Francesco/who-killed-jfk huggingface dataset:
[104-10215-10129.pdf — page 20]
SECRET(Then Filled In)# APPROVAL REQUEST|          |                                                     || -------- | --------------------------------------------------- || **TO**   | Deputy Director of Security                         || **ATT.** | . Rice 2613 I bldg                                  || **FROM** | Chief, CI/Operational Approval and Support Division ||             |               || ----------- | ------------- || **DATE**    | 11 April 1958 || **PROJECT** |               || **SUBJECT:** | C                                         ||              | C-25507                                   ||              | **NO.** 112569                            || **1. TYPE OF REQUEST**          | **2. METHOD OF HANDLING** || ------------------------------- | ------------------------- || POA CBA                         | EXPEDITE ROUTINE          || 3. INDICES RESULTS REQUESTED BY |                           || **4. FBI CHECK REQUESTED**      |                           || BY (Date)                       |                           |5. AREA OF SUBJECT'S ASSIGNMENT   For briefing by CI/ICD and WH/III/Mexico representatives in safehouse.6. USE OF SUBJECT7. INVESTIGATION NOT TO REVEAL INTEREST OF| U. S. GOVERNMENT | CIA | SEE REMARKS || ---------------- | --- | ----------- ||                  |     |             |8. COVER SUGGESTED FOR INVESTIGATION| OFFICIAL | COMMERCIAL || -------- | ---------- ||          |            |FIELD TRACES9. RESULTS OF TRACESRI TRACES|                          |     || ------------------------ | --- || **GREEN LIST INITIATED** |     || YES                      | NO  |10. ATTACHMENTS PRO-PART I OTHER: MEMO12. REMARKS![signature]SECRETFORM NO. 693 REPLACES FORM 59-601 JUN 55 WHICH IS OBSOLETE.INITIALS (9)
[104-10215-10129.pdf — page 21]
# INSTRUCTION SHEETSECRETDATE: 11 Apr 58CASE NO.: C-25507TO: Processing SectionPLEASE TAKE THE FOLLOWING ACTION ON THE CASE SET FORTH ABOVE.(Always check "Remarks" below for limitations or details)SET UP FOR:POA WITH:EXPEDITE INDICES FOREXPEDITE FOR CHECK FORSET UP FOR:OA CSA PROP APP SPECIAL INQUIRY COVERT NAME CHECKISSUE OPERATIONAL APPROVAL REQUEST RI TRACESISSUE PROVISIONAL OPERATIONAL APPROVAL REQUEST OPERATIONAL & DIV. TRACESINVESTIGATION STILL OUTSTANDING REQUEST FIELD TRACESFORWARD ATTACHMENT TO DIVISION REQUEST PRO I PRO IIFORWARD ATTACHMENT TO SECURITY REQUEST ADDITIONAL BIOGRAPHIC INFONOTICE: 1ST 2ND 3RD & FINAL REQUEST GREEN LISTPREPARE CANCELLATION FORM FURNISH GREEN LIST INFORMATIONSEND TO RI/ARCHIVES REQUEST RESULTS OF TECH. INTERROGATIONFILE SEND "QUERY" MEMO TO DIVISIONEXTEND POA FOR _______ DAYS UNTIL OTHER (See Remarks)REMARKS: Use: for briefing by CI/ICD and WH/III Mexico representatives in safehouse.FORM NO. 707 OBSOLETE PREVIOUS EDITIONS.SECRET![signature]
[104-10215-10129.pdf — page 22]
11 April 1958MEMORANDUM FOR : Chief, Safehouse Branch, Office of LogisticsTHROUGH : Chief, Central Cover Branch, ID/PREQUKSTING OFFICE: WH/III/MexicoCASE OFFICER : Louis D. Puckett, Ext. 2555, 3162PROJECT : OGA, Hexico City Station Allotment No. 8-3570-83-599REFERENCE : R 45-1025, 25 June 1956Type of safehouse requested: OfficeLocation and Favironment: Washington, D. C.- Business areaMaximum Price Range: $50/weekOccupancy from: 21 April 1958 To: 23 May 1958Intended Use: Safehcuse will be occupied by one (1) career agent and personnel from the CI Staff and WH/III/-exico. The agent will live elsewhere, not in the safehouse. The agent is a U. S. citisen, 36 years old. Sensitive material will be in the safehouse during the day. None vill be left overnight. A tape recorder for play back will be used there during the day and will be stored overaight.Cover Arrangement: Subject is a U. S. citisen - his cover is that of employee of Public Surveys Institute, (a netional polling firm) in Dallas, Texas. During a recent operational trip he took photo- graphs which have appeared in the *New York Times* and the *New York Daily Mirror*. He has in the past sold news stories and fiction. is family will live at Presidential Gardens Apartments, Alexandria, Virginia, during the agent's stay in the Washington area.Funds are available:R. F. DahlgrenChief, WH/IIII CENTIFY THAT FUNDS WAS AVAILABLEOBLIGATION REFERENCE No 733CHARGE TO ALLOTMENT No 8/3570-83-599AUTHORIZING OFFICER
[104-10215-10129.pdf — page 23]
SECRETCI/OACOMMENTS:A meeting in Security office was held with the following present.A. Rice - Security SSDB. Pearson - Security SSDC. Phulm - Polygraph groupM. Reynolds - WH dirH. Mockuby - WH dirW. Odom - CI StaffPurpose of the meeting to discuss polygraph problems for subject.S.O. will work out details for WH and subject will probably be brought to Miami for the poly-quarters re subject1) I&R hand pick on subject2) quarters re wifeDATE: 9 Dec 1957 BY:SECRET
[104-10215-10129.pdf — page 24]
SECRET(When Filled In)MEMORANDUM FOR: WH/III - Willard Galbraith, Chief 15 Jul 57FROM: CI/Operational Approval and Support DivisionSUBJECT: CROZIER, Ross Lester1.  Your request dated 26 Feb 56 for approval to use the Subject has been processed by the Office of Security.2.  The results of this action are transmitted herewith.Attachment:so memo 3 Jul 57. acMICROFILMEDDEC. 6 1957Distribution:1 Addressee1 FileSECRET
[104-10215-10129.pdf — page 25]
# INSTRUCTION SHEET**SECRET**(Then Filled In)DATE: 11 July 57CASE NO: e-25507TO: Processing SectionPLEASE TAKE THE FOLLOWING ACTION ON THE CASE SET FORTH ABOVE.(Always check "Remarks" below for limitations or details)SET UP FOR:POA WITH:EXPEDITE INDICES FOREXPEDITE FOR CHECK FORSET UP FOR:CACSAFSAFSOP APPSPECIAL INQUIRYLOVDIT NAME CHECKISSUE OPERATIONAL APPROVALREQUEST RI TRACESISSUE PROVISIONAL OPERATIONAL APPROVALREQUEST OPERATIONAL & DIV. TRACESINVESTIGATION STILL OUTSTANDINGREQUEST FIELD TRACESFORWARD ATTACHMENT TO DIVISION193eachS.D. homREQUEST: PGG 1, PGG 11FORWARD ATTACHMENT TO SECURITYREQUEST ADDITIONAL BIOGRAPHIC INFONOTICE:1ST2ND3RD & FINALREQUEST GREEN LISTPREPARE CANCELLATION FORM.FURNISH GREEN LIST INFORMATIONSEND TO RI/ARCHIVESREQUEST RESULTS OF TECH. INTERROGATIONFILESEND "QUERY" MEMO TO DIVISIONEXTEND POA FOR ________ DAYS UNTILOTHER (See Remarks)REMARKS:Send to Chief WH/111(Eyes only)![signature]FORM NO. 707 OBSOLETE PREVIOUS EDITIONS:1 FEB 56SECRET(21)
[104-10215-10129.pdf — page 26]
# SECRETOffice Memorandum • UNITED STATES GOVERNMENT.TO : Chief, CI/OA DATE: 3 JUL 1957FROM : Deputy Director of Security (Investigations and Support)SUBJECT: C-25507#1125691.  Reference is made to your memorandum dated 28 February 1957 wherein a covert security approval was requested to enable the Subject's conversion from contract agent to career agent status for use as principal agent for Project AMPHIODARCH in Cuba under non-official cover. Reference is also made to our memorandum of 2 April 1957 in which a provisional covert security clearance was granted for the above use.2.  In accordance with the provisions set forth in the Director's Memorandum of 14 February 1949 entitled, "Security and Operational Clearances," a covert security clearance is granted for the use of the Subject, as described in your request as set forth in paragraph 1, above.3.  This clearance is contingent upon the following:a. The receipt by this office of full overseas traces and such actual overseas investigation as is possible on Subject and on his wife and her family.b. that Subject be afforded a polygraph inter- rogation as soon as possible and that the verbatum results be promptly furnished to this office. The Office of Security will be happy to assist in arranging this interrogation.4.  Subjects of covert security clearances are not to represent themselves as, nor are they to be represented as, employees of CIA.5.  Your attention is called to the fact that a covert security clearance does not constitute complete compliance with the provisions of CIA Regulation 10-210. Therefore, if you should desire at a later date to change the status or use of this individual, a request for clearance to cover any proposed change should be submitted to this office.SECRET
[104-10215-10129.pdf — page 27]
SECRET-2-3 JUL 19576. This clearance becomes invalid in the event the Subject's services are not utilized within 60 days of the date of this memorandum.FOR THE DIRECTOR OF SECURITY:![signature of Frosthall] (Robert H. Cunningham)SECRET
[104-10215-10129.pdf — page 28]
# SECRETOffice Memorandum • UNITED STATES GOVERNMENTTO: Chief, CI/OA DATE: 3 JUL 1957FROM: Deputy Director of Security (Investigations and Support)SUBJECT: C-25507 Crozier, Ruse lester#1125691.  Concurrent with this memorandum a covert security clearance is being issued to enable the Subject's conversion from contract agent to career agent for use as principal agent for Project AMPHARCH in Cuba under non-official cover.2.  This is to advise that information has been received from a confidential source of the Office of Security concerning Argentina CORDERO Calderon and her sister, Counsuelo, who are believed to be the Subject's wife and sister-in-law respectively. According to a December 1944 report, the above individuals were described as Costa Rican citizens then in Panama under suspicion and members of the Russian Ballet team of Pedro and Lidia CHUPRINE. Argentine is known to speak and understand German. She was formerly married to Pedro MARZAL, reportedly a German national and formerly on both British and U. S. Proclaimed List. She is reliably reported to have made pro-German remarks and is pro-Gervan in her sympathies. It was further reported that both of the above indivimals have at times attempted to secure information from members of the American Armed Forces.3.  In view of the above information, it is requested that current overseas traces and investigation be conducted on the Subject as well as on his wife and sister-in-law, Counsuelo, and other members of his wife's immediate family and that the results thereof be furnished this office.4.  The covert security clearance which is being issued in this case is made contingent upon the faovrable results of the requested overseas traces and investigation.FOR THE DIRECTOR OF SECURITY:Robert H. CunninghamThis data is the property of the Security Office and should be returned whenfis has served its purpose. la existence or contents most not be disclosed encrpe to CIA Staff Officers directly concerned. This material shall act be repeodaced in my manner whatsoever without the prior approval of the Serrating Office.SECRET
[104-10215-10129.pdf — page 29]
SECRET(When Filled In)1 April 1957MEMORANDUM FOR:Wn/il/Cuba/McAuleyFROM:CI/Operational Approval and Support DivisionSUBJECT:Chürich, hoss Lester1.  Your request dated _________ for approval to use the Subject has been processed by the Office of Security.2.  The results of this action are transmitted herewith.Attachment:so memo 2 April 1957/parDistribution:1 Addressee1 File![signature of Thomas Cassell, Jr.]SECRETFORM NO. 3881 JUN 55REPLACES FORM 39-46WHICH IS OBSOLETE.
[104-10215-10129.pdf — page 30]
# Office Memorandum • UNITED STATES GOVERNMENTTO: Chief, CI/CA DATE: 2 APR 1957FROM: Acting Deputy Director of Security (Investigations and Support)SUBJECT: C-25507#1125691.  Reference is made to your memorandum dated 28 February 1957, wherein a provisional covert security approval and a covert security approval were requested to enable the Subject's conversion to career agent status for use as Principal Agent for Project AMPHODARCH in Cuba, under non-official cover.2. In accordance with the provisions set forth in Clandestine Services Instruction No. 10-5 and Field Regulation 10-215, a provisional covert security approval is granted for the use of the Subject, as described in your request as set forth in paragraph #1. above.3. It should be noted that the provisional covert security approval herein granted is based on limited investigative coverage and should not be in any way construed as a final security determination relative to a full covert security approval. Upon completion of additional investigation now pending, you will te appropriately advised as to our decision with regard to the issuance of a full covert security approval.4. Subjects of provisional covert security approvals are not to represent themselves as, nor are they to be represented as, employees of CIA.5. Your attention is called to the fact that a provisional covert security approval does not constitute complete compliance with the provisions of CIA Regulation 10-210. Therefore, if you should desire at a later date to charge the status or use of this individual, a request for approval to cover any proposed change should be submitted to this office.6. This approval becomes invalid in the event the Subject's services are not utilized within 60 days of the date of this memorandum.FOR THE DIRECTOR OF SECURITY:Fred H. Hall
[104-10215-10129.pdf — page 31]
SZURET8 March 1957MEMORANDUM FOR: Chief, Office of SecurityVIA: Chief, CI/CASUBJECT: Arthur G. VAIVADA (sp.)C-255071. Reference is made to OS's verbal request of 7 March 1957, for additional information on Subject in connection with our request for a Provisional Covert Security Approval dated 26 February 1957.2. Subject was born in De Kalb, Illinois, on 20 June 1922. He received his primary and high school education in De Kalb and entered the U. S. Army in 1940, later transferring to the U. S. Air Force. He served as an operations and intelligence specialist, first in the China-Burma theater and later in Panama. He was discharged from the service in 1945 with the grade of Technical Sergeant. After his discharge, he worked for a brief period as a laboratory technician in the Sterling (Illinois) Silica-Cel Corporation and then returned to the Panama Canal Zone to marry a Costa Rican girl in December 1945. For about four months he worked as a stevedore and labor foreman in the Canal Zone. In April 1946 he re-enlisted in the Air Force in the Canal Zone and was discharged three years later, in 1949.3. Late in 1948 he was recruited by the Agency, and on 1 June 1949 became a CIA contract agent. Since that date, he has served as a contract agent with continuing high level performance, first in Costa Rica, later in Guatemala and Cuba. He is currently assigned to Cuba where he is utilized as Principal Agent of Project ANTHODARCH. Subject has worked principally and successfully so, on Communist Party penetration operations since his engagement with CIA, and his current work involves the handling of a net of agents providing coverage of Communist, leftist, revolutionary and other political activities at the University of Habana, and the student-youth circles in general in Cuba.4. Subject has always proven to be loyal and trustworthy. In view of his outstanding record and strong overall qualifications, and his expressed desire for a career with CIA, it has been recommended he be converted from contract to career agent status. He was promoted recently to the equivalent of a GS-10 rating.SEURET
[104-10215-10129.pdf — page 32]
SECRET25. Subject's spouse, a Costa Rican citizen, han expressed desire to acquire U. S. citizenship, and has now made the necessary arrango- ments to accompany her husband to the U. 8. for this purpose, when Subject returns for Covert training at Headquarters in the very near future.6. Covert Security Approval, with an expedite Provisional Covert Security Approval, has bean requested in connection with the recomenda- tion to convert Subject from contract to staff status.J. C. KINGChief, Western Hemisphere DivisionSECRET
[104-10215-10129.pdf — page 33]
# SECRET(When Filled In)# REQUEST FOR INVESTIGATION AND (OR) NAME CHECKTO: Deputy Director of SecurityATT: Mr. Rice 2613 IFROM: Chief, CI/Operational Approvaland Support DivisionSUBJECT: C-25507NO. #112569PCSA & X1. TYPE OF REQUESTCSA3. INDICES RESULTS REQUESTED BY2. METHOD OF HANDLINGROUTINE4. FBI CHECK REQUESTEDBY (Date)5. AREA OF SUBJECT'S ASSIGNMENT(WH/III/Cuba)6. USE OF SUBJECTsee remarks7. INVESTIGATION NOT TO REVEAL INTEREST OFU. S. GOVERNMENT CIA SEE REMARKS OTHER:8. COVER SUGGESTED FOR INVESTIGATIONOFFICIAL COMMERCIAL9. RESULTS OF TRACESFIELD TRACESNDIRI TRACESNDI10. ATTACHMENTS PRO-PART X OTHERS PHSGREEN LIST INITIATEDYES NO12. REMARKS6. Subject has served CIA in a contract capacity since 1949, with a continuous high level of performance. He is currently assigned to Cuba, where he is being 'utilised a the Principal Agent for Project AMPHOLARCH. Project AMPHODAFCH is an FI operation designed to provide information on political activities (including Communist) in university circles in Havana, Cuba. In view of his outstanding record and strong overall qualifications, and his expressed desire for a career with CIA, it has been recommended he be converted from contract to career agent status.DATE 28 February 1957PROJECTPCSA requested by 15 march 1957.
[104-10215-10129.pdf — page 34]
# INSTRUCTION SHEETTO: Processing SectionDATE 27 Fe6:57 CASE NO. 25507PLEASE TAKE THE FOLLOWING ACTION ON THE CASE SET FORTH ABOVE.(Always check "Remarks" below for limitations or details)SET UP FOR:POA BITHΕΧΡΕΟΙΤΕ INDICES FOREXPEDITE FOR CHECK FORSET UP FOR:CSAPROP APPSPECIAL INQUIRYCOVERT NAME CHECEISSUE OPERATIONAL APPROVALREQUEST RI TRACESISSUE PROVISIONAL OPERATIONAL APPROYALREQUEST OPERATIONAL & DIY. TRACESINVESTIGATION STILL OUTSTANDINGREQUEST FIELD TRACESFORWARD ATTACHMENT TO DIVISIONREQUESTFORWARDЕТАНИЕНТJO SECURITY oregonists PHSNOTICE:IST2403RD FINALREQUEST ADDITIONAL BIOGRAPHIC INFOREQUEST GREEN LISTPREPARE CANCELLATION FORMFURNISH GREEN LIST INFORMATIONSEND TO RI/ARCHIVESREQUEST RESULTS OF TECH. INTERROGATIONSEND "QUERY" MEMO TO DIVISIONEXTEND POA FOR DAYS UNTILOTHER (See Remarks)REMARKS:![signature]![signature]
[104-10215-10129.pdf — page 35]
SECRET(When Filled In)REQUEST FOR INVESTIGATION AND APPROVALTO: CI/Operational Approval and SupportDivisionFROM:(Division) WH/III/CUBASUBJECTCI/OA FILE NO.SO FILE NO.Ross Lester CORZIERC-25507Arthur G. VAIVADAUSE OF AGENT OR EMPLOYEE (Full details)Subject has served CIA in a contract capacity since 1949, with a continuoushigh level of performance. He is currently assigned to Cuba, where he is beingutilized as the Principal Agent for Project AMPHODARCH. Project AMPHODARCH isan FI operation designed to provide information on political activities (including-Commmist) in university circles in Havana, Cuba. In view of his outstandingrecord and strong overall qualifications, and his expressed desire for a careerwith CIA, it has been recomended he be converted from contract to career agent status.TYPE ACTION REQUESTEDPROVISIONAL APPROVALPROVISIONAL COVERT SECURITY APPROVAL 15 MarchOPERATIONAL APPROVALCOVERT SECURITY APPROVALGOVERNMEST NAME CHECKPROPRIETARY APPROVALSPECIAL INDJIRY (SO field investigation)OTHER:PRO AND GREEN LIST STATUSPRQ 1. OR EQUIVALENT, IS ATTACHED IN TOO COPIESPRO II WILL BE FORWARDED WHEN RECEIVEDX PRO 11 15 ATTACHED. IF-OBTAINABLEGREEN LIST CHECK HAS GEER INITIATEDFIELD TRACES..X REVEAL NO INFORMATION OF VALUE : WILL BE FORWARDED WHEN RECEIVED: NOT INITIATED. NOT EXPECTED TO POSSESS RELEVANT INFO.REVEAL INFORMATION AS ATTACHEDSUGGESTED INVESTIGATIVE COVERCOVERNMENT ACADEMICCOMMERCIAL OTHER:R1 TRACESDIVISION TRACESX RECORD (Bot derogatory) NO RECORDX RECORD (Not derogatory) NO RECORDINDICATE SPECIAL LIMITATIONS ON INVESTIGATION OR SPECIAL COVERAGE DESIREDSUBJECTIS AWARE UNAWARE OF CIA INTERESTUNAWARE OF O.S. GOVERNMENT INTERESTUNAWARE OF INPENDING INVESTIGATIONHAS BEEN BRIEFED ON A "COVER STORY".SIGNATURE OF CASE OFFICEREXTENSION SIGNATURE OF BRANCH CHIEFNeisbe S. MacAuley 1021 Barton 2056 W. GalbraithFORM NO. 7721 SEP 55SECRET.
[104-10215-10129.pdf — page 36]
# PERSONAL HISTORY STATEMENTInstructions: 1. Answer all questions completely. If question is not applicable write "NA." Write "unknown" only if you do not know the answer and cannot obtain the answer from personal records. Use the blank pages at the end of this form for extra details on any question or questions for which you do not have sufficient room.2. Type, print, or write carefully; illegible or incomplete forms will not receive consideration.HAVE YOU READ AND DO YOU UNDERSTAND THE INSTRUCTIONS?YesSEC. 1. PERSONAL BACKGROUNDA. FULL NAMEMiss Ross Lester Crozier(Use No Initials)(First)(Middle)(Last)Telephone HoneOfficeExt. HoneHomePRESENT ADDRESS5th Street 655, Havana (Vedado)Cuba(Country)PERMANENT ADDRESSSai Juan Tibas, San Jose, Costa Rica(SL. and Number)(City)(State)B. NICKNAMEHoneWHAT OTHER NAMES HAVE YOU USED!UNDER WHAT CIRCUMSTANCES HAVE YOU EVER USED THESE NAMES?HOW LONG?IF A LEGAL CHANGE, GIVE PARTICULARS20 June 1922 DeKalb irinots USAC. DATE OF BIRTHPLACE OF BIRTH(City)(State)(Country)D. PRESENT CITIZENSHIPUSBY BIRTH!BY MARRIAGE!(Country)BY NATURALIZATION CERTIFICATE NO.ISSUEDBY(Date)(Court)HAVE YOU HAD A PREVIOUS NATIONALITY?No(Yes or No)(Country)HELD BETWEEN WHAT DATES!TOANY OTHER NATIONALITY!(Country)GIVE PARTICULARSHAVE YOU TAKEN STEPS TO CHANGE PRESENT CITIZENSHIP?GIVE PARTICULARS:SEP 1950 38-1
[104-10215-10129.pdf — page 37]
E. IF BORN OUTSIDE U. S. WHEN DID YOU FIRST ARRIVE IN THIS COUNTRY? __NA__PORT OF ENTRY? __NA__ ON PASSPORT OF WHAT COUNTRY? __NA__LAST U. S. VISA __________ (Number) __________ (Type) __________ (Place of Issue) __________ (Date of Issue)SEC. 2. PHYSICAL DESCRIPTIONAGE __34__ SEX __M__ HEIGHT __6'2"__ WEIGHT __175__EYES __Blue__ HAIR __Brown__ COMPLEXION __Ruddy__ SCARS __None__BUILD __Slender__ OTHER DISTINGUISHING FEATURES __Nose broken-to left__SEC. 3. MARITAL STATUSA. SINGLE __No__ MARRIED __Yes__ DIVORCED __No__ WIDOWED __No__STATE DATE, PLACE, AND REASON FOR ALL SEPARATIONS, DIVORCES OR ANNULMENTS __NA__B. WIFE OR HUSBAND (IF YOU HAVE BEEN MARRIED MORE THAN ONCE-INCLUDING ANNUL- MENTS-USE A SEPARATE SHEET FOR FORMER WIFE OR HUSBAND GIVING DATA REQUIRED BELOW FOR ALL PREVIOUS MARRIAGES.)NAME OF SPOUSE Argentina de los Angeles Cordero de CrozierPLACE AND DATE OF MARRIAGE 17 Dec. 1945, Cristobal, Canal ZoneHIS (OR HER) ADDRESS BEFORE MARRIAGE San Jose, Costa RicaLIVING OR DECEASED Living DATE OF DECEASE __NA__ CAUSE __NA__PRESENT, OR LAST, ADDRESS 5th St., No. 655 Vedado, Habana, CubaDATE OF BIRTH __15/3/18__ PLACE OF BIRTH San Jose, Costa RicaIF BORN OUTSIDE U. S. INDICATE DATE AND PLACE OF ENTRY __NA__CITIZENSHIP Costa Rican WHEN ACQUIRED? Birth WHERE? San Jose, C.R.OCCUPATION Housewife LAST EMPLOYER NoneEMPLOYER'S OR BUSINESS ADDRESS __NA__MILITARY SERVICE FROM __NA__ TO __NA__ BRANCH OF SERVICE __NA__COUNTRY __NA__ DETAILS OF OTHER GOVT. SERVICE, U. S. OR FOREIGN
[104-10215-10129.pdf — page 38]
## SEC. 4. CHILDREN OR DEPENDENTS (Include partial dependents):1. NAME Ross Arnulfo Crosier RELATIONSHIP Son AGE 6 1/2CITIZENSHIP US ADDRESS 5th St., No. 655, Habana, Cuba2. NAME Lillian Caridad Crosier RELATIONSHIP Daughter AGE 4 1/2CITIZENSHIP US ADDRESS 5th St., No. 655, Habana, Cuba3. NAME NA RELATIONSHIP NA AGECITIZENSHIP NA ADDRESS NA## SEC. 5. FATHER (Give the same information for stepfather and/or guardian on a separate sheet)FULL NAME Lester Earl CrozierLIVING OR DECEASED Living DATE OF DECEASE NA CAUSE NAPRESENT, OR LAST, ADDRESS RR No. 1 Tampico Illinois USADATE OF BIRTH Mar. 15 1900 PLACE OF BIRTH Palestine Illinois USAIF BORN OUTSIDE U. S. INDICATE DATE AND PLACE OF ENTRY NACITIZENSHIP US WHEN ACQUIRED? Birth WHERE? aboveOCCUPATION Truckdriver LAST EMPLOYER Self-employedEMPLOYER'S OR OWN BUSINESS ADDRESS RR No. 1 Tampico Illinois USAMILITARY SERVICE FROM 1917 TO 1919 BRANCH OF SERVICE US ArmyTheatre: France-BelgiumDETAILS OF OTHER GOVT. SERVICE, U. S. OR FOREIGN NA## SEC. 6. MOTHER (Give the same information for stepmother on a separate sheet)FULL NAME Elisabeth Lorene McKibbenLIVING OR DECEASED Living DATE OF DECEASE NA CAUSE NAPRESENT, OR LAST, ADDRESS RR No. 1 Tampico Illinois USADATE OF BIRTH Sept. 1903 PLACE OF BIRTH La Moille, Illinois USACITIZENSHIP US WHEN ACQUIRED? Birth WHERE? aboveIF BORN OUTSIDE U. S. INDICATE DATE AND PLACE OF ENTRY NA