[104-10194-10026.pdf — page 218]
SECRET(When Filled In)REPORT OF SERVICE ABROADTO: Office of Personnel, Transactions and Records Branch, Status Section| SERIAL NO. | NAME                  |                            || ---------- | --------------------- | -------------------------- || 024345     | LAST (Print) Phillips | FIRST 7-24 Daniel MIDDLE a |INSTRUCTIONSUSE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TDY. INSERT APPROPRIATE CODE NUMBER IN "CODE" COLUMNTO UESIGNATE WHETHER SUBMISSION IS OF BASIC DATA, CORRECTION OR CANCELLATION (One only). REPORT DATES OY 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 25-26 | DAY 27-28   | YEAR 29-30 | MONTH 31-32 | DAY 33-34 | YEAR 35-36    |     | 1. PCS (Basic) 5. CORRECTION 9. CANCELLATION | CODE 37 | 38 39 | Domimica     | 40-42 |              |         |      ||             |             |            | 08          | 26        | 67            |     |                                              | 1       |       | Verezuela    | 17    |              |         |      |TDY DATES OF SERVICE|             | ARRIVAL 0/9 |            |             |           | DEPARTURE 0/3 |     |                                              |         |       | TYPE OF DATA |       | O/P USE ONLY | AREA(S) | CODE || ----------- | ----------- | ---------- | ----------- | --------- | ------------- | --- | -------------------------------------------- | ------- | ----- | ------------ | ----- | ------------ | ------- | ---- || MONTH 25-24 | DAY 27-28   | YEAR 29-30 | MONTH 31-32 | DAY 33-34 | YEAR 35-36    |     | 2. TDY (Basic) 4. CORRECTION 0. CANCELLATION | CODE 37 | 38 38 |              | 40-42 |              |         |      ||             |             |            |             |           |               |     |                                              |         |       |              |       |              |         |      |OFFICE OF PERSONNEL USE ONLY PUNCH AREASOURCE DOCUMENT AND CERTIFICATIONTRAVEL VOUCHER![check mark] CABLEOTHER (Specily)DISPATCHDUTY STATUS OR TIME AND ATTENDANCE REPORTDOCUMENT IDENTIFICATION NU.DOCUMENT DATE/PERIODAugust 2 1967REMARKS|     | PREPARED BY                         |                | REPORT ANNOTATED ON CONTROL DOCUMENT | ABOVE DATA CERTIFIED CORRECT. BASED UPON SOURCE DOCUMENT CITED |     || --- | ----------------------------------- | -------------- | ------------------------------------ | -------------------------------------------------------------- | --- || DCO | ![check mark] C & L DIVISION. CTSR. | DATE 16 Aug 67 |                                      | SIGNATURE                                                      |     ||     | ![check mark] C & T DIVISION        |                |                                      |                                                                |     |THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNELIN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDERFORM 1451a OBSOLETE PREVIOUS EDITIONSSECRET(4-10)