AGE, WHO ARE NOT SELF-SUPPORTING.13. PROVIDE THE FOLLOWING INFORMATION FOR ALL CHILDREN AND DEPENDENTS| NAME             | RELATIONSHIP | YEAR OF BIRTH | SEX | CITIZENSHIP | ADDRESS                                      || ---------------- | ------------ | ------------- | --- | ----------- | -------------------------------------------- || Anna Tarasoff    | wife         | 1923          | x   | USA         | 2819- Gainsville Str. S.E., Washington, D.C. || Barbara Tarasoff | daughter     | 1945          | x   | USA         | same as above                                || Raymond Tarasoff | son          | 1949          | x   | USA         | same as above                                |ADDITIONAL COMMENT AND/OR CONTINUATION OF PRECEDING ITEMSPlaces of residence:EOD Date: 20 Feb 195618 Feb 1956 - 7 Jul 1956 Wesley Hall, 1426 21st Str., Washington, N.W., D.C.7 Jul 1956 - 1 Dec 1956 3605 - Minnesota Ave. S.E., Washington, D.C.1 Dec 1956 - Present 2819 - Gainsville Str. S.E., Washington, D.C.DATE COMPLETED 19 Jul 1957SIGNATURE OF EMPLOYEE Boris D. TarasoffSECRET16
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![logo of Central Intelligence Agency]## SECRECY AGREEMENTDate1.  I am aware of the fact that the Central Intelligence Agency by reason of the sensitive nature of its work, must observe very strict security measures.2.  I agree to honor the requests of the Central Intelligence Agency relative to my application for employment or rendition of services whether it be accepted or rejected.3.  I agree not to inform anyone that I am being considered for a position in the Central Intelligence Agency, unless specifically authorized by a representative of the Central Intelligence Agency.4.  I agree not to disclose processing procedures I have observed in the Central Intelligence Agency.5.  I agree not to discuss by name or otherwise, any individuals with whom I have talked in the course of my application for employment to the Central Intelligence Agency.SignatureWitnessFORM NO. 2701 OCT 54
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# PERSONAL HISTORY STATEMENT![Signature]
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> [Figure: Handwritten document, difficult to read due to image quality.]> The document contains several lines of text written on what appears to be lined paper. Due to the poor quality of the image, individual words and sentences are not decipherable.
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GEOTOMOLOGICAL INVESTIGATIONSOIL PERIOD AND FLOOD BOARD ROAD BED EMPLOYMENT AREA AT TAX ROODAGRI- EMPLOYMENT AIVE ADDRESS AT TAX ROOD DID DURINGNOT FINAL TOYO
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