Francesco/who-killed-jfk huggingface dataset:
[104-10195-10002.pdf — page 76]
# SECRET(4) You will initially report to this organization, upon assumption of cover status and thereafter on an annual basis, your rate of cover coinpensation. Any changes during the your will also be reported. This organization will pay ay your basic contractual salary (initially $33,260) until such time as reports indicate cover Income in excess of that set out in sub-paragraph two (2) above. You will thereafter be paid at your full rate of compensation loss anticipated carned cover income based on the last report. Adjustments, if any, will be made following receipt of the yearend report. Failure to timely submit reports may result in a delay or suspension of contractual payments due you hereunder.(b) Other Cover Emoluments. With the exception of earned cover income, emoluments (Including benefits in kind) received from or through your cover activities are the property of the Government and will be disposed of at such times and in such a manner as the Government may prescribe.5. Taxes. (a) As an oniployee of the Government, you must satisfy your Federal tax liability on the taxable Income paid to you under paragraph three (3) above. Such income may be said you by or through a cover facility. Because of cover, operational and security considerations, the Tax Committee of this organization is authorised to make certain determinations and establish procedures which will result in the full satisfaction of your Federal income tax liability on said income. It is specifically understood and agreed that such determinations and procedures, whether oral or written, constitute an integral part of this contract and are legally incorporated herein by reference.(b) You will not be required to bear the expense of foreign taxes on income paid or guaranteed you by the Government under paragraph three (3) above. You will be reimbursed for such foreign taxes paid by you, consistent with your cover.6. Allowances. You will be entitled to: (a) Living quarters allowances in conformance with regulations of this organization applicable to its appointed personnel. In the event you are furnished quarters by your cover facility or the Government you will not be entitled to the living quarters allowances herein indicated.(b) Cost-of-living allowances in conformance with applicable regulations of this organization including, but not limited to, a post allowance or, if applicable, an equalization allowance in lieu thereof, a supplementary post allowance, a transfer allowance, a home service transfer allowance and a separation allowance.
[104-10195-10002.pdf — page 78]
SAGTET(d) Your participation in the Retirement and Disability System of this Organization is preserved by virtue of your transfer without a break in service from a position of employment wheroin qualification for such status was achieved. Contributions into the Retirement and Disability Fund will be deducted from the basic conspensation due you hereunder.(e) You are herein authorised continued coverage under the Federal Employees' Health Benefits Act. This organization is presently authorized to bear ara portion of of the prendum cost, you will bear the remainder. Your financial contribution will be effected either by payroll deduction or by direct remittance at periodic intervals to be established by this organization.(f) You are herein authorized continued coverage under the Federal Employees' Group Life Insurance Act unless you have previously executed a written waiver of said coverage. This organization is presently authorized to bear a portion of the premium cost, you will bear the remainder. Your financial contribution will be effected either by payroll deduction or by direct remittance at periodic intervals to be established by this organization.(g) (1) This organization is authorized to pay the cost of necessary hospitalization and related travel expenses for illness or injury incurred by a United States-citizen full-time Contract Employee in the line of duty while abroad,(2) This organization may pay certain necessary costs of hospitalization and related travel expenses for illness or injury incurred by the dependents of a United States citizen full-time Contract Em. ployee permanently assigned abroad, while they are located abroad.It is understood and agreed that the eligibility and extent of the participation by you and your dependents in the above medical programs will be in conform- ance with the rules, regulations, and policies of this organization in effect at the time an illness or injury is incurred, that all claims will be submitted only to this organization and that adjudication of such claims by this organiza - tion shall be final and conclusive.(h) You will be entitled to claim reimburserment for loss of personal property pursuant to applicable Government regulations.11. Offset. Emoluments (including benefits in kind) received from or through your cover activities are the property of the U. S. Government. Pro- cedurally, such emoluments will be offset against amounts due you under this agreement and are acknowledged to be payment by the Government hereunder and for federal income tax purposes. If cover emoluments exceed those due you under this contract, you will dispose of the excess amount in conformance with governmental instructions.
[104-10195-10002.pdf — page 79]
SCREST12. Execution of Documents. If, in the performance of services under this contract, you assuing the custody of Government funds' or take title of record to property of any nature whatsoever and wherever situate, which property has in act been purchased with monles of the U. S. Government, you hereby recognize and acknowledge the existance of a trust relationship, elther express or constructive, and you agree to execute whatever documents may be required by the Government to evidence this relationship.13. Secrecy. (a) You will be required to keep forever secret this contract and all classified information which you may obtain by reason hereof (unless released in writing by the Governnient from such obligation), with full knowledge that violation of such secrecy may subject you to criminal prosecution under the espionage laws of the United States and other applicable laws and regulations.(b) In the event you marry or remarry during the term of this contract, you agree to advise this organization at least one hundred twenty (120) days in advance of such contemplated marriage, or otherwise as soon as known, and to furnish such personal history data on your prospective spouse as may be required by this organization. You understand and agree that should this organization deterning that your marriage would limit or otherwise impair your usefulness to the Covernment, this contract may be terminated.14. Instructions. Instructions received by you from the Government in briefing, training or otherwise are a part of this contract and are incorporated herein, provided that such instructions are not inconsistent with the terms hereof,15. Reassignments. During your period of service under this agreement, it may be necessary for this organization to terminate an assigniment for easons beyond your control. In such event, you will be given every consideration for other assignments appropriate to Career Agents,16. Unauthorized Commitments, No promises or commitments: pertaining to rights, privileges or benefits other than those expressly stipulated in writing in this agreement or any armendment thereto shall be binding on the Government. Specifically, you herein acknowledge that this organization makes no commitment, either express or implied, that appointed employment status will be offered you at the conclusion of or during your period of contractual service,17. Term. This contract is effective as of 15 and shall continue thereafter for an indefinite period unless sooner terminated:(a) Upon ninety (90) days' actual notice by either party hereto,(b) Upon actual notice to you in the event the results of an initially required medical examination are determined by this organization to be unsatisfactory, or
[104-10195-10002.pdf — page 80]
(c) Without prior notice by the Government, in the event of a breach of this contract by your violation of the security provisions hereof or by your otherwise rendering yourself unavailable for acceptable service.Ternilnation of this agreement will not release you from the obligations of any security oath you may be required to take.UNITED STATES GOVERNMENT/s/, Rob H. LedeberBYContracting OfficerACCEPTED:Thomas B. CasasinWITNESS:APPROVED:RCB/dhc4/5/72
[104-10195-10002.pdf — page 81]
SECRET(When filled in)# NOTIFICATION OF PERSONNEL ACTION1. SERIAL NUMBER2. NAME (LAST, FIRST, MIDDLE)   LASASIN, THOMAS, D3. NATURE OF PERSONNEL ACTION   INITIAL ENTRY4. EFFECTIVE DATE   05 15 725. CATEGORY OF EMPLOYMENT   CAREER AGENT6. PREPARED   05/11/72(S)7. FINANCIAL ANALYSIS NO CHARGEABLE8. CSC OR OTHER LEGAL AUTHORITYA. FUNDSV TO VV TO VA9. ORGANIZATIONAL DESIGNATIONS   DDP DIRECTORATE   EUROPEAN DIVISION3136-123110. LOCATION OF OFFICIAL STATION    PARIS, FRANCE11. POSITION TITLE    UPS OFFICER12. POSITION NUMBER13. CAREER SERVICE DESIGNATION14. CLASSIFICATION SCHEDULE (GS, WG, OR WM)    GS15. OCCUPATIONAL SERIES16. GRADE AND STEP    15 017. SALARY OR RATE    006: 02036    33260    LET: 02467418. REMARKS    STATUS INFORMATIONBIRTH DATE: 24 SEX: M MARITAL ST: DIV NO. DEPENDENTS: 01CITIZENSHIP: US/BIRTH LONGEVITY COMP: FED SERVICE COMP: 030744TYPE RETIREMENT: CIA R-D HOSPITILIZATION: F PLAN:FEGLI: YES PREV. GOVT SERV: 4 SAL. TASK LIMIT:PAY BASIS: A A/L IND: 4 S/L IND: 4CONTRACT INFORMATIONEFF DATE: 051572 EXPIRATION DATE: INDEFIN DATE ORIG CONTRACT: 051572REFERRING OFFICER: EUR PERS REFER ORG: EUR PHONE: 6913ENTITLEMENTS/ELIGIBILITIES/ALLCWANCESTAX STAFF: Y FED EXMP: STATE EXMP: STATE:TRAVEL: CMI OPS EXPENSE: Y HOUSING: A POST/EQUAL:HUMF LEAVE: 4 DIFFERENTIAL: Y OFFSET CLAUSE: Y STO GOVT: YLEUISE PAY: Y PREMIUM PAY: ALLCWANCE COMM: N EDUCATION:STEP INCRES: N UTH TAX RATE: N OTHER ALLOWNS: N SEPARATION:SIGNATURE OR OTHER AUTHENTICATION![Signature]form 11508:7-66 MFG 2 72Use PreviousEditionSECRETGROUP 1Excluded from automaticdowngrading anddeclassification(+51)
[104-10195-10002.pdf — page 82]
BBG 01 JUN 71SECRET(When Filled In)NOTIFICATION OF PERSONNEL ACTION1. SERIAL NUMBER 2. NAME (LAST, FIRST, MIDDLE)008102 CASASIN THOMAS B3. NATURE OF PERSONNEL ACTION 4. EFFECTIVE DATE 5. CATEGORY OF EMPLOYMENTEXTENSION OF PRA 02 25 71 REGULARNTEL: 24 FEBRUARY 19736. FUNDS V TO V V TO CF 8. CSC OR OTHER LEGAL AUTHORITYCF TO V CF TO CFX9. ORGANIZATIONAL DESIGNATIONS 10. LOCATION OF OFFICIAL STATIONDDP/EUR 1136 1231 0000FOREIGN FIELDFRENCH AREAPARIS STATION PARIS, FRANCEPARIS ANNEX11. POSITION TITLE 12. POSITION NUMBER 13. SERVICE DESIGNATIONOPS OFFICER 0663 014. CLASSIFICATION SCHEDULE (GS, 18 etc.) 15. OCCUPATIONAL SERIES 16. GRADE AND STEP 17. SALARY OR RATEGS 0136.01 15 7 2909918. REMARKSSIGNATURE OR OTHER AUTHENTICATIONUse Previous SECRETEdition(16-511)CREFOIExcluded from automateddowngrading anddeclassification(When Filled In)
[104-10195-10002.pdf — page 83]
EBG: 17 AUG 70SECRET(When filled in)NOTIFICATION OF PERSONNEL ACTION1. SERIAL NUMBER 2 NAME (LAST FIRST MIDDLE)MC102 CASASIN THOMAS B3 NATURE OF PERSONNEL ACTIONEXTENSION OF PRANTE 24 FEBRUARY 1971FUNDSV TO VV TO CFCF TO VXCF TO CF4 EFFECTIVE DATE 5 CATEGORY OF EMPLOYMENT07 20 70 REGULAR7 Financial Ano, s No Chargeable 8 CSC OR OTHER LEGAL AUTHORITY1136 1231 0000 50 USC 403 J9 ORGANIZATIONAL DESIGNATIONS:10 LOCATION OF OFFICIAL STATIONDOP/CURFOREIGN FIELDFRENCH AREAPARIS STATIONPARIS ANNEXPARIS, FRANCE11 POSITION TITLE 12 POSITION NUMBER 13 SERVICE DESIGNATIONCPS OFFICER0608D14 CLASSIFICATION SCHEME (UNS LCN)15 OCCUPATIONAL CODE16 GRADE AND STEP17 SALARY OR RATE030136.0115 72746318 REMARKSSIGNATURE OR OTHER AUTHENTICATIONFOR'A5 661150Use Previous EditionSECRETGROUP 1Excluded from automatic downgrading and declassification(4-51)(When Filled in)
[104-10195-10002.pdf — page 84]
# NOTIFICATION OF PERSONNEL ACTION10 MAR 69**SECRET**1 SERIAL NUMBER2 NAME (LAST FIRST MIDDLE)CASASIN THOMAS B3 NATURE OF PERSONNEL ACTION4 EFFECTIVE DATE5 CATEGORY OF EMPLOYMENTEXTENSION OF PRA NTE; 24 FEB. 1970 02 23 69REGULAR6 FUNDSV TO VV TO CF7 FINANCE Allotment No. Chargeable8 CSC OR OTHER LEGAL AUTHORITYCF TO VXCF TO CF8136 1231 000050 USC 403 J9 ORGANIZATIONAL DESIGNATIONS10 LOCATION OF OFFICIAL STATIONDDP 'EURFOREIGN FIELDCENTRAL REGIONPARIS STATION:ANNEX, PARISPARIS, FRANCE11 POSITION NUMBER12 SERVICE DESIGNATIONOPS OFFICER1668D14 CLASSIFICATION SCHEDULE (GS. 18. etc.)15 OCCUPATIONAL SERIES16 GRADE AND STEP17 SALARY OR RATE630136.0115 72373418 REMARKSSIGNATURE OR OTHER AUTHENTICATION![form 1150 image]FORM 3-66 1150Use Previous EditionSECRET![group 1 image]
[104-10195-10002.pdf — page 85]
SECRET(When Filed In)NOTIFICATION OF PERSONNEL ACTION1. SERIAL NUMBER 2. NAME (LAST, FIRST, MIDDLE)   006102 CASAS IN THOMAS B3. NATURE OF PERSONNEL ACTION   REASSIGNMENT4. FUNDS 5. TO W. 6. TO W. 6. TO W. 7. Financial Analysis Re. Changable 8. CSC.OR. OTHER LEGAL AUTHORITY   X9. ORGANIZATIONAL DESIGNATIONS   DDP/EUR   FOREIGN FIELD   CENTRAL REGION   PARIS STATION   ANNEX, PARIS   7136-1231-0000 50 USC 403 J10. LOCATION OF OFFICIAL STATION    PARIS, FRANCE11. POSITION TITLE    OP3 OFFICER12. POSITION NUMBER    DE1313. SERVICE DESIGNATION    D14. CLASSIFICATION (SCHEDULE & SERIES) 15. OCCUPATIONAL SERIES 16. GRADE AND STEP 17. SALARY OR RATE    GS 0136.01 15 6 2058518. REMARKSSIGNATURE OR OTHER AUTHENTICATIONUse PreviousEditionSECRETLSDP 1Located free actiw(4-511)(When Filled In)
[104-10195-10002.pdf — page 86]
# SECRET(When Filed In)## NOTIFICATION OF PERSONNEL ACTION1. SERIAL NUMBER 2. NAME (LAST-FIRST-MIDDLE)006102 CASASIN THOMAS B3. NATURE OF PERSONNEL ACTION 4. EFFECTIVE DATE 5. CATEGORY OF EMPLOYMENT   DESIGNATION AS PARTICIPANT IN CIA   RETIREMENT AND DISABILITY SYSTEM| MO  | DA  | YR  || --- | --- | --- || 04  | 10  | 66  |REGULAR6. FUNDS 7. COST CENTER NO. CHARGEABLE 8. CSC OR OTHER LEGAL AUTHORITY| T.O.T.W | T.O.T.W | T.O.T.W || ------- | ------- | ------- || X       |         |         |6136 1231 0000 SECTION 203P.L. 88-6439. ORGANIZATIONAL DESIGNATION 10. LOCATION OF OFFICIAL STATIONDUP/VEFOREIGN FIELDPARIS STATIONINTERNAL OPERATIONS SECTIONPARIS, FRANCE11. POSITION TITLE 12. POSITION NUMBER 13. SERVICE DESIGNATIONOPS OFFICER 0885 014. CLASSIFICATION SCHEDULE (AS 15. OCCUPATIONAL SERIES 16. GRADE AND STEP 17. SALARY OR RATEGS 0136.01 15 5 1941518. REMARKS:    EMPLOYEE WILL RECEIVE NOTIFICATION FROM THE DIRECTOR OF PERSONNEL OF THIS DESIGNATION.SIGNATURE OR OTHER AUTHENTICATION![signature block]FORM11-421150Use Previous EditionSECRET![SEBUP logo](When Filled In)
[104-10195-10002.pdf — page 87]
# SECRETAMENDMENT TOSUPPLEMENT TO STAFF AGENT PERSONNEL ACTIONFOR THOMAS B. CASASINMr. Thomas B. CasasinDear Mr. Casasin:Reference is made to your Staff Agent Supplement, effective 5 August 1962.Effective 27 September 1965, all reference to income is deleted from that supplement and the following provision is substituted:*Taxes.* As an appointed employee of the Government you must satisfy your Federal income tax liability on taxable income paid to you. Such income may be paid you by or through a cover facility. Because of cover, operatioml and security considerations the Tax Committee of this organization is authorized to make certain determinations and establish procedures which will result in the full satisfaction of your Federal income tax liability on Income directly received as a result of your Federal employment. Such determinations and procedures constitute an integral part of your Staff Agent administration.UNITED STATES GOVERNMENTBYPersonnel OfficerCopy Panchs & to puidTid 852 637.mar 66
[104-10195-10002.pdf — page 88]
Chief, EUROPEAN DivisionChief of Station, PARISO ADMIN PERS TOPSY WODEERThomas D. CASASINREF: PARIS 27701, 27 April 1972As reported in reference, CASASIN begins his UNCAIRD job on 5 June 1972. Forwarded USC are a Curriculum,. Vitae which he prepared for UNGAIRD and a completed form required for an LNLUTE security clearance.Reginald M. GUNIONAttachment:1. As stated, USCDistribution:2. C/EUR w/att USC1- NCE/REGCS COPYOEPA-95019SECRETMAY 8 19724 May 1972
[104-10195-10002.pdf — page 93]
# IDENTIFICATION AND PERSONNEL DATAFOR EMPLOYMENT OF UNITED STATES CITIZENINSTRUCTIONS - Prepare in quadruplicate. All sections must be completed. Write "None" where applicable. Type or print answers. If space is not adequate for complete answers continue under item 23, and attach a supplemental sheet to this form if necessary. All addresses must show street number, street, city, and State.1. NAME (Last, First, Middle)   RICHARDSON, Jacques G.2. OTHER NAMES USED (Maiden name, former married names changed legally or otherwise, aliases, etc. Specify which, and show dates used)3. PRESENT ADDRESS AND LENGTH OF RESIDENCE THERE   5 villa Madrid 3 years   92 Neuilly, France5. DESCRIPTION   HEIGHT WEIGHT HAIR EYES   178 cm 72 kg Brown Black6. MARITAL STATUS (Check one)   □ SINGLE □ SEPARATED   **X** DIVORCED   □ MARRIED □ WIDOWED7. BIRTH DATE   DAY MONTH YEAR   20 Jan 248. BIRTHPLACE (City, county, State, and country)   Baltimore, Maryland4. DATES AND PLACES OF RESIDENCE (Go back 15 years. Continue under item 23 on other side if necessary.)| FROM      | TO        | NUMBER AND STREET                                   | CITY       | STATE    || --------- | --------- | --------------------------------------------------- | ---------- | -------- || June 1969 | Present   | 5 villa Madrid                                      | 92 Neuilly | France   || Sept 1962 | June 1969 | 9 villa Madrid                                      | 92 Neuilly | France   || Sept 1960 | Aug 1962  | 312 Lamond Place                                    | Alexandria | Va 22314 || Feb 1955  | June 1957 | Location managed by Geneve atu, sotaya-u, Tokyo, da |            |          |9. UNITED STATES CITIZENSHIP.INDICATE WHETHER:(A) BY BIRTH **[X]** (C) NATURALIZATION □(D) DERIVATIVE □| DATE           | DATE           || -------------- | -------------- || CERTIFICATE NO | CERTIFICATE NO || PLACE          | PLACE          |10. SOCIAL SECURITY NO    042 20 533011. MILITARY SERVICE (Past of present)| SERIAL NO | BRANCH | FROM (YR.) | TO (YR.) | TYPE OF DISCH. || --------- | ------ | ---------- | -------- | -------------- || 31316266  | Army   | 1945       | 1946     | Hon            || 0 937200  | Army   | 1946       | 1948     | Hon            |12. EDUCATION (All schools above elementary)| NAME OF SCHOOL          | ADDRESS                | FROM (YR.) | TO (YR.) | DEGREES || ----------------------- | ---------------------- | ---------- | -------- | ------- || High School of Montreal | Ave Nonty St, Montreal | 1940       |          | Diploma || University of Michigan  | Ann Arbor              | 1947-X     |          | BA      || Georgetown University   | Washington DC          | 1951       |          |         || Rensselaer Polytechnic  | Troy NY.               |            | 1962     | Certif  |sic att. 2 to OFPA-98019 CS COPY DEFERRED
[104-10195-10002.pdf — page 94]
Sta "ilitiore Seignt Publishing Paris France "o accont- H. Chodkiewicz lipeace onTechnoloy Communic'n Publishing New Yorkly dittoMr P. ParkCorover-tort Public'ns Publishing few York I to join Tech-Er. Conover, Jr nology ComArmy Office of Ch of RED reportrinnbineton DCto recenterStaff; Col M. P. Garrity privindiTokyo CM Center Industrial Tokyo Japan ContractCol J. N. Stewart surveys. expirationUSIA (IPS) Govt info Wechington DCTo accontMr Mundy services o'sous asamtHousing Authority, Public housing To accept"Baltimore; Mr Kilburn authority Baltimore Md better jobGuide Publications Inc Publishing Paltimore Md To accentDr Kobre botter job14. FOREIGN COUNTRIES VISITED (SINCE 1930) (Exclusive of military service)| COUNTRY                | DATE LEFT USA | DATE RETURNED USA | PURPOSE           || ---------------------- | ------------- | ----------------- | ----------------- || Western Europe         | 1944          | 1945              | Military service  || Japan                  | 1946          | 1948              | ditto             || Japan-Korea            | 1950          | 1953              | USIA activities   || Japan                  | 1955          | 1960              | Civil service     || Western Europe         | 1960          | 1960              | Tourism           || France, western Eurone | 1962          | 1972              | Business, tourism |
[104-10195-10002.pdf — page 95]
## 16. ARE YOU NOW OR HAVE YOU EVER BEEN A MEMBER OF THE COMMUNIST PARTY, U.S. A., OR ANY COMMUNIST OR FASCIST ORGANIZATION?(ANSWER "YES" OR "NO")## 17. ARE YOU NOW OR HAVE YOU EVER BEEN A MEMBER OF ANY FOREIGN OR DOMESTIC ORGANIZATION, ASSOCIATION, MOVEMENT, GROUP OR COMBINATION OF PERSONS WHICH IS TOTALITARIAN, FASCIST, COMMUNIST, OR WHICH HAS ADOPTED OR SHOWS ADOPTION OF, THE COMMUNIST OR FASCIST, IDEOLOGY OR ADVOCATES OR TEACHES DOCTRINES UNDER THE CONSTITUTION OF THE UNITED STATES OR WHICH SEEKS TO ALTER THE FORM OF GOVERNMENT OF THE UNITED STATES BY UNCONSTITUTIONAL MEANS?(ANSWER "YES" OR "NO")## 18. MEMBERSHIP IN OTHER ORGANIZATIONS (List all organizations in which you are now a member or have been a member, except those which show religious or political affiliations.)| NAME                       | ADDRESS    | TYPE         | FROM | TO      | OFFICE HELD || -------------------------- | ---------- | ------------ | ---- | ------- | ----------- || British Interplanetary Sec | London     | Professional | 1955 | present | Fellow      || Sec of Tech Communication  | Washington | "            | 1968 | present | Sen Kember  || Intl Science Writers Assn  | London     | "            | 1955 | present | Member      || American Club              | Paris      | Social       | 1962 | present | Member      |## 19. RELATIVES (Parents, spouse, divorced spouse, children, brothers, and sisters, living or dead. Name of spouse should include maiden name and any other names by previous marriage. If person is dead, so state under "address" and enter other information as of time of death.)| RELATION | NAME IN FULL           | YEAR OF BIRTH | ADDRESS           | COUNTRY OF BIRTH | PRESENT CITIZENSHIP || -------- | ---------------------- | ------------- | ----------------- | ---------------- | ------------------- || Daughter | Pamela A. Richardson   | 1950          | 5 villa Madrid    | USA              | USA                 ||          |                        |               | 92 Neuilly France |                  |                     || Daughter | Michelle D. Richardson | 1953          | 5 villa Madrid    | USA              | USA                 ||          |                        |               | 92 Neuilly France |                  |                     |
[104-10195-10002.pdf — page 96]
4-00000420 Ent 23 Strept (60)Hew Yor': BY 10010Col dorden inde340 Kochtend. Cirele292921 HAVE YOU EVER BEEN ARRESTED TAKEN INTO CUSTODY, BLED FOR INVESTIGATION OF QUESTIONING, OR CHARGED BY ANY LAW ENFORCEMENTAUTHORITY (You may emil. (1) Traffic violations for which you paid a fine of 830 of loss, and (2) anything that happened Lofore your lichbirthday. All other incidente must be included, even though thay wore dien,issed or you merely furloited collateral)22. WHILE IN THE MILITARY SERVICE WERE YOU EVER ARRESTED FOR AN OFFENSE WHICH RESULTLO IN A TRIAL BY DICK COURT OR BY SUMMARY, SPECIAL    OR GENERAL COURT-MARTIAL?IF YOUR ANSWER TO 21 OR 2 IS YES, GIVE DETAILS IN ITEM 21, SHOWING FOR LACH INCIDENT (1) DATE (2) CHARGE,(0) PLACE, (4) LAW INFORCING AUTHORITY OIL TYPE OF COURT OR COURT-MARTIAL, AND C) ACTION TAKEN.23 SPACE FOR LONTINUING ANSWERS TO QUESTIONS (Show item numbers to which arioware apply. Altach a separate sheet if there is not enoughspace here.)CERTIFICATIONNOTE: The original copy must be signed by the person named in item I on this form.I certify that the above information is correct and complete to the best of my knowledge and belief.Hay 1 1972SIGNATURE (Sign original ordy)US GOVERNMENT POSTING OFKE I401SPO sarPO 643-4472