[104-10224-10001.pdf — page 155]
# APPLICATION FOR SECURITY INVESTIGATION21. RELATIVES - List all persons living in the United States or Territories of the United States who are NOT RELATED TO YOU AND WHO    HAVE KNOWLEDGE of your qualifications and fitness for the position for which you are applying. Do not report names of supervisors.| FULL NAME            | PRESENT BUSINESS OR HOME ADDRESS    | BUSINESS OR OCCUPATION       || -------------------- | ----------------------------------- | ---------------------------- || 1. Edward C. Sweeney | 725 15th Street, N.W., Wash D.C.    | Attorney                     || 2. Edward Ring       | 452 Oakwood Street, S.E., Wash D.C. | Adm Ass't to Senator Bridgeo || 3. William Armbrust  | 4006 Loraine Ave Falls Church Va    | Ass't Postmaster             |INDICATE ANSWER BY PLACING "X" IN PROPER COLUMN| QUESTIONS                                                                                                                                                                                                                                                                                                                                                                                                                                                                       | YES | NO  || ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | :-: | :-: || 22. (a) Are you a citizen of the United States of America?                                                                                                                                                                                                                                                                                                                                                                                                                      |  X  |     || (b) As a native or naturalized citizen of the United States do you owe allegiance to the United States of America?                                                                                                                                                                                                                                                                                                                                                              |  X  |     || 23. Are you now, or have you ever been, a member of the Communist Party, U.S.A., or any Communist organization?                                                                                                                                                                                                                                                                                                                                                                 |     |  X  || 24. Are you now, or have you ever been, a member of a Fascist organization?                                                                                                                                                                                                                                                                                                                                                                                                     |     |  X  || 25. Are you now, or have you ever been, a member of any foreign or domestic organization, association, movement, group, or combination of persons which advocates or approves of acts of force or violence to deny other persons their rights under the Constitution of the United States, or which seeks to alter the form of government of the United States by unconstitutional means?                                                                                       |     |  X  || If your answer to question 23, 24, or 25 above is "Yes," state the period or periods during which you belonged to and were a part of this organization, giving complete name and address of organization, best of others and data of membership. Give complete details of your activities, together with complete details of all acts or omissions in furtherance of the purposes of the organization. Make any explanation you desire regarding your membership or activities. |     |     || 26. Does the United States Government employ in a civilian capacity any relative or spouse (by blood or marriage) with whom you live or have lived within the past 24 months?                                                                                                                                                                                                                                                                                                   |     |  X  || If your answer is "Yes," give the in Item 31, EACH such relative: (1) full name; (2) period employed; (3) relative to you; (4) department or activity by which employed; and (5) kind of appointment.                                                                                                                                                                                                                                                                           |     |     || 27. A. Have you any physical handicap, chronic disease, or other disability?                                                                                                                                                                                                                                                                                                                                                                                                    |     |  X  || B. Have you ever had a nervous breakdown?                                                                                                                                                                                                                                                                                                                                                                                                                                       |     |  X  || C. Have you ever had tuberculosis?                                                                                                                                                                                                                                                                                                                                                                                                                                              |     |  X  |INDICATE ANSWER BY PLACING "X" IN PROPER COLUMN| QUESTIONS                                                                                                                                                                                                                                                                                                                                                                                                                   | YES | NO  || --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | :-: | :-: || 28. May inquiries be made of your present employer regarding your character, qualifications, etc.?                                                                                                                                                                                                                                                                                                                          |     |  X  || 29. Do you now receive or have you applied for an annuity from the United States or District of Columbia Government under any retirement or any pension or other compensation for military                                                                                                                                                                                                                                  |     |  X  || If "Yes," give details in Item 31.                                                                                                                                                                                                                                                                                                                                                                                          |     |     || 30. Are you now indebted or employee of, any State, Territory, country or municipality?                                                                                                                                                                                                                                                                                                                                     |     |  X  || If "Yes," give details in Item 31.                                                                                                                                                                                                                                                                                                                                                                                          |     |     || 31. Have you ever been barred by the U. S. Civil Service Commission from taking examinations or accepting civil-service appointment?                                                                                                                                                                                                                                                                                        |     |  X  || If your answer is "Yes," give dates of and reasons for such ban.                                                                                                                                                                                                                                                                                                                                                            |     |     || 32. A. Have you ever been discharged from employment because: (1) Your conduct was not satisfactory? (2) Your work was not satisfactory?                                                                                                                                                                                                                                                                                    |     |  X  || B. Have you ever resigned after official notification that: (1) Your conduct was not satisfactory? (2) Your work was not satisfactory?                                                                                                                                                                                                                                                                                      |     |  X  || C. Have you ever been discharged from the Armed Services under other than honorable conditions?                                                                                                                                                                                                                                                                                                                             |     |  X  || If your answer to A, B, or C is "Yes," give details in Item 31 as directly as you can remember, including the name and address, approximate date, and reasons in each case.                                                                                                                                                                                                                                                 |     |     || 34. Have you ever been arrested, charged, or held by federal, State, or local law-enforcement authorities for any violation of any federal, State, city, county or municipal law, regulation, or ordinance? Do not include anything that happened before your 16th birthday. Do not include traffic violations for which a fine of $25 or less was imposed. All other charges must be included even if they were dismissed. |     |  X  || If your answer is "Yes," give in Item 31 for each case: (1) offense or charge; (2) approximate date; (3) place; (4) disposition.                                                                                                                                                                                                                                                                                            |     |     |33. SPACE FOR DETAILED ANSWERS TO OTHER QUESTIONS. Indicate item numbers in which answers apply.| Item No. |                                              | Item No. |                                                                      || -------- | -------------------------------------------- | -------- | -------------------------------------------------------------------- || 19.      | Australia ....... 1 yr ....... 1942          | 29.      | Retiring July 1961 after 20 years of active service in the U.S. Army ||          | New-Guinea ..... 1943 ...... 1 yr            |          |                                                                      ||          | Philippine ........ 1944 ...... 1/2 yr       |          |                                                                      ||          | Japan ................... 1945 ...... 1/4-yr |          |                                                                      ||          | United Kingdom 1950-1953                     |          |                                                                      ||          | Ethiopia ............ 1953-1955              |          |                                                                      |ATTENTION: If you are appointed, all facts you give will be subject to investigation including a check of your fingerprints. Before signing this application be certain you have answered all questions correctly and that your credibility can be decided on the basis of all the facts. Omission about such matters in cases of discretion will be considered together with the favorable information in your record in determining your personal fitness for federal employment. However, a false statement or dishonest answer to any question may be grounds for cancellation of your application or your dismissal after appointment and is punishable by law.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 27 March 1961Signature