[104-10224-10001.pdf — page 36]
# SECRET(When Filed In)NOTIFICATION OF PERSONNEL ACTION|                                                                                                |                                  |                                                                   |                    || ---------------------------------------------------------------------------------------------- | -------------------------------- | ----------------------------------------------------------------- | ------------------ || 1. SERIAL NUMBER                                                                               | 2. NAME (LAST, FIRST, MIDDLE)    |                                                                   |                    || 77455                                                                                          | ARIS, J ROSLAW A                 |                                                                   |                    || 3. NATURE OF PERSONNEL ACTION                                                                  | 4. EFFECTIVE DATE                | 5. CATEGORY OF EMPLOYMENT                                         |                    ||                                                                                                | MO 1 17 DA YR 71                 | REGULAR                                                           |                    || 6. FUNDS                                                                                       |                                  | 7. Remarks (Analyze No Chargeable 8. CSC OR OTHER LEGAL AUTHORITY |                    ||                                                                                                | V TO V X V TO CF                 | 257 53 WI 5 USC 3 J                                               |                    ||                                                                                                | CF TO V   CF TO CF               |                                                                   |                    || 9. ORGANIZATIONAL DESIGNATIONS                                                                 | 10. LOCATION OF OFFICIAL STATION |                                                                   |                    || TECHNICAL SERVI SAN SUPPORT GROUP RESEARCH AND ENGINEERING DIVISION ADVANCED TECHNOLOGY BRANCH | WAS, D.C.                        |                                                                   |                    || 11. POSITION TITLE                                                                             | 12. POSITION NUMBER              | 13. SERVICE DESIGNATION                                           |                    || D AND E TECH                                                                                   | 644                              | 12                                                                |                    || 14. CLASSIFICATION SCHEDULE (GS, WB, etc.)                                                     | 15. OCCUPATIONAL SERIES          | 16. GRADE AND STEP                                                | 17. SALARY OR RATE || GS                                                                                             | 167/08                           | 9 5                                                               | 1,564              || 18. REMARKS                                                                                    |                                  |                                                                   |                    |SPACE BELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL|                                                                             |                       |                                  |                                |                                      || --------------------------------------------------------------------------- | --------------------- | -------------------------------- | ------------------------------ | ------------------------------------ || 19. ACTION CODE                                                             | 20. Employ. Code      | 21. OFFICE CODING                | 22. STATION CODE               | 23. INTEGER CODE                     || 37                                                                          | 7                     | 75313 VALE                       | 75213                          | 1                                    || 28. NITE EXPIRES                                                            | 29. SPECIAL REFERENCE | 30. RETIREMENT-DATA              | 31. SEPARATION DATA CODE       | 32. Correction/Cancellation Data     || MO                                                                          | 76 YR 10              | RSSA CODE:                       | DA                             | YR                                   ||                                                                             |                       | NONE                             |                                |                                      || 24. DATE OF BIRTH                                                           | 25. DATE OF GRACE     | 26. DATE OF LEI                  | **EOD DATA**                   | 33. SECURITY REQ. NO                 || MO 11 DA 15 YR 17                                                           | MO DA                 | MO DA YR                         | ![arrow pointing to the right] | 34. SEX                              || 35. VET PREFERENCE                                                          | 36. SERV. COMP. DATE  | 37. LONG. COMP. DATE             | 38. CAREER CATEGORY            | 39. FEGLI / HEALTH INSURANCE         || CODE                                                                        | MO DA YR              | MO DA YR                         | CAR DESV CODE PROV TEMP        | COM 0. WAIVER 1. YES HEALTH INS CODE || G-NONE 1-5 PT. 2-10 PT.                                                     |                       |                                  |                                | 40. SOCIAL SECURITY NO               || 41. PREVIOUS CIVILIAN GOVERNMENT SERVICE                                    | 42. LEAVE CAT CODE    | 43. FEDERAL TAX DATA             | 44. STATE TAX DATA             |                                      || CODE                                                                        | FORM EXECUTED CODE    | MO. TAX EXEMPTIONS FORM EXECUTED | CODE NO TAX STATE CODE EXEMP.  |                                      || 0 NO PREVIOUS SERVICE                                                       | 1. YES                | 1. YES                           | 1. YES                         |                                      || 1. NO BREAK IN SERVICE                                                      | 2-NO                  | 2-NO                             | 2-NO                           |                                      || 2-BREAK IN SERVICE (LESS THAN 3 YRS) 3. BREAK IN SERVICE (MORE THAN 3 YRS.) |                       |                                  |                                |                                      |SIGNATURE OR OTHER AUTHENTICATION![signature block]SECRET FVD![text Excluded from automatic downgrading and declassification](1.51) (When Filled In)PRINTED BY THE STANDARD COMPANY, U. S. A.