[104-10291-10001.pdf — page 229]
# SECRET(When Filled In)SECTION III CONTINUED FROM PAGE 121. DATES OF MILITARY SERVICE OF SPOUSE (From and To ) BY MONTH AND YEARMarch 1945 - Feb 194622. BRANCH OF SERVICEE. MGT and Res Coord23. COUNTRY GITH UNICH MILITARY SERVICE AFFILIATED,U.S.24. DETAILS OF OTHER GOSAMINE SERVICE, U.S. DU FOREIGNNoneSECTION IV RELATIVES BY BLOOD, MARRIAGE OR ADOPTION LIVING ABROAD OR WHO ARE NOS 9.3. CITIZENS| 1. FULL NAME (Lot-Pirot-Middle)                 |                         |                         || ----------------------------------------------- | ----------------------- | ----------------------- || / /A                                            | 2. MELATIC02018         |                         || 4. ADDRESS OR COUNTRY IN SHICH RELATIVE RESIDES |                         |                         || 5. CITIZENSHIP (Country)                        | 6. FREQUENCY OF CONTACT | 7. DATE OF LAST CONTACT || 1. FULL NAME (Last-Pirat-Middle).               |                         |                         || ----------------------------------------------- | ----------------------- | ----------------------- || 2. RELATIONSHIP                                 | 3. AGE                  |                         || 4. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES |                         |                         || 5. CITIZENSHIP (Country)                        | 6. FREQUENCY OF CONTACT | 7. DATE OF LAST CONTACT || 1. FULL NAME (LOGE P iddle)                     |                         |                         || ----------------------------------------------- | ----------------------- | ----------------------- || 2. RELATI                                       |                         |                         || 4. ADDRESS CR COUNTRY IN SHICH RELATIVE RESIDES |                         |                         || 5. CITIZENSHIP (Country)                        | 6. FREQUENCY OF CONTACT | 7. DATE OF LAST CONTACT || 1. FULL NAME (Loot-Firat Middla)                |                         |                         || ----------------------------------------------- | ----------------------- | ----------------------- || 2. RELATIGOUHIP                                 | 3. AGE                  |                         || 4. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES |                         |                         || 5. CITIZENSHIP (Country)                        | 6. FREQUENCY OF CONTACT | 7. DATE OF LAST CONTACT |5. SPECIAL REMARK. IF ANY CONCERNING THESE RELATIVESSECTION V FINANCIAL STATUS1. ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY?Yes No2.DO YOU HAVE ANY FINANCIAL INTEREST IN, OR OFFICIAL CONNECTION NOS. CORPORATIONS. OR BUSINESSES 04 אס לוWITH U.S. CORPORATIONS OR BUSINESSES HAVING SUBSTANTIAL FOREIGN INTERESTSTYes No.IF YOU HAVE παςπέλιο "72S." GIVE COMPLETE DETAILS ON A SEPARATE SHEET AND ATTACH IN A SEALED ENVELOPE.3. DO YOU HECEIVE AN ANRIDITY FROM THE UNITED STATES OR DISTRICT OF COLLYSIA GOVERNMENT DER ANY RETIREMENT ACT, PERSION ON CORPENSATION FOR MILITARY OR NAVAL SERVICEPYP- No4. IF YOU HAVE ANSWERED "YES" TO QUESTION 3 ABOVE, GIVE COMPLETE DETAILS、N/A5.THOUT WEFERENCE TO YOUR SALARY STATE OTHER SOURCES DE RECURRINT INCOR NOR INDICATED BY PRECEDING ITEMS.N/ASECTION V CONTINUED TO PAGE 3SECRET2