[104-10194-10012.pdf — page 313]
23. REFERENCES - List three persons living in the United States or Territories who are NOT related to you by blood or marriage with whom you have had business or social dealings. Do not repeat names of supervisors listed under Item 15 (c) above.)| FULL NAME            | BUSINESS OR HOME ADDRESS (Give complete address including street and number) | BUSINESS OF OCCUPATION || -------------------- | ---------------------------------------------------------------------------- | ---------------------- || Buford Ellis         | Farmers & Merchants National Bank. Abilene, Texas                            | Bank Pres.             || Dr. H. A. Richardson | President of Hardin Simmons Univ.                                            | Pres. of Univ.         || Mrs. J. H. Robnett   | 1738 21st., Wash., D.C.                                                      |                        |24. May inquiry be made of your present employer regarding your character qualifications etc.?    Indicate "Yes" or "No" answer by placing X in proper column:| YES | NO  || --- | --- ||     | X   |25. Are you a citizen of the United States?| YES | NO  || --- | --- || X   |     |26. Do you advocate or have you ever advocated or are you now or have you ever been a member of any organization that advocates the overthrow of the Government of the United States by force of violence?    If your answer is "Yes" give complete details in Item 38| YES | NO  || --- | --- ||     | X   |27. Within the past 12 months, have you habitually used intoxicating beverages to excess?| YES | NO  || --- | --- ||     | X   |28. Since your 16th birthday have you ever been convicted of fined, or imprisoned or placed on probation or forfeiting collateral for the violation of any law (including minor traffic ordinance or regulation or ordinance including minor traffic ordinance violations for which a fine of $25 or less was imposed.)    If your answer is "Yes" list all such cases under Item 38. Give in each case (1) the date (2) the nature of the violation (3) the name and location of the Court (4) the penalty imposed if any or other disposition of the case. If finger- your fingerprints will be taken| YES | NO  || --- | --- || X   |     |29. Have you ever been discharged or forced to resign for unsatisfactory service from any position?    If your answer is "Yes" give in Item 38 the name and address of employer date and reason in each case| YES | NO  || --- | --- ||     | X   |30. Do you receive an annuity from the U. S. or D. C. Government under any retirement act for any pension or other compensation for military or naval service?    If your answer is "Yes", give in Item 38 reason for retirement, that is age optional disability or by reason of voluntary or involuntary separation after a years' service, amount of retirement pay and under what retirement act and rating if retired from military or naval service| YES | NO  || --- | --- ||     | X   |31. Are you an official or employee of any State Territory, county, or municipality?    If your answer is "Yes" give details in Item 38| YES | NO  || --- | --- ||     | X   |32. Does the U. S. Government employ in a civilian capacity any relative of yours (by blood or marriage) with whom you live or have lived within the past 6 months?    If your answer is "Yes" show n Item 38 EACH such relative (1) full name (2) present address (3) relationship (4. department or agency by whom employed and (5) kind of appointment| YES | NO  || --- | --- || X   |     |33. Have you ever had a nervous breakdown?    If your answer is "Yes" give complete details in Item 38| YES | NO  || --- | --- || X   |     |34. Have you ever had tuberculosis?    If your answer is "Yes" give complete details in Item 38| YES | NO  || --- | --- || X   |     |35. Space for detailed answers to other questions (Indicate item numbers to which answers apply).| ITEM No | ITEM || ------- | ---- ||         |      |If more space is required use paper the same size as this page. Write on each sheet your name address date of birth, and examination title.36. Indicate "Yes" or "No" answer by placing X in proper column:| YES | NO  || --- | --- ||     | X   |(1) Were you ever in the United States Military or Naval Service during time of W. W. I?(1) Is the word "honorable or other satisfactory" used in your discharge or separation papers to designate character of your discharge or separation?HonorableWas service performed with full military duty?YesDate of entry or active military service: 6 Jan. 1945 Date of separation or separation: 28 Aug. 1948Branch of service (Army Navy, M. C., C. G. etc.): Navy Grade or rating at separation: Ensign USNR Serial No.: 445048IF YOUR ANSWERS TO THE QUESTIONS (No. 36) INDICATE THAT YOU ARE ENTITLED TO VETERAN PREFERENCE, SUCH PREFERENCE WILL BE CONSIDERED IN THE EXAMINATION. IF APPOINTED, YOU WILL BE REQUIRED TO FURNISH TO THE APPOINTING OFFICER PRIOR TO ENTRY ON DUTY, OFFICIAL EVIDENCE OF HONORABLE SEPARATION FROM ACTIVE MILITARY OR NAVAL FORCES OF THE UNITED STATES DURING TIME OF WAR. DO NOT SUBMIT PHOTOCOPY OF DISCHARGE OR SEPARATION WITH THIS APPLICATION.37. If all you service in the U. S. Military or Naval Service June the ONLY, did you participate in a campaign or expedition on the service ribbon?| YES | NO  || --- | --- ||     | X   |(a) Are you a disabled veteran?(b) Are you the unmarried widow of a veteran?(c) Are you the wife of a veteran who his service connected disability?IF YOUR ANSWER TO QUESTION 36 IS "YES" AND YOU WISH TO CLAIM VETERAN PREFERENCE, ATTACH TO THIS APPLICATION VETERAN PREFERENCE CLAIM CIVIL SERVICE COMMISSION FORM 1461 TOGETHER WITH THE NECESSARY PROOF SPECIFIED THEREINTHIS SPACE FOR USE OF APPOINTING OFFICE ONLYThe information contained in the answers to Question 36 above has been verified by comparison with the discharge certificate on . . . . . . . . . . ., 19. . . . . . .AgencyTitleFALSE STATEMENT ON THIS APPLICATION IS PUNISHABLE BY LAW (U. S. CODE TITLE 18 SECTION 90).I certify that the statements made by me in this application are true complete and correct to the best of my knowledge and belief and are made in good faith.Date: 19 Oct. 1946 Signature of applicant: /s/ J. Waltr Moore