[104-10224-10012.pdf — page 254]
# SECRETSECTION V CONTINUED FROM PAGE:| 6. BANKING INSTITUTIONS WITH WHICH YOU HAVE ACCOUNTS |                                || ---------------------------------------------------- | ------------------------------ || NAME OF INSTITUTION                                  | ADDRESS (City, State, Country) || JEFFERSON FEDERAL SAVINGS                            | WASHINGTON DC                  || RIGGS (THRIFTI-CHECK)                                |                                |7. HAVE YOU BEEN DECLARED, OR PETITIONED FOR, BANKRUPTCY? YES NO8. IF YOU HAVE ANSWERED "YES" TO QUESTION 7 ABOVE, GIVE PARTICULARS, INCLUDING COURT AND DATE(S)N/A## SECTION VI| CITIZENSHIP                                                                                                    |                                            || -------------------------------------------------------------------------------------------------------------- | ------------------------------------------ || 1. COUNTRY OF CURRENT CITIZENSHIP                                                                              | 2. CITIZENSHIP ACQUIRED BY: CHECK (X) ONE: || U.S.                                                                                                           | Birth  Naturalization Other (Specify):     || 3. HAVE YOU TAKEN STEPS TO CHANGE YOUR PRESENT CITIZENSHIP?  NO                                                |                                            || 4. GIVE PARTICULARS                                                                                            |                                            || 5. IF YOU HAVE APPLIED FOR U.S. CITIZENSHIP, INDICATE PRESENT STATUS OF YOUR APPLICATION (Attach papers, etc.) |                                            || - N/A                                                                                                          |                                            |## SECTION VII### EDUCATION1. CHECK (X) HIGHEST LEVEL OF EDUCATION ATTAINED:| LESS THAN HIGH SCHOOL GRADUATE                 | TECHNICAL SCHOOL GRADUATE                 || ---------------------------------------------- | ----------------------------------------- || HIGH SCHOOL GRADUATE                           | BACHELOR'S DEGREE                         || TRADE, BUSINESS, OR COMMERCIAL SCHOOL GRADUATE | GRADUATE STUDY LEADING TO MASTER'S DEGREE || FOUR YEARS COLLEGE OR LESS                     | MASTER'S DEGREE                           |2. COLLEGE OR UNIVERSITY STUDY| NAME AND LOCATION OF COLLEGE OR UNIVERSITY | SUBJECT | DATES ATTENDED | DEGREE REC'D | DATE REC'D | SEM/QTR HRS COMPLETED (Specify) || ------------------------------------------ | ------- | -------------- | ------------ | ---------- | ------------------------------- || MAJOR                                      | MINOR   | FROM           | TO           |            |                                 ||                                            |         |                |              |            |                                 ||                                            |         |                |              |            |                                 ||                                            |         |                |              |            |                                 ||                                            |         |                |              |            |                                 ||                                            |         |                |              |            |                                 ||                                            |         |                |              |            |                                 ||                                            |         |                |              |            |                                 |3. TRADE, COMMERCIAL AND SPECIALIZED SCHOOLS| NAME OF SCHOOL | STUDY OR SPECIALIZATION | DATES ATTENDED | TOTAL HOURS || -------------- | ----------------------- | -------------- | ----------- ||                |                         | FROM           | TO          ||                |                         |                |             ||                |                         |                |             ||                |                         |                |             |4. MILITARY TRAINING (Full time duty in specialized schools such as Ordnance, Intelligence, Communications, etc.)| NAME OF SCHOOL | STUDY OR SPECIALIZATION | DATES ATTENDED | TOTAL HOURS || -------------- | ----------------------- | -------------- | ----------- ||                |                         | FROM           | TO          ||                |                         |                |             ||                |                         |                |             |5. OTHER EDUCATIONAL TRAINING NOT INDICATED ABOVESECRET3