Francesco/who-killed-jfk huggingface dataset:
[104-10194-10022.pdf — page 103]
SECRET.SECTION DI1. PRESENT STATUS: Married2. NAME OF SPOUSE: Waylon IsID:LOO Veronica3. DATE OF BIRTH: May 23 19144. PLACE OF BIRTH: Dubois, Pa., USA.5. OCCUPATION: Administrative Asst6. PRESENT EMPLOYER: CIA7. CITIZENSHIP: US8. FORMER CITIZENSHIPS COUNTRY(IES): None9. DATE U S CITIZENSHIP ACQUIRED: N/ASECTION XDEPENDENT CHILDREN AND DEPENDENTS OTHER THAN SPOUSE| NAME                 | RELATIONSHIP | DATE AND PLACE OF BIRTH | CITIZENSHIP | PERMANENT ADDRESS || -------------------- | ------------ | ----------------------- | ----------- | ----------------- || Frances R. Hidalgo   | daughter     | Feb 23 1950 NYC NY     | US          | Alexandria, Va    || Balmes N. Hidalgo Sr. | father       | Dec 15 1890 Puerto Rico | IC          | NYC NY            || Rose Hidalgo         | mother       | Jan 12 1892 Spain       | US          | NYC NY            |SECTION XIPROFESSIONAL SOCIETIES AND OTHER ORGANIZATIONS| NAME AND CHAPTER                         | ADDRESS                 | DATE OF MEMBERSHIP |   || --------------------------------------- | ----------------------- | ------------------ | - || American Red Cross Civil Defense team   | Montgomery Ctr, Md.    | 1964               | Present  || Franconia Volunteer Fire Department     | Franconia, Va           | 1958               | 1963    || Rockville Volunteer Fire Department     | Rockville, Ma           | 1964               | Present  || International Rescue and First Aid Association |                         | 1967               | Present  |DATE: 9 Feb 1968SECRET-7-
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SECRET(When Filled in)# LANGUAGE PROFICIENCY AND AWARDS DATA1. PERSONNEL SERIAL NO. 11-612. LDNO3. MAME-17-24)4. COMPONENT5. GRADE6. DATE OF DIRTH7. LANGUAGE8. CODE 25-27)9. DATE OF TEST10. ANNIVERSARY DATE 126-33)11. TEST PURPOSE12. TEST SCORES READING (34) WRITING (35) PRONUNCIATION (30) SPEAKING (37) UNDERSTANDING (38)    13 ELIGIBILITY (39)    AWARDABLE    NOT    AWARDABLE    AWARD    KILL    :T14. I CERTIFY THIS EMPLOYEE FOR AWARD15. TYPE OF AWARD    BIONATURE    DATE    A.M    C    R.W.S16. AMOUNT OF AWARD    $17. I CENTJPY THAT FUNDS ARE AVAILABLE    OBLIGATION REF. NO.    SIGNATURE18. FEDERAL TAX DEDUCTION    $20. CHARGE ALLOTMENT NO.    DATE19. STATE/DC TAX DEDUCTION    $    22 EMPLOYEE PAYROLL NO.21. NET AMOUNT OF AWARD    $23. FORWARD CHECK TO    24 ALLOTMENT OF ASSIGNMENT    FORM    4.58 1273 USE PREVIOUS EDITIONS25. CHECK NO.    DATESECRET(10-43) MRD COPY---SECRET(When Filled In)# LANGUAGE PROFICIENCY AND AWARDS DATA1. PERGONNEL SERIAL NO. 11-61   2 LD NO.2. NAME (7-24)4. COMPONENT5. GRADE6. DATE OF BIRTH7. LANGUAGE8. CODE (25-27)9. DATE OF TEST10. ANNIVERSARY CATE (28-33)11. TEST PURPOSE12. TEST SCORES READING (34) WRITING (35) PRONUNCIATION (36) SPEAKING (37) UNDERSTANDING (38)13. ELIGIBILITY (39)    AWARDABLE    NOT    AWARDABLE    AWARD    SAILL14. I CERTIFY THIS EMPLOYEE FOR AWARD15. TYPE OF AWARD    SIGNATURE    DATE    A.M    C    R.W.S16. AMOUNT OF AWARD    $17. I CERTIFY THAT FUNDS ARE AVAILABLE    OBLIGATION REF. NO.    SIGNATURE18. FEDERAL TAX DEDUCTION    $20. CHARGE ALLOTMENT NO.    DATE19. STATE/DC TAX DEDUCTION    $22. EMPLOYEE PAYROLL NO.21. NET AMOUNT OF AWARD    $23. FORWARD CHECK TO24. ALLOTMENT OF ASSIGNMENT    FORM    4-58 1273 USE PREVIOUS EDITIONS25. CHECK NO.    DATESECRET(10-45) MRD COPY
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# SECRET(When Filled In')# LANGUAGE DATA RECORDPART I-GENERAL127 6301. NAME (Lost-Firet-Middle)   Hidalgo, Palmes Nieves JR3. LANGUAGESpanish 7202. DATE OF BIRTH   May 27 19124. TODAY'S DATE   lay 9 19585. I HAVE NO PROFICIENCY IN ANY FOREIGN LANGUAGEPART 11-LANGUAGE ELEMENTSSECTION A.Reading (40)1. I CAN READ TENTS OF ANY DIFFICULTY. OF A GENERAL MATURE CA IN FIFITS I AM FAMILIAN BIT, ISINI. THE DICTIONARY ONLY RARELY.2. I CAN READ TEXTS OF MOST CHADES OF DIFFICULTY OF A MANATOM 11141 AM FAMILIAH PITH. LUST THE DICTIONARY OCCASIONALLY.3. I CAN READ TEXTS OF AVERAGE DIFFICULTY (nesspapers, reference materials, etc.). USING THE DICTIONARY FREQUENTLY.4. I CAN REAU SIMPLE TEXTS, SUCH AS STREET SIGNS, NEWSPAPER HEADLINES. ETC.. USING THE DICTIONARY FREQUENTLY.5. I HAVE NO READING ABILITY IN THE LANGUAGE.SECTION B.Writing (41)1. I CAN WRITE PERSONAL LETTERS AND SIMILAR MATERIAL #ITH COMPLETE SUCCESS DIMOUT USING THE DICTIONARY. I CAN BRITE FACTUAL NARRATIVE AND EXPOSITORY MATERIAL #ITH REASONABLE CLARITY, ITH VERY FEW GRAMMATICAL ERRORS. IN NATIVE STYLE, USING THE DICTIONARY ONLY RARELY.2. I CAN WRITE PERSONAL LETTERS AND SIMILAR SIMPLE MATERIAL WITH COMPLETE SUCCESS, USING THE DICTIONARY ONLY RARELY. I CAN BRITE FACTUAL NARRATIVE AND EXPOSITORY MATERIAL BITH PERSONABLE CLARITY, WITH FER GRAMMATICAL ERRORS, BUT IN A STYLE WHICH MAY NOT BE NATIVE, USING THE DICTIONARY OCCASIONALLY.3. I CAN WRITE PERSONAL LETTERS AND SIMILAR SIMPLE MATERIAL, WITH REASONABLE SUCCESS IN CONVEYING MY MEANING. BUT WITH OCCASIONAL MINOR GRAMMATICAL ERRORS AND IN OBVIOUSLY FOREIGN BARD STYLE, USING THE DICTIONARY OCCASIONALLY.4. I CAN WRITE PERSONAL LETTERS AND SIMILAR SIMPLE MATERIAL, WITH PEASONABLE SLUCCESS IN CONVEYING, MY MEANING, BUT WITH MANY GRAMMATICAL ERRORS AND IN A VERY FOREIGN AWKWARD STYLE. USING THE DICTIONARY FREQUENTLY.5. I CANNOT WRITE IN THE LANGUAGE.SECTION C.Pronunciation (42)1. MY PRONUNCIATION IS NATIVE.2. WHILE NATIVES CAN DETECT AN ACCENT IN MY PRONUNCIATION THEY HAVE NO DIFFICULTY UNDERSTANDING ME.3. MY PRONUNCIATION IS OBVIOUSLY FOREIGN. BUT ONLY RARELY CAUSES DIFFICULTY FOR NATIVES TO UNDERSTAND.4. MY PRONUNCIATION IS OCCASIONALLY DIFFICULT FOR NATIVES TO UNDERSTAND.5. IMAVE NO SKILL IN PRONUNCIATION.CONTINLE ON REVERSE SIDESECRETFORM NO, 444C1 FER 37
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CONTINUATION OF PART 11-LANGUAGE ELEMENTSSECTION D. Speaking (43)1. I SPEAR FLUENTLY AND ACCURATELY IN ALL PRACTICAL AND SOCIAL SITUATIONS I CONVERSE FREELY AND IDIOMATICALLY IN ALL FIELDS WITH NICHIAM FAMILIAR.2. I SPEAK FLUENTLY AND ACCURATELY IN NEARLY ALL PRACTICAL AND SOCIAL SITUATIONS I CAN CONVERSE IN MOST FIELDS IN NICHIAM FAMILIAR AND I EMPLOY SOME POPULAR SAVINGS, LITERARY QUOTATIONS. AND COMMON PROVERBS.3. I GET ALONG QUITE WELL IN SITUATIONS OF DAILY LIFE AND TRAVEL AND CAN CONDUCT ROUTINE BUSINESS IN PARTICULAR FIELDS.4. I MANAGE TO GET ALONG IN THE MOST COMMON SITUATIONS OF DAILY LIFE AND TRAVEL.5. I HAVE NO ABILITY TO USE THE LANGUAGE IN ANY OF THE ABOVE RESPECTS.SECTION E. Understanding (4)1. I UNDERSTAND NON TECHNICAL CONVERSATION ON ALL SURJECTS, BOTH FACE TO FACE AND ON THE TELEPHONE I UNDERSTAND NEARLY EVERYTHING I HEAR ON THE RALIO AND AT THE MOVIES. PLAYS, AND LECTURES.2. I UNDERSTAND NON TECHNICAL CONVERSATION ON NEARLY ALL SUBJECTS, BOTH FACE TO FACE AND ON THE TELEPHONE: 1 UNDERSTAND MOST OF WHAT I HEAR ON THE RADIO AND AT THE MOVIES, PLAYS, AND LECTURES. INCLUDING MOST JOKES AND PUNS.3. I UNDERSTAND WEARLY ALL CONVERSATION ON TOPICS OF DAILY LIFE AND TRAVEL, BOTH FACE TO FACE AND ON THE TELE- PHONEL I UNDERSTAND MUCH OF WHAT I HEAR ON THE RADIO, AND AT THE MOVIES, PLAYS, AND LECTURES.4. I UNDERSTAND THE SIMPLEST CONVERSATION, BOTH FACE TO FACE AND ON THE TELEPHONE: I UNDERSTAND SOME OF WHAT I HEAR ON THE RADIO AND AT THE MOVIES, PLAYS, AND LECTURES.5. I AM NOT ABLE TO UNDERSTAND THE SPOKEN LANGUAGE.BEFORE CONTINUING - CHECK PART 11 TO ENSURE THAT YOU HAVE CIRCLED ONE NUMBER PER SECTION.PART 111-EXPERIENCE AS TRANSLATOR OR INTERPRETER (45)1. 1 HAVE MAD EXPERIENCE AS A TRANSLATOR.2. I HAVE HAD EXPERIENCE AS AN INTERPRETER.3. BOTH OF THE ABOVE STATEMENTS APPLY.4. NONE OF THE ABOVE STATEMENTS APPLY.PART IV-CERTIFICATIONI CERTIFY THAT THE INFORMATION GIVEN ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND BELIEF. THIS CERTIFICATION CONSTITUTES MY APPLICATION FOR A MAINTENANCE AWARD PROVIDED I AM ELIGIBLE UNDER THE TERMS OF REGULATION NO. 25-115. PAR. IC(4). I UNDERSTAND THAT I MUST PASS AN OBJECTIVE LANGUAGE PROFICIENCY TEST BEFORE I BECOME ELIGIBLE FOR AN AWARD, IND THAT IRRESPECTIVE OF THE DATE OF TESTING, ANNUAL MAINTENANCE AWARDS WILL BE CUMULATIVE A' OF THE ANNIVERSARY DATE OF COMPLETING THIS FORM.DATE SIGNEDI 9 hiny 1958.SIGNATURE
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# LANGUAGE DATA RECORDSECRETPART I-GENERAL1. NAME (Last-First-Middle)   Hidalgo, Balmes Nieves JR2. DATE OF BIRTHMay 27 1993. LANGUAGEPortuguese 6304. TODAY'S DATEMay 9 19585. I HAVE NO PROFICIENCY IN ANY FOREIGN LANGUAGEPART II-LANGUAGE ELEMENTS## SECTION A. Reading (40)1. I CAN READ TEXTS OF ANY DIFFICULTY, OF A GENERAL NATURE OR IN FIELDS I AM FAMILIAR WITH, USING THE DICTIONARY ONLY RARELY.2. I CAN READ TEXTS OF MOST GRADES OF DIFFICULTY, OF A GENERAL NATURE OR IN FIELDS I AM FAMILIAR WITH, USING THE DICTIONARY OCCASIONALLY.3. I CAN READ TEXTS OF AVERAGE DIFFICULTY (newspapers, reference materials, etc.), USING THE DICTIONARY FREQUENTLY.4. I CAN READ SIMPLE TEXTS, SUCH AS STREET SIGNS, NEWSPAPER HEADLINES, ETC. USING THE DICTIONARY FREQUENTLY.5. I HAVE NO READING ABILITY IN THE LANGUAGE.## SECTION B. Writing (41)1. I CAN WRITE PERSONAL LETTERS AND SIMILAR MATERIAL WITH COMPLETE SUCCESS WITHOUT USING THE DICTIONARY. I CAN WRITE FACTUAL NARRATIVE AND EXPOSITORY MATERIAL WITH REASONABLE CLARITY, WITH VERY FEW GRAMMATICAL ERRORS. IN NATIVE STYLE, USING THE DICTIONARY ONLY RARELY.2. I CAN WRITE PERSONAL LETTERS AND SIMILAR SIMPLE MATERIAL WITH COMPLETE SUCCESS, USING THE DICTIONARY ONLY RARELY. I CAN WRITE FACTUAL NARRATIVE AND EXPOSITORY MATERIAL WITH REASONABLE CLARITY. WITH FEW GRAMMATICAL ERRORS, BUT IN A STYLE WHICH MAY NOT BE NATIVE, USING THE DICTIONARY OCCASIONALLY.3. I CAN WRITE PERSONAL LETTERS AND SIMILAR SIMPLE MATERIAL, WITH REASONABLE SUCCESS IN CONVEYING MY MEANING, BUT WITH OCCASIONAL, MINOR GRAMMATICAL ERRORS AND IN OBVIOUSLY FOREIGN, AWKWARD STYLE, USING THE DICTIONARY OCCASIONALLY.4. I CAN WRITE PERSONAL LETTERS AND SIMILAR SIMPLE MATERIAL, WITH REASONABLE SUCCESS IN CONVEYING MY MEANING, BUT WITH MANY GRAMMATICAL ERRORS AND IN A VERY FOREIGN, AWKWARD STYLE: USING THE DICTIONARY FREQUENTLY.5. I CANNOT WRITE IN THE LANGUAGE.## SECTION C. Pronunciation (42)1. MY PRONUNCIATION IS NATIVE.2. WHILE NATIVES CAN DETECT AN ACCENT IN MY PRONUNCIATION THEY HAVE NO DIFFICULTY UNDERSTANDING ME.3. MY PRONUNCIATION IS OBVIOUSLY FOREIGN, BUT ONLY RARELY CAUSES DIFFICULTY FOR NATIVES TO UNDERSTAND.4. MY PRONUNCIATION IS OCCASIONALLY DIFFICULT FOR NATIVES TO UNDERSTAND.5. I HAVE NO SKILL IN PRONUNCIATION.
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CONTINUATION OF PART II-LANGUAGE ELEMENTSSECTION 2. Speaking (43)1. I SPEAK FLUENTLY AND ACCURATELY IN ALL PRACTICAL AND SOCIAL SITUATIONS. I CONVERSE FREELY AND IDIOMATICALLY IN ALL FIELDS WITH WHICH I AM FAMILIAR.2. I SPEAK FLUENTLY AND ACCURATELY IN NEARLY ALL PRACTICAL AND SOCIAL SITUATIONS. I CAN CONVERSE IN MOST FIELDS WITH WHICH I AM FAMILIAR AND I EMPLOY SOME POPULAR SAYINGS, LITERARY QUOTATIONS, AND COMMON PROVERBS.3. I GET ALONG QUITE WELL IN SITUATIONS OF DAILY LIFE AND TRAVEL AND CAN CONDUCT ROUTINE BUSINESS IN PARTICULAR FIELDS4. I MANAGE TO GET ALONG IN THE MOST COMMON SITUATIONS OF DAILY LIFE AND TRAVEL.5. I HAVE NO ABILITY TO USE THE LANGUAGE IN ANY OF THE ABOVE RESPECTS.SECTION E. Understanding (44)1. I UNDERSTAND NON-TECHNICAL CONVERSATION ON ALL SUBJECTS, BOTH FACE-TO-FACE AND ON THE TELEPHONE: I UNDERSTAND NEARLY EVERYTHING I HEAR ON THE RADIO AND AT THE MOVIES, PLAYS, AND LECTURES.2. I UNDERSTAND NON-TECHNICAL CONVERSATION ON NEARLY ALL SUBJECTS, BOTH FACE-TO-FACE AND ON THE TELEPHONE. I UNDERSTAND MOST OF WHAT I HEAR ON THE RADIO AND AT THE MOVIES, PLAYS, AND LECTURES, INCLUDING MOST JOKES AND PUNS.3. I UNDERSTAND NEARLY ALL CONVERSATION ON TOPICS OF DAILY LIFE AND TRAVEL, BOTH FACE-TO-FACE AND ON THE TELEPHONE: I UNDERSTAND MUCH OF WHAT I HEAR ON THE RADIO, AND AT THE MOVIES, PLAYS, AND LECTURES.4. I UNDERSTAND THE SIMPLEST CONVERSATION, BOTH FACE-TO-FACE AND ON THE TELEPHONE: I UNDERSTAND SOME OF WHAT I HEAR ON THE RADIO AND AT THE MOVIES, PLAYS, AND LECTURES.5. I AM NOT ABLE TO UNDERSTAND THE SPOKEN LANGUAGE.BEFORE CONTINUING - CHECK PART II TO ENSURE THAT YOU HAVE CIRCLED ONE NUMBER PER SECTION.PART III-EXPERIENCE AS TRANSLATOR OR INTERPRETER (45)1. I HAVE HAD EXPERIENCE AS A TRANSLATOR.2. I HAVE HAD EXPERIENCE AS AN INTERPRETER.3. BOTH OF THE ABOVE STATEMENTS APPLY.4. NONE OF THE ABOVE STATEMENTS APPLY.PART IV-CERTIFICATIONI CERTIFY THAT THE INFORMATION GIVEN ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND BELIEF. THIS CERTIFICATION CONSTITUTES MY APPLICATION FOR A MAINTENANCE AWARD PROVIDED I AM ELIGIBLE UNDER THE TERMS OF REGULATION NO. 25-115, PAR. C(4). I UNDERSTAND THAT I MUST PASS AN OBJECTIVE LANGUAGE PROFICIENCY TEST BEFORE I BECOME ELIGIBLE FOR AN AWARD, AND THAT IRRESPECTIVE OF THE DATE OF TESTING, ANNUAL MAINTENANCE AWARDS WILL BE CUMULATIVE AS OF THE ANNIVERSARY DATE OF COMPLETING THIS FORM.DATE SIGNED SIGNATURE9. May 1958  /s/ Balazs, B Felix
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CONFIDENTIALSECURITY APPROVALDATE : 17 April 1964YOURREFERENCE: 18658 DDP/SASCASE NO.: 65077TO : Director of PersonnelATTN :SUBJECT : HIDALGO, Balmes Nieves, Jr.1. This is to inform you that Subject has been approved for the appointment specified in your request under the provisions of Headquarters Regulations 10-3 and 20-5 including access to classified information through TOP SECRET as required in the performance of duties.2. Unless arrangements are made within 60 days for entrance on duty within 120 days, this approval becomes invalid.3. As part of the entrance on duty processing:A personal interview in the Office of Security must be arranged.A personal interview is not necessary.Please advise Chief, Clearance Branch, extension 5620 when Subject enters on duty.4. This is a conversion case.FOR THE DIRECTOR OF SECURITY:![signature of W. A. Cobarne]W. A. CobarneChief, Personnel Security Division
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CONFIDENTIAL(When Filled In)STAFF AGENT CLEARANCEDATE : 22 April 1963YOUR REFERENCE: Memorandum of 19 April 1963CASE NO. : 65077TO : Chief, Contract Personnel DivisionATTH. : Staff Agents BranchSUBJECT : Hedrige B Jr.1. This is to advise that a security clearance is granted for the employ- ment of the Subject as a Staff Agent, OS-11, by DDP/SAS in the capacity of Oper- ations Officer under Project JMWAVE.2. If your office should desire at a later date to change the status or use of the Subject, a request to cover any proposed change should be submitted to this office.3. Unless arrangements are made within 60 days for entrance on duty within 120 days, this Approval becomes invalid.4. As a part of entrance on duty processing:A personal interview in the Office of Security must be arranged by your office.A personal interview is not necessary.W. a. OdomeW. A. OsborneCONFIDENTIAL
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CONFIDENTIAL(WHEN FILLED IN)SECURITY APPROVALDATE: 10 March 1958YOURREFERENCE:CASE NO.: 65077TO: Director of PersonnelFROM: Director of SecuritySUBJECT: HIDALGO, Balmes Nieves1. This is to inform you of security approval of the subject person as follows:*   Subject has been approved for the appointment specified in your request under the provisions of Regulations 10-210 and 20-730, including access to classified information through Top Secret as required in the performance of his duties.*   Subject has been approved for appointment under the authority of Paragraph 4(d) of Regulation 10-210, and under Regulation 20-730 including access to classified information through Top Secret as required in the performance of his duties.2. Unless arrangements are made within 60 days for entrance on duty within 120 days, this approval becomes invalid.3. As part of the entrance on duty processing:*   A personal interview in the Office of Security must be arranged.*   A personal interview is not necessary.*   This clearance is issued in advance of receipt of a SP-377. Subject will be assigned to the WH Division.FOR THE DIRECTOR OF SECURITY:![signature of W. M. Knott]W. M. KnottChief, Personnel Security DivisionFORM NO. 1173 REPLACES FORM 38-1001 MAR 57 WHICH IS OBSOLETECONFIDENTIAL(5)
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SEGRETBIOGRAPHIC INFORMATIONName:Ralnos N. HIDALGO, Jr.Grade:GS-11Service Designation:CIDate and Place of Birth:27 May 1919Havana, CubaMarital Status:MarriedEducation and Career Outside the Agency:1945-46 New York University - No degree (2 yrs)Nov 45-Dec 49 FBI, Eastern part of United States -Undercover AgentLanguages:Spanish - FluentPortuguese & French - FairMilitary Duty:27 Mar 39-27 Sep 1943 New York National Guard(Federalized Oct 40) U.S. ArmyCIA Experience:18 Feb 52 Ex Appt., Contract Employee, CS-9, DDP/WH/HYPOTHESIS, Panama City, Panama1 Feb 56 Promotion, Contract Employee, GS-11, DDP/WH, HYPOTHESIS, Panama City, PanamaCIA Training:Covert training
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CONFIDENTIAL(When Filled In)INSTRUCTIONS: COMPLETE IN DUPLICATE. THE DATA RECORDED ON THIS FORM IS ESSENTIAL IN DETERMINING TRAVEL EXPENSESALLOWABLE IN CONNECTION WITH LEAVE AT GOVERNMENT EXPENSE, OVERSEAS DUTY, RETURN TO RESIDENCE UPON SEPARATION, ANDFOR PROVIDING CURRENT RESIDENCE AND DEPENDENCY INFORMATION REQUIRED IN THE EVENT OF AN EMPLOYEE EMERGENCY. THEORIGINAL OF THIS FORM WILL BE FILED IN THE EMPLOYEE'S OFFICIAL PERSONNEL FOLDER.NAME OF EMPLOYEE(Last) (First) (Middle)HIDALGO JR BALMES NIEVES1. RESIDENCE DATA   PLACE OF RESIDENCE WHEN APPOINTED LAST PLACE OF RESIDENCE IN CONTINENTAL U.S. (If appointed abroad)   D.C.   PLACE IN CONTINENTAL U.S. DESIGNATED AS PERMANENT RESIDENCE   D.C.2. MARITAL STATUS   CHECK (X) ONE: SINGLE [ ] MARRIED [x] SEPARATED [ ] DIVORCED [ ] WIDOWED [ ] ANNULLED [ ]IF MARRIED, INDICATE PLACE OF MARRIAGE DATE OF MARRIAGEBELZONI MISS. USA 9-APR-1943IF DIVORCED, PLACE OF DIVORCE DECREE DATE OF DECREEIF WIDOWED, INDICATE PLACE SPOUSE DIED DATE SPOUSE DIEDIF PREVIOUSLY MARRIED, INDICATE NAME(S) OF SPOUSE REASON(S) FOR TERMINATION, AND DATE(S)3. MEMBERS OF FAMILY   NAME OF SPOUSE ADDRESS (No., Street, City, Zone, State) TELEPHONE NUMBER   LOUISE HIDALGO   NAMES OF CHILDREN ADDRESS SEX AGE   LUZ MARIA F 13   FRANCES REBECCA F 9NAME OF FATHER (Or male guardian) ADDRESS TELEPHONE NUMBERBALMES N HIDALGONAME OF MOTHER (Or female guardian) ADDRESS TELEPHONE NUMBERROSE HIDALGOWHAT MEMBER(S) OF YOUR FAMILY HAS BEEN TOLD OF YOUR AFFILIATION WITH THE AGENCY FOR EMERGENCY PURPOSES?WIFE4. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY   NAME (Mr., Mrs., Miss) (Last-First-Middle) RELATIONSHIP   HIDALGO LOUISE WIFE   HOME ADDRESS (No., Street, City, Zone, State) HOME TELEPHONE NUMBERBUSINESS ADDRESS (No., Street, City, Zone, State) AND NAME OF EMPLOYER, IF APPLICABLE BUSINESS TELEPHONE & EXTENSIONIS THE INDIVIDUAL NAMED ABOVE AWARE OF YOUR AGENCY AFFILIATION?[x] YES [ ] NOIS THIS INDIVIDUAL AUTHORIZED TO MAKE DECISIONS ON YOUR BEHALF?[x] YES [ ] NODOES THIS INDIVIDUAL KNOW THAT HE HAS BEEN DESIGNATED AS YOUR EMERGENCY ADDRESSEE?[x] YES [ ] NOTHE PERSONS NAMED IN ITEM 3 ABOVE MAY ALSO BE NOTIFIED IN CASE OF EMERGENCY. IF SUCH NOTIFICATION IS NOT DESIRABLEBECAUSE OF HEALTH OR OTHER REASONS, PLEASE SO STATE IN ITEM 7 ON THE REVERSE SIDE OF THIS FORM.5. VOLUNTARY ENTRIES   INDICATE ANY BANKING INSTITUTIONS WITH WHICH YOU HAVE ACCOUNTS   GREENWICH SAVINGS BANKCONTINUED ON REVERSE SIDECURRENT RESIDENCE AND DEPENDENCY REPORTFORM NO. USE PREVIOUS1 JAN 57 61 EDITIONS.CONFIDENTIAL
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CONFIDENTIAL(When Filled In)S. (CONTINUED)IN WHOSE NAME(S) ARE THE ACCOUNTS LISTED?Barnes N. Middleton f/k/a Louise MiddletonHAVE YOU COMPLETED A LAST WILL AND TESTAMENT?HAVE YOU EXECUTED A POWER OF ATTORNEY?6. ADDITIONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMSDo NOT notify OTHER PERSONS in ITEM 3 of.EMERGENCY. UNLESS wife is NOT AVAILABLE.SIGNED ATDATESIGNATURECONFIDENTIAL
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PART IIL—DETERMINING CREDITABLE SERVICEAND SERVICE COMPUTATION DATE FORLEAVE PURPOSESTOTAL SERVICE (Item 12)NONCREDITABLE SERVICE (Item 13)CREDITABLE SERVICE (Leave purposes)ENTRANCE ON DUTY DATE (Present agency)LESS CREDITABLE SERVICE (Leave purposes)SERVICE COMPUTATION DATE (Leave purposes)| YEARS | MONTHS | DAYS || ----- | ------ | ---- ||       |        |      ||       |        |      || 54    | 3      | 17   || 11    | E      | 1    || 46    | 7      | 16   |PART 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)TOTAL SERVICE (Item 12)NONCREDITABLE SERVICE (Item 14)CREDITABLE SERVICE (RIF purposes)ENTRANCE ON DUTY DATE (Present agency)LESS CREDITABLE SERVICE (RIF purpose)SERVICE COMPUTATION DATE (RIF purpose).(Enter as the "service computation date on the employee's "Service Record Card," SP-7)| YEARS | MONTHS | DAYS || ----- | ------ | ---- ||       |        |      ||       |        |      ||       |        |      ||       |        |      ||       |        |      |REMARKS:
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# PERSONAL HISTORY STATEMENT![Personal History Statement]HAVE YOU READ AND DO YOU UNDERSTAND THE INSTRUCTIONS?## 1: PERSONAL BACKGROUNDFULL NAMEALIAS/NICKNAMES/MAIDEN NAMES (If Applicable)DATE OF BIRTHPLACE OF BIRTHAGESEXHEIGHTWEIGHTEYE COLORHAIR COLORDRIVER'S LICENSE NUMBER AND STATESOCIAL SECURITY NUMBERDO YOU HAVE A VALID PASSPORT? YES NOPASSPORT NUMBERSTATE OF ISSUANCEHAVE YOU EVER SERVED IN THE MILITARY? YES NOBRANCHDATE OF ENLISTMENTDATE OF SEPARATIONTYPE OF SEPARATIONRANK AT SEPARATIONARE YOU CURRENTLY EMPLOYED? YES NOEMPLOYERADDRESSCITYSTATEZIP CODEPHONESUPERVISOR NAMEPOSITIONSTARTING DATEENDING DATEREASON FOR SEPARATION
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REVISE DRAFTMEMORANDUMTO: ALL DEPARTMENT OF HEALTH EMPLOYEESFROM: [Illegible] (A.G.)DATE: [Illegible]SUBJECT: POLICY RE-CONVEYANCINGThe Department of Health has revised its policy regarding re-conveyancing of state-owned property to include all types of property. The revised policy now reads as follows:"Re-conveyancing of state-owned property is prohibited, except where the re-conveyance is to a state or local government entity for a public purpose. The Department of Health shall determine whether a proposed re-conveyance meets the requirements of this policy."This policy applies to all employees of the Department of Health. Violations of this policy may result in disciplinary action, up to and including termination of employment.
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14-00000![document page]
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## DATE OF BIRTH:## PLACE OF BIRTH:## TOWN, OUTSIDE THE IMMEDIATE MAIN AND PLACE OF ENTRY:## IF PLACE IS UNKNOWN WHY?## LIST ALL OTHER NAMES EVER USED AND DATES USED UNDER:## ACCOUNT FOR RELATIVE BY BLOOD, MARRIAGE OR ADOPTION, WHO RESIDE IN THE UNITED STATES OR WHO ARE NOT CITIZENS OF THE UNITED STATES:## ACCOUNT FOR RELATIVE BY BLOOD, MARRIAGE OR ADOPTION NOT RESIDING IN THE UNITED STATES OR A FOREIGN GOVERNMENT:
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REMARKS BY GOVERNOR JOHN Y. BROWNDEMOCRATIC NATIONAL CONVENTIONSAN FRANCISCO, CALIFORNIAJULY 12, 1984My friends, for years, Kentucky has been the land of beautiful horses and fast basketball. Now, we are known as the home of Wendell Ford and Walter Huddleston. For years, we sent colorful characters to Washington. Now, we send statesmen.Walter Mondale needed two things to be President. One, a winning record. Two, a strong team to help him govern. In 1980, he needed to carry at least 20 states to win. He carried only 13, In 1984, he must carry at least 30.He needed somebody who knew how to carry states, who could pull the votes from the South. He came to Kentucky and found Martha Layne Collins. She is an outstanding running mate.He needed somebody who knew the mind of the people, who understood their hopes and dreams. He chose a brilliant and compassionate woman.He needed somebody who would give him a broader base and more appeal. He selected a Governor who had achieved the unusual: the ability to communicate with all people. He went to Kentucky and found Martha Layne Collins.In 1980, the Republicans carried Kentucky by 160,000 votes. It had been 20 years since they had won the state. In 1983, Martha Layne Collins brought Kentucky back to the Democratic Party and into the future.With Walter Mondale, she will do that for America.Vote Democratic.Paid for by the Democratic National Committee, Charles T. Manatt, Chairman