[104-10222-10005.pdf — page 52]
# SECRET(When Filled In)REQUEST FOR PERSONNEL ACTION|                  |                    V to V                    |           V to UV           |                  |                    || ---------------- | :------------------------------------------: | :-------------------------: | ---------------- | ------------------ ||                  |                   UV to V                    |          UV to UV           |                  |                    || 1. Serial No.    |         2. Name (Last-First-Middle)          |   DATE PREPARED Mo Da Yr    |                  |                    ||                  |              KOSIAN, Thomas J.               |                             |                  |                    || 3. Date Of Birth |             4. Vet. Pref. 5. Sex             |     6. CS EOD Mo Da Yr      |                  |                    || Mo Da Yr         |                 None-0 Code                  |                             |                  |                    || 6 20 30          |                  3. Pt-1: 1                  |              M              |                  |                    ||                  |                 10. Pt-2: 1                  |                             |                  |                    || 7. SCD Mo Da Yr  | 8. CSC Retmt 9. CSC Or Other Legal Authority | 10. Appt. Affiday 11: FECLI | 12. LCD Mo Da Yr | 13. DISCH Mo Da Yr ||                  |                   Yes - 1                    |           Yes - 1           |                  |                    ||                  |                 No - 2 Code                  |         No - 2 Code         |                  |                    |CURRENT ASSIGNMENT| 14. Organizational Designation |        Code        | 15. Location Of Official Station |   Station Code    |                    |                          || ------------------------------ | :----------------: | :------------------------------: | :---------------: | ------------------ | ------------------------ || DDP/WH                         |                    |        Mexico City Mexico        |                   |                    |                          || Branch III                     |                    |                                  |                   |                    |                          || Mexico City Mexico Station     |                    |                                  |                   |                    |                          || 16. Dept: Field                | 17. Position Title |         18. Position No.         |     19. Serv.     | 20. Occup. Series. |                          || Ualid Fran-X                   | Operations Officer |               426                |        05         | 0136.01            |                          || 21. Grade & Step               | 22. Salary Or Rate |              23. SD              | 24. Date Of Grade | 25. PSI Due        | 26. Appropriation Number || 9 - 2                          |       $ 6135       |                D                 |      6/15/58      | 6/12/69            | 0135-5700-3000           |ACTION| 27. Nature Of Action | Code | 28. E.R. Date | 29. Type Of Employee | Code | 30. Separation Data || -------------------- | :--: | :-----------: | :------------------: | :--: | :-----------------: || Integration          |      |   Mo Da Yr    |                      |      |                     || Department of State  |      |    1 16 60    |                      |      |                     |PROPOSED ASSIGNMENT| 31. Organizational Designation |        Code        | 32. Location Of Official Station |   Station Code    |                   |                          || ------------------------------ | :----------------: | :------------------------------: | :---------------: | ----------------- | ------------------------ ||                                |                    |                                  |                   |                   |                          || 33. Dept: Field                | 34. Position Title |         35. Position No.         |     36. Serv.     | 37. Occup. Series |                          || USALD Fran-X                   |                    |               FSS                |                   |                   |                          || 38. Grade & Step               | 39. Salary Or Rate |              40. SD              | 41. Date Of Grade | 42. PSI Due       | 43. Appropriation Number || 10 - 4                         |       $ 5540       |                                  |     Mo Da Yr      | Mo Da Yr          |                          |SOURCE OF REQUESTA. Requested By (Name And Title)OPSER/CCD/OSLB. For Additional Information Call (Name & Telephone Ext)M. Roney, x8161C. Request Approved By (Signature And Title) Date ApprovedMarqunte KorayCLEARANCES| Clearance         | Signature | Date        | Clearance       | Signature | Date || ----------------- | --------- | ----------- | --------------- | --------- | ---- || A. Career Board   |           |             | D. Disposal     |           |      || B. Post Control   |           |             | E. Medical      |           |      || C. Classification |           | AYH - 12-60 | F. Approved By. |           |      |all sick and all annual leave to be transferred to Department of State.![Signature]FORM 1152aSECRETContinued on reverse side