Francesco/who-killed-jfk huggingface dataset:
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# ADMINISTRATIVEInternal Use Only# REPORT OF SERVICE ABROADTO: Office of Personnel, Control Division, Statistical Reporting BranchSERIAL NO. LAST NAME36130 Flores DanielINSTRUCTIONSUSE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TOY. INSERT APPROPRIATE CODE NUMBER IN "CODE" COLUMNTO DESIGNATE WHETHER SUBMISSION IS OF BASIC DATA, CORRECTION, OR CANCELLATION (One only).REPORT DATES BY USINGTHE NUMBER FOR THE MONTH, AND LAST TWO DIGITS ONLY FOR YEAR. REFER TO OFI NO. 38 SERIES.PCS DATES OF SERVICE| ARRIVAL O/S       | DEPARTURE O/S     | TYPE OF DATA                                 | O/P USE ONLY | COUNTRY || ----------------- | ----------------- | -------------------------------------------- | ------------ | ------- || MONTH DAY YEAR    | MONTH DAY YEAR    |                                              | CODE         | CODE    || 25-26 27-28 29-30 | 31-32 33-34 35-36 | 1. PCS (Basic) 2. CORRECTION 3. CANCELLATION | 37 38-39     | 40-42   |TOY DATES OF SERVICE| ARRIVAL O/S       | DEPARTURE O/S     | TYPE OF DATA                                 | O/P USE ONLY | AREA(S) | CODE  || ----------------- | ----------------- | -------------------------------------------- | ------------ | ------- | ----- || MONTH DAY YEAR    | MONTH DAY YEAR    |                                              | CODE         |         | 40-42 || 25-26 27-28 29-30 | 31-32 33-34 35-36 | 4. TOY (Basic) 5. CORRECTION 6. CANCELLATION | 37 38-39     |         |       || 07 09 75          | 07 14 75          | 2                                            | WH           | 811     |       |OFFICE OF PERSONNEL USE ONLY - PUNCH AREATRAVEL VOUCHERSOURCE DOCUMENT AND CERTIFICATIONDISPATCHCABLEDUTY STATUS OR TIME AND ATTENDANCE REPORTOTHER (Specify)DOCUMENT IDENTIFICATION NO.DOCUMENT DATE/PERIODREMARKSPREPARED BY DATE7/15/75ABOVE DATA CERTIFIED CORRECT BASED UPON SOURCEDOCUMENT CITEDSIGNATURETHIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNELIN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDERADMINISTRATIVE-Internal Use Only
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# SECRET(When Filled In)# REPORT OF SERVICE ABROADFILEBY/4'TO: Office of Personnel, Transactions and Records Branch, Status SectionSERIAL NO. -LAST(Print)Flores036130FIRST7-14DanielINSTRUCTIONSUSE 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, OR CANCELLATION (One only). REPORT DATES BY USING THE NUMBER FOR THE MONTH. AND LAST TWO DIGITS ONLY FOR YEAR. REFER TO OFI NO. 58. REVISED.## PCS DATES OF SERVICE| MONTH | DAY   | YEAR  | TYPE OF DATA    | CODE | O/P USE ONLY | COUNTRY | CODE  || ----- | ----- | ----- | --------------- | ---- | ------------ | ------- | ----- || 25-26 | 27-28 | 29-30 | 1. PCS (Basic)  | 37   | 38 39        |         | 40-42 ||       |       |       | 2. CORRECTION   |      |              |         |       ||       |       |       | 3. CANCELLATION |      |              |         |       ||       | 03    | 05    | 74              | 1    |              | Peru    | 520   |## TOY DATES OF SERVICE| MONTH | DAY   | YEAR  | TYPE OF DATA    | CODE | O/P USE ONLY | AREA(S) | CODE  || ----- | ----- | ----- | --------------- | ---- | ------------ | ------- | ----- || 25-26 | 27-28 | 29-30 | 2. TOY (Basic)  | 37   | 38 39        |         | 40-42 ||       |       |       | 4. CORRECTION   |      |              |         |       ||       |       |       | 6. CANCELLATION |      |              |         |       |OFFICE OF PERSONNEL USE ONLY - PUNCH AREASOURCE DOCUMENT AND CERTIFICATION[X] TRAVEL VOUCHERDISPATCHCABLEDUTY STATUS OR TIME AND ATTENDANCE REPORTOTHER (Specify)DOCUMENT IDENTIFICATION NO.DOCUMENT DATE/PERIOD185131REMARKSPREPARED BYREPORT ANNOTATED ON CONTROL DOCUMENTABOVE DATA CERTIFIED CORRECT, BASED UPON SOURCE DOCUMENT CITEDC 1 DIVISIONDATE3/08/74SIGNATURETHIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNEL IN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDERFORM 1451aSECRET(6-10)
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# ADMINISTRATIVEInternal Use Only# REPORT OF SERVICE ABROADTO: Office of personnel, Control Division, Statistical ReportSERIAL NO.LASTNAME236130 FLORES DANIELINSTRUCTIONSUSE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TOY. INSERT APPROPRIATE CODE NUMBERED IN "CODE" COLUMN TO DESIGNATE WHETHER SUBMISSION IS OF BASIC DATA, CORRECTION, OR CANCELLATION (One only). REPORT DATES BY USING THE NUMBERS FOR THE MONTH, AND LAST TWO DIGITS ONLY FOR YEAR. REFER TO OFI NO. 58. REVISED.## PCS DATES OF SERVICE| ARRIVAL D/S | DEPARTURE D/S | TYPE OF DATA | 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 | 40-42 |## TOY DATES OF SERVICE| ARRIVAL D/S | DEPARTURE D/S | TYPE OF DATA | 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  |     || 10          | 05            | 74           | 10           | 07      | 74    | 2                                            |     | Europe | 801 |OFFICE OF PERSONNEL USE ONLY - PUNCH AREASOURCE DOCUMENT AND CERTIFICATIONTRAVEL VOUCHER DISPATCHCABLE DUTY STATUS OR TIME AND ATTENDANCE REPORTOther (Specify)DOCUMENT IDENTIFICATION NO. DOCUMENT DATE/PERIODWH 119-75 10/4-10/7/74REMARKSPREPARED BY ABOVE DATA CERTIFIED CORRECT, BASED UPON SOURCE DOCUMENT CITEDDATE SIGNATURE12/23/74THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNEL IN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDERADMINISTRATIVE-Internal Use Only
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# SECRET(When Filled In)# REPORT OF SERVICE ABROADTO:Office of Personnel, Transactions and Records Branch, Station![FILE NOTIFIED BY 64]SERIAL NO.LASTNAMEFIRST0225FLORESJODETINSTRUCTIONSUSE 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, OR 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 | O/P USE ONLY | COUNTRY |       |                 |      |       |       || ----------- | ------------- | ------------ | ------------ | ------- | ----- | --------------- | ---- | ----- | ----- || MONTH       | DAY           | YEAR         | MONTH        | DAY     | YEAR  |                 | CODE |       | CODE  || 25-26       | 27-28         | 29-30        | 31-32        | 33-34   | 35-36 | 1. PCS (Basic)  | 37   | 38 39 | 40-42 ||             |               |              |              |         |       | 2. CORRECTION   |      |       |       ||             |               |              |              |         |       | 3. CANCELLATION |      |       |       |ΤΟΥ DATES OF SERVICE| ARRIVAL O'S | DEPARTURE O/S | TYPE OF DATA | O/P USE ONLY | AREA(S) |       |                 |      |       |      || ----------- | ------------- | ------------ | ------------ | ------- | ----- | --------------- | ---- | ----- | ---- || MONTH       | DAY           | YEAR         | MONTH        | DAY     | YEAR  |                 | CODE |       | CODE || 25-26       | 27-28         | 29-30        | 31-32        | 33-34   | 35-36 | 1. TOY (Basic)  | 37   | 38 39 |      || 07          | 07            | 74           | 07           | 11      | 74    | 2. CORRECTION   | 2    |       | WII  ||             |               |              |              |         |       | 3. CANCELLATION |      |       |      |OFFICE OF PERSONNEL USE ONLY - PUNCH AREATRAVEL VOUCHERSOURCE DOCUMENT AND CERTIFICATIONDISPATCHCABLEDUTY STATUS OR TIME AND ATTENDANCE REPORTOTHER (Specify)DOCUMENT IDENTIFICATION NU.DOCUMENT DATE/PERIODREMARKS| PREPARED BY             | REPORT ANNOTATED ON CONTROL DOCUMENT | ABOVE DATA CERTIFIED CORRECT, BASED UPON SOURCE DOCUMENT CITED || ----------------------- | ------------------------------------ | -------------------------------------------------------------- || DCO L& L DIVISION CTDD. | DATE 6/28-74                         | SIGNATURE                                                      || & L DIVISION            |                                      |                                                                |THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNEL IN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDERSECRETFORM 1451a
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# SECRET(When Filled in)# REPORT OF SERVICE ABROADTO:Office of Personnel, Control Division, Statistical ReportingSERIAL NO. LAST NAME036130 FLORES DANIELINSTRUCTIONSUSE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TDY. INSERT APPROPRIATE CODE NUMBER IN "CODE" COLUMN TO DESIGNATE WHETHER SUBMISSION IS OF BASIC DATA, CORRECTION OR CANCELLATION (One only). REPORT DATES BY USING THE NUMBER FOR THE MONTH, AND LAST TWO DIGITS ONLY FOR YEAR. REFER TO OF! NO. 58 REVISED.## PCS DATES OF SERVICE| ARRIVAL O/S       | DEPARTURE O/S     | TYPE OF DATA    | CODE | O/P USE ONLY || ----------------- | ----------------- | --------------- | ---- | ------------ || MONTH DAY YEAR    | MONTH DAY YEAR    |                 |      |              || 25-26 27-28 29-30 | 31-32 33-34 35-36 | 1. PCS (Basic)  | 37   | 38 39        ||                   |                   | 3. CORRECTION   |      |              ||                   |                   | 5. CANCELLATION |      |              |## ΤΟΥ DATES OF SERVICE| ARRIVAL 0/5       | DEPARTURE 0/5     | TYPE OF ΠΑΤΑ    | CODE | O/P USE ONLY | AREA(S) || ----------------- | ----------------- | --------------- | ---- | ------------ | ------- || MONTH DAY YEAR    | MONTH DAY YEAR    |                 |      |              |         || 25-20 27-28 29-30 | 31-32 33-34 35-36 |                 |      |              |         || 06 13 74          | 06 21 74          | 2. TOY (Basic)  | 37   | 38 39        | WA      ||                   |                   | 4. CORRECTION   |      |              |         ||                   |                   | 6. CANCELLATION | 2    |              | P//     |OFFICE OF PERSONNEL USE ONLY - PUNCH AREASOURCE DOCUMENT AND CERTIFICATIONTRAVEL VOUCHER DISPATCHCABLE DUTY STATUS OR TIME AND ATTENDANCE RepeatOTHER (Specify)COCUMENT IDENTIFICATION NO. DOCUMENT DATE DATE/PERIODLN 542.74. 6/13-6/01/78DEMARKS2 Nov? YTHIS REPORT WILL BE FILED IN THE OFFICE OF PISI18 THE INDIVIDUAL'S OFFICIAL PERL 10:01SECRET
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ADMINISTRATIVEInternal Use OnlyREPORT OF SERVICE ABROADTO: Office of Personnel, Control Division, Statistical ReportSERIAL NO. LAST NAME036130 FLURES DANIELINSTRUCTIONSUSE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OF TOY. INSERT APPROPRIATE CODE NUMBER IN "CODE" COLUMNTO DESIGNATE WHETHER SUBMISSION IS OF BASIC DATA, CORRECTION, OR CANCELLATION (One only). REPORT DATES BY USINGTHE NUMBER FOR THE MONTH, AND LAST TWO DIGITS ONLY FOR YEAR. REFER TO OFI NO. 58 REVISED.PCS DATES OF SERVICE| ARRIVAL O/S | DEPARTURE O/S | TYPE OF DATA | O/P USE ONLY | COUNTRY |       |                                              |         |     |            || ----------- | ------------- | ------------ | ------------ | ------- | ----- | -------------------------------------------- | ------- | --- | ---------- || MONTH       | DAY           | YEAR         | MONTH        | DAY     | YEAR  | 1. PCS (Rovic) 3. CORRECTION 5. CANCELLATION | CODE 37 |     | CODE 40-42 || 25-26       | 27-28         | 29-30        | 31-32        | 33-34   | 35-36 |                                              | 38 39   |     |            |TOY DATES OF SERVICE| ARRIVAL 0/S | DEPARTURE O/S | TYPE OF DATA | O/P USE ONLY | AREA(S) | CODE  |                                             |         |         |            || ----------- | ------------- | ------------ | ------------ | ------- | ----- | ------------------------------------------- | ------- | ------- | ---------- || MONTH       | DAY           | YEAR         | MONTH        | DAY     | YEAR  | 2. TOY (Door) 4. CORRECTION 6. CANCELLATION | CODE 37 |         | CODE 40-42 || 25-26       | 27-28         | 29-30        | 31-32        | 33-34   | 35-36 |                                             | 38 39   |         |            || 08          | 12            | 74           | 18           | 16      | 74    |                                             | 2       | LA AREA | 811        |OFFICE OF PERSONNEL USE ONLY - PUNCH AREASOURCE DOCUMENT AND CERTIFICATION![photo of a check box] TRAVEL VOUCHER![photo of a blank line]![photo of a blank line]![photo of a blank line]![photo of a signature] 11.6.2THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNELIN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDERADMINISTRATIVE-Internal Use Only
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# SECRETFIELD REASSIGNMENT QUESTIONNAIREDO NOT COMPLETE FOR HEADQUARTERS USE ONLYOF EMPLOYEE (use pseudo only if SA) DATE(from item 5.1) NAME OF SUPERVISOR (true) DATE (from 110m 5.2)Daniel Flores 27 Feb 73 Richard Welch 27 Feb 73DATE RECEIVED AT HEADQUARTERS: DISPATCH NUMBER: DATE RECEIVED BY CAREER SERVICE.2 March 1973 HPLT-6502TO BE COMPLETED BY EXPLOYEE1. DATE OF BIRTH 2. SERVICE YOUR CURRENT POSITION, TITLE 4. STAPION OR BASE 5. CRYPT FOR   DESIGN AND GRADE CURRENT COVER4 Aug 1935 GS-11 Lima LNFALLFI Case OfficerOA. DATE OF PCS ARRIVAL 60. REQUESTED DATE OF OC. EXPECTED DATE OF FIRST 60. DESIRED DATE TO REPORT TO DUTYIN FIELO DEPARTURE CHECK-IN AT MO AFTER LEAVE24 Sept 1971 30 Nov 1974 1 Feb 1975 15 Feb 1975 (dependingon training.)7. NUMBER AND AGES OF DEPENDENTS WHO WILL TRAVEL WITH YOURWife: 37, daughter: 3O. PERSONAL CIRCUMSTANCES THAT SHOULD DE CONSIDERED IN DETERMINING NEXT ASSIGNMENTINoneLIST YOUR MAJOR DUTIES DURING CURRENT TOUR (a special note on transmittal form).(aiso attach personal cover questionnaire in accordance with CS1-F 240-8)September 1971 - July 1972 - Activities of the Communist Party andextreme leftist groups. Labor activities. Propara-tion of project outlines and progress reports.August 1972 - Prosent - Chinese Operations. News media capability.Preparation of project outlines and progress reports.10 FRAINING DESIR1001787BHAT TRAINING YOU OFLIEVE YOU SHOULD HAVE OUDING THE hiul sfvtal viagIn the near future I would like to take an advanced operations course.In connection with this, I would like to concentrate on the Soviet andChinese targets in Latin America. Special courson in these two areaswould be extremely helpful. Some time in the future I would like toattend the mid-career course.
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SECRETAt this point in my career the Soviet and Chinese targets are of major interest to me. Although I would prefer to work on Chinese operations in my next assignment, as an alternative I would consider working on Soviet operations.INDICATE IF YOU DESIRE TO EXTEND YOUR CURRENT TOUR BY CHECKING IN APPROPRIATE BOX. ALSO INDICATE PREFERENCE FOR NEXT REGULAR ASSIGNMENT BY INSERTING 1, 2, 3 (1st, 2nd, and 3rd choice) IN REMAINING BOXES.COMPLETE ALL ALTERNATE CHOICES AND OPTIONS IN ALL CASES EVEN THOUGH YOU ARE REQUESTING AN EXTENSION OF YOUR TOUR.*   EXTEND TOUR 14 MONTHS AT CURRENT STATION TO 31 November 1974*   OF ASSIGNED TO HDQTRS FOR A TOUR OF DUTY. INDICATE YOUR CHOICE OF DIVISION, STAFF OR OFFICE.*   OF ARSIGNED TO ANOTHER FIELD STATION, INDICATE CHOICE OF GEOGRAPHIC AREA OR SPECIALIZATION    1st CHOICE Caracas 2ND CHOICE Mexico 3RD CHOICE Buenos Aires*   RETURN TO MY CURRENT STATIONTO BE COMPLETED BY FIELD STATIONIN CONSIDERATION OF THE EXPERIENCE AND PERFORMANCE OF THE EMPLOYEE AND HIS PREFERENCE FOR NEXT ASSIGNMENT, INDICATE YOUR RECOMMENDATION FOR HIS NEXT ASSIGNMENT AND TRAINING:Concur. This officer is doing a good job on his assigned targets and his overall abilities give the Station a flexibility it often needs to call on.TO BE COMPLETED BY APPROPRIATE HEADQUARTERS OFFICEIN CONSIDERATION OF THE EXPERIENCE AND PERFORMANCE OF THE EMPLOYEE HIS PREFERENCE FOR NEXT ASSIGNMENT, AND THE STAFFING REQUIREMENTS OF YOUR COMPONENT, INDICATE YOUR COMPONENT'S RECOMMENDATION FOR HIS WEST ASSIGNMENT AND TRAINING.Subject's tour has been extended fourteen months to 31 November 1974.DATE 4/23/73 TITLE C/NII/Pers SIGNATURE H.L. BertholdFOR USE BY CAREER SERVICEEMPLOYEE NOTIFIED BY DISPATCH NO. HP15-3284 DATE (typed 23 Apr 73)SECRET
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SECRETREPORT OF SERVICE ABROADTO: Office of Personnel, Transactions and Records Branch, Status SectionSERIAL NO. LAST NAME036130 FLORES DANIELINSTRUCTIONSUSE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TOY. INGEST APPROPRIATE COOM NUMBER IN "CODE" COLUMN TO DESIGNATE WHETHER SUBMISSION IS OF BASIC DATA, CORRECTION, OR CANEFELATION (One waly). REPORT DATES DY USING THE NUMBER FOR THE MONTH, AND LAST TOO DIGITS ONLY FOR YEAR. REFER 10 OF NO. 88. VISED.PCS DATES OF SERVICE| ARRIVAL O/S  | DEPARTURE O/S | TYPE OF DATA    | O/P USE ONLY | COUNTRY | CODE  || ------------ | ------------- | --------------- | ------------ | ------- | ----- || MONTH: 25-26 | MONTH: 31-32  | 1. PCS (Basic)  | 37 38 39     | ECUADOR | 40-42 || DAY: 27-28   | DAY: 33-34    | 4. CORRECTION   |              |         | 195   || YEAR: 29-30  | YEAR: 35-36   | 8. CANCELLATION |              |         |       ||              | 0 5 2 8 7 1   |                 | 1            |         |       |ΤΟΥ DATES OF SERVICE| ARRIVAL O/S  | DEPARTURE O/S | TYPE OF DATA    | O/P USE ONLY | AREA (S) | CODE  || ------------ | ------------- | --------------- | ------------ | -------- | ----- || MONTH: 25-26 | MONTH: 31-32  | 2. TOY (Basic)  | 37 38 39     |          | 40-42 || DAY: 27-28   | DAY: 33-34    | 4. CORNECTION   |              |          |       || YEAR: 29-30  | YEAR: 35-38   | 8. CANCELLATION |              |          |       |OFFICE OF PERSONNEL USE ONLY - PUNCH AREASOURCE DOCUMENT AND CERTIFICATIONTRAVEL VOUCHER DISPATCHCable DUTY STATUS OF TIME AND ATTENDANCE REPORTOTHER (Specify)DOCUMENT IDENTIFICATION NU. DOCUMENT DATE/PER10016318 29 Day 1971REMARESPREPARED BY ABOVE DATA CRATIFIES CORRECT, BASED UPON SOURCEDOCUMENT CITEDDATE SIGNATURE6/9/71THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNEL IN THE INDIVIDUAL'S OFFICIAL PERSOPHEL FOLDERSECRET
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# SECRET(when filled in)1. PHYSICAL DWELLING PLAT (Permanent Place of Residence unless address in item 6 is approved in lieu thereof)FULL ADDRESSWashington, D. C.6. OTHER PLACE REQUESTED (Requested Permanent Place of Residence if different from item 3)FULL ADDRESSAPPROVEDDEPUTY DIRECTORDATECONCURDEPUTY DIRECTORDATEAPPROVEDDIRECTOR OF PERSONNELDATE5.20.71DIRECTOR OF PERSONNEL## IV. HOME LEAVE POINT7. AMONG THE PLACES YOU MAY REQUEST AS A HOME LEAVE POINT ARE; YOUR PERMANENT PLACE OF RESIDENCE SHOWN ABOVE, HEADQUARTERS AREA, AND WHERE YOUR CHILDREN, PARENTS, PARENTS-IN-LAW, BROTHERS, SISTERS, BROTHERS-IN-LAW, OR SISTERS-IN-LAW RESIDE.8. YOU MAY REQUEST FOR APPROVAL SOME OTHER POINT SUBJECT TO THE PROVISIONS OF HR 20-30B(3)(C). THE REQUEST MUST BE ACCOMPANIED BY A MEMORANDUM EXPLAINING THE CIRCUMSTANCES.9. DESIGNATION PER ITEM 7 ABOVEFULL ADDRESS4505 Washington StreetMilwaukie, Oregon10. DESIGNATION PER ITEM 8 ABOVE.FULL ADDRESSRELATIONSHIP OF RELATIVE AT HOME LEAVE POINTParents-in-lawAPPROVEDDEPUTY DIRECTORDATECONCURDEPUTY DIRECTORDATEAPPROVEDDIRECTOR OF PERSONNELDATEDIRECTOR OF PERSONNEL5-20-71EMPLOYEE CERTIFICATIONI have read and understand my service obligations and travel entitlements as described in this agreement.SIGNATURE OF EMPLOYEESee Dispatch AttachedDaniel5/20/71DATESECRET
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# CONFIDENTIALRESIDENCE AND DEPENDENCY REPORTAS ORIGINAL OF THIS FORM WILL BE EXECUTED BY EACH EMPLOYEE AT THE TIME OF HIS APPOINTMENT AND WHEN A CHANGE OCCURSIF THE INFORMATION SHOWN BELOW. ITEMS OF CHANGE MAY BE REPORTED IN THE APPROPRIATE BLOCKS WITHOUT COMPLETING THEREMAINDER OF THE FORM IF THE EMPLOYEE'S SIGNATURE AND DATE. WHEN REPORTING. ITEM 4 ALSO COMPLY WITH HRD 20-1.PERSONNEL EMERGENCY AND LOCATOR RECORDS. THIS FORM WILL BE COMPLETED ONLY BY HEADQUARTERS PERSONNEL AND NOT SENTTO THE FIELD. FORM WILL BE FILED IN THE EMPLOYEE'S OFFICIAL PERSONNEL FOLDER.## GENERALNAME OF EMPLOYEE(Last)FLORES(First)Daniel(Middle)SOCIAL SECURITY NUMBER460-48-62301. SINGLE   [X]   MARRIED   MARITAL STATUS (Check one)   SEPARATED   DIVORCED   WIDOWED   ANNULLED   IF MARRIED, PLACE OF MARRIAGE   DATE OF MARRIAGE   Lima, Peru   18 November 1960   IF DIVORCED, PLACE OF DIVORCE DECREE   "N/A"   DATE OF DECREE2. MEMBERS OF FAMILYNAME OF SPOUSEADDRESS (No. Street, City, State, Zip Code)TELEPHONE NO.Dorothy A. FloresThe American Embassy, Lima, PeruNAME OF CHILDRENADDRESSSEXDATE OF BIRTHKendra Flores(Same as above.)F3 March 1971NAME OF FATHER (or male guardian)ADDRESSTELEPHONE NO.Jose S. FloresPox 39, Gonzales, Texas 78629512-672-6061NAME OF MOTHER, INCLUDING MAIDEN NAME (orADDRESSTELEPHONE NO.female guardian)Agustina Flores (Deceased)WHAT MEMBER(S) OF YOUR FAMILY IF ANY, HAS BEEN TOLD OF YOUR AFFILIATION WITH THE ORGANIZATION IF CONTACT IS RE-QUIRED IN AN EMERGENCY.Mr. Lonnie G. Bruce3. OTHER RELATIVES WHO ARE DEPENDENT UPON ME FOR AT LEAST 51% OF THEIR SUPPORT AND MEET OTHER REQUIRE-   MENTS IN TRAVEL REGULATIONS (HR 22-15). SPECIFY NAMES AND RELATIONSHIPS.| NAME | DATE OF BIRTH | RELATIONSHIP || ---- | ------------- | ------------ |4. PERSON RESIDING IN U.S. TO BE NOTIFIED IN CASE OF EMERGENCYNAME (Mr., Mrs., Miss) (Last-First-Middle) RELATIONSHIPMr. Lonnie G. Bruce Brother-in-lawHOME ADDRESS (No., Street, City, State, Zip Code) AND NAME OF EMPLOYER, IF APPLICABLE HOME TELEPHONE NUMBER973 E. Walnut St., Seguin, Texas 78155 512-379-7620BUSINESS ADDRESS (No., Street, City, State, Zip Code) AND NAME OF EMPLOYER, IF APPLICABLE BUSINESS TELEPHONE & EXTENSIONIS THE INDIVIDUAL NAMED ABOVE DITTING OF YOUR AGENCY AFFILIATIONT (If "No" give name and address of organization he believes you work for.)YES [X]NOIS THE INDIVIDUAL AUTHORIZED TO MAKE DECISIONS ON YOUR BEHALF IN THE EVENT YOU ARE INCAPABLET (If "No" give name and address of person, if any, who can make such decisions in case of emergency.)YES [X]NODorothy A. Flores The American Embassy Lima, Peru5015 THIS INDIVIDUAL KNOW THAT HE HAS BEEN DESIGNATED AS YOUR EMERGENCY ADDRESSEL (If answer is "No"explain why in item 6.)YES [X]NOThe persons named in item 2 or 3 above may also be notified in case of emergency. IF SUCH NOTIFICATION IS NOT DE-SIRABLE BECAUSE OF HEALTH OR OTHER REASONS, PLEASE SO STATE IN ITEM 6 ON THE REVERSE SIDE OF THIS FORM.FORM7.7061.CONFIDENTIAL(4)