[104-10225-10003.pdf — page 315]
# SECRET(When Filled in)REPORT OF SERVICE ABROADTO: Office of Personnel, Transactions and Records Branch, Status Section|            |           NAME            || ---------- | :-----------------------: || SERIAL NO. | LAST     FIRST     MIDDLE ||            |          (Print)          || `025658`   |  `Piccolo` `Joseph` `S,`  |INSTRUCTIONSUSE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TOY. INSERT APPROPRIATE CODE NUMBER IN "CODE" COLUMN TO DESIGNATE WHETHER SUBMISSION IS OF BASIC DATA, CORRECTION, OF CANCELLATION (One only). REPORT DATES BY USING THE NUMBER FOR THE MONTH. AND LAST TWO DIGITS ONLY FOR YEAR. REFER TO OFI NO. 38. REVISED.PCS DATES OF SERVICE|       | ARRIVAL O/S |     |       |       | DEPARTURE O/S |     |       |                 TYPE OF DATA                 | CODE | O/P USE ONLY |      COUNTRY       |  CODE  || ----- | ----------- | :-: | :---: | ----- | ------------- | :-: | :---: | :------------------------------------------: | ---- | :----------: | :----------------: | :----: || MONTH | DAY         |     | YEAR  | MONTH | DAY           |     | YEAR  |                                              |      |              |                    |        || 25-26 | 27-28       |     | 29-30 | 31-32 | 33-34         |     | 35-36 | 1. PCS (Basic) 3. CORRECTION 5. CANCELLATION | 37   |    38 39     | Managua, Nicaragua | 40-42  ||       |             |     |       | `01`  | `1`           |     | `69`  |                                              | `/`  |              |      Nigeria       | `5/25` |TOY DATES OF SERVICE|       | ARRIVAL O/S |     |       |       | DEPARTURE O/S |     |       |                 TYPE OF DATA                  | CODE | O/P USE ONLY | AREA(S) | CODE  || ----- | ----------- | :-: | :---: | ----- | ------------- | :-: | :---: | :-------------------------------------------: | ---- | :----------: | ------- | :---: || MONTH | DAY         |     | YEAR  | MONTH | DAY           |     | YEAR  |                                               |      |              |         |       || 25-26 | 27-28       |     | 29-30 | 31-32 | 33-34         |     | 35-36 | 2. TOY (Basic)" 4. CORRECTION 6. CANCELLATION | 37   |    38 39     |         | 40-42 ||       |             |     |       |       |               |     |       |                                               |      |              |         |       |OFFICE OF PERSONNEL USE ONLY - PUNCH AREASOURCE DOCUMENT AND CERTIFICATIONTRAVEL VOUCHERDISPATCH✓ CABLEDUTY STATUS OR TIME AND ATTENDANCE REPORTOTHER (Specify)DOCUMENT IDENTIFICATION Nu.`LN 15783`DOCUMENT DATE/PERIOD6 January 1969REMARKS| PREPARED BY          | REPORT ANNOTATED ON CONTROL DOCUMENT | ABOVE DATA CERTIFIED CORRECT. BASED UPON SUURCE DOCUMENT CITED || -------------------- | :----------------------------------: | :------------------------------------------------------------: || OCO                  |                  .                   |                                                                || ✓ & T DIVISION ETGO. |            DATE: 11/13/68            |                   SIGNATURE: Phyllis G Ming                    |THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNEL IN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDERSECRET![Form 1451a is a blank US government form.](6-10)