Francesco/who-killed-jfk huggingface dataset:
[104-10291-10014.pdf — page 122]
SECRET# FITNESS REPORT## SECTION A1. NAMEO'NEAL,   BIRCH D8. OFFICIAL POSITION TITLEOPS OFFICER CH9. CHECK (X) TYPE OF APPOINTMENTX CARFER RESERVE TEMPORARYCAREER PROVISIONAL (See Instructions - Section C)SPECIAL (Specify):10. CHECK (X) TYPE OF REPORTINITIALX ANNUALSPECIAL (Specify):11. DATE REPORT DUE IN O.P.30 April 196612. REPORTING PERIOD (From - to)1 April 1965 - 31 March 1966## SECTION B PERFORMANCE EVALUATIONW - Weak Performance ranges from wholly inadequate to slightly less than satisfactory. A rating in this category requires positive remedial action. The nature of the action could range from counseling, to further training, to placing on probation, to reassignment or to separation. Describe action taken or proposed in Section C.A - Adequate Performance meets all requirements. It is entirely satisfactory and is characterized neither by deficiency nor excellence.P - Proficient Performance is more than satisfactory. Desired results are being produced in a proficient manner.S - Strong Performance is characterized by exceptional proficiency.O - Outstanding Performance is so exceptional in relation to requirements of the work and in comparison to the performance of others doing similar work as to warrant special recognition.## SPECIFIC DUTIESList up to six of the most important specific duties performed during the rating period. Insert rating letter which best describes the manner in which employee performs EACH specific duty. Consider ONLY effectiveness in performance of that duty. All employees with supervisory responsibilities MUST be rated on their ability to supervise (indicate number of employees supervised).SPECIFIC DUTY NO. 1RATINGLETTERSPECIFIC DUTY NO. 2RATINGLETTERSPECIFIC DUTY NO. 3RATINGLETTERSPECIFIC DUTY NO. 4RATINGLETTERSPECIFIC DUTY NO. 5RATINGLETTERSPECIFIC DUTY NO. 6RATINGLETTEROVERALL PERFORMANCE IN CURRENT POSITIONTake into account everything about the employee which influences his effectiveness in his current position such as performance of specific duties, productivity, conduct on job, cooperativeness, pertinent personal traits or habits, and particular limitations or talents. Based on your knowledge of employee's overall performance during the rating period, place the letter in the rating box corresponding to the statement which most accurately reflects his level of performance.RATINGLETTERSFORM 45 OBSOLETE PREVIOUS EDITIONS.SECRET
[104-10291-10014.pdf — page 123]
SECRETMEMORANDUM IN LIEU OF FITNESS REPORTSUBJECT: Birch D. O'NEAL(1 April 1965 - 31 March 1966)Mr. O'Neal continues to be engaged in special complex and sensitive counterintelligence cases which require detailed analysis. His performance is always at a high level. He supervises his personnel competently and he follows good government economy practices.![signature of James R. Hunt]James R. HuntDeputy ChiefCounter Intelligence StaffEMPLOYEE SIGNATURE:![Birch D. O'Neal signature]Birch D. O'NealREVIEWING OFFICIAL:![J. Angleton signature]James AngletonChief, Counter Intelligence StaffSECRET![stamp with text Excluded from automatic downgrading and declassification]
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# SECRET# FITNESS REPORTEMPLOYEE SERIAL NUMBER058553## SECTION A1. NAMEO'NEAL, BIRCH D6. OFFICIAL POSITION TITLE   IO-CI2. DATE OF BIRTH 3. SEX   06/01/13 M7. OFF/DIV/BR OF ASSIGNMENT   DDP/CI/SIG4. GRADE 5. SD   GS-15 D8. CURRENT STATION   Wash., D.C.9. CHECK (X) TYPE OF APPOINTMENTX CAREER RESERVE TEMPORARYCAREER PROVISIONAL (See Instructions - Section C)SPECIAL (Specify)10. CHECK (X) TYPE OF REPORTX ANNUAL INITIAL REASSIGNMENT SUPERVISOR REASSIGNMENT EMPLOYEESPECIAL (Specify):11. DATE REPORT DUE IN O.P.    30 April 196512. REPORTING PERIOD (From - To)    1 April 1964 - 31 March 1965## SECTION B PERFORMANCE EVALUATIONW - Weak Performance ranges from wholly inadequate to slightly less than satisfactory. A rating in this category requires positive remedial action. The nature of the action could range from counseling, to further training, to placing on probation, to reassignment or to separation. Describe action taken or proposed In Section C.A - Adequate Performance meets all requirements. It is entirely satisfactory and is characterized neither by deficiency nor excellence.P - Proficient Performance is more than satisfactory. Desired results are being produced in a proficient manner.S - Strong Performance is characterized by exceptional proficiency.O - Outstanding Performance is so exceptional in relation to requirements of the work and in comparison to the performance of others doing similar work as to warrant special recognition.## SPECIFIC DUTIESList up to six of the most important specific duties performed during the rating period. Insert rating letter which best describes the manner in which employee performs EACH specific duty. Consider ONLY effectiveness in performance of that duty. All employees with supervisory responsibilities MUST be rated on their ability to supervise (indicate number of employees supervised).SPECIFIC DUTY NO. 1See Attached memorandumRATINGLETTERSPECIFIC DUTY NO. 2RATINGLETTERSPECIFIC DUTY NO. 3RATINGLETTERSPECIFIC DUTY NO. 4RATINGLETTERSPECIFIC DUTY NO. 5RATINGLETTERSPECIFIC DUTY NO. 6RATINGLETTER## OVERALL PERFORMANCE IN CURRENT POSITIONTake into account everything about the employee which influences his effectiveness in his current position such as performance of specific duties, productivity, conduct on job, cooperativeness, pertinent personal traits or habits, and particular limitations or talents. Based on your knowledge of employee's overall performance during the rating period, place the letter in the rating box corresponding to the statement which most accurately reflects his level of performance.21 APR 1965RATINGLETTERSFORM 45 OBSOLETE PREVIOUS EDITIONS.SECRET
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SECRET16 APR 1665MEMORANDUM IN LIEU OF PITNESS REPORTSUBJECT: Birch D. O'Neal(1 April 1964 - 31 March 1965)There has been no change in assignment during the reporting period. Mr. O'Neal has been engaged for the major part of the time in conducting and performing complex research in connection with several sensitive counterintelligence cases. His performance has continued at a high level without interruption. He is a competent supervisor and follows economical practices.(James R. HuntDeputy ChiefCounter Intelligence StaffEMPLOYEE SIGNATURE:Birch D. O'NealREVIEWING OFFICIAL:J. AngletonJames AngletonChief, Counter Intelligence StaffSECRET![GROUP 1 Excluded from automatic downgrading and declassification]
[104-10291-10014.pdf — page 126]
# SECRET(When Filled In)FITNESS REPORTEMPLOYEE SERIAL NUMBER058553SECTION AGENERAL1. NAME(Last)O'NEAL,(First)BIRCH(Middle)D2. DATE OF BIRTH   06/01/133. SEX   M4. GRADE   GS-155. SD   D6. OFFICIAL POSITION TITLE   10-CI7. OFF/DIV/BR OF ASSIGNMENT   DDP/CI STAFF/SIG8. CURRENT STATION   Washington, D.C.9. CHECK (X) TYPE OF APPOINTMENTX CAREERRESERVETEMPORARYCAREER-PROVISIONAL (See Instructions - Section C)SPECIAL (Specify):11. DATE REPORT DUE IN O.P.30 April 196410. CHECK (X) TYPE OF REPORTINITIALREASSIGNMENT SUPERVISORX ANNUALREASSIGNMENT EMPLOYEESPECIAL (Specify):12. REPORTING PERIOD (From to-)    1 April 1963 - 31 March 1964SECTION BPERFORMANCE EVALUATIONW - WeakPerformance ranges from wholly inadequate to slightly less than satisfactory. A rating in this category requires positive remedial action. The nature of the action could range from counseling, to further training, to placing on probation, to reassignment or to separation. Describe action taken ur proposed In Section C.A - AdequatePerformance meets all requirements. It is entirely satisfactory and is characterized neither by deficiency nor excellence.P - ProficientPerformance is more than satisfactory. Desired results are being produced in a proficient manner.S - StrongPerformance is characterized by exceptional proficiency.O - OutstandingPerformance is so exceptional In relation to requirements of the work and in comparison to the performance of others doing similar work as to warrant special recognition.SPECIFIC DUTIESList up to six of the most important specific duties performed during the rating period. Insert rating letter which best describes the manner in which employee performs EACH specific duty. Consider ONLY affectiveness in performance of that duty. All employees with supervisory responsibilities MUST be rated on their ability to supervise (Indicate number of employees supervised).SPACIFIC DUTY NO. 1RATINGLETTERSPECIFIC DUTY NO. 2RATINGLETTERSPECIFIC DUTY NO. 3RATINGLETTERSPECIFIC DUTY NO. 4RATINGLETTERSPECIFIC DUTY NO. 5RATINGLETTERSPECIFIC DUTY NO. 6RATINGLETTEROVERALL PERFORMANCE IN CURRENT POSITIONTake into account everything about the employee which influences his affectiveness in his current position such as performance of specific duties, productivity, conduct on job, cooperativeness, pertinent personal traits or habits, and particular limitations or talents. Based on your your knowledge of employee's overall performance during the rating period, place the letter in the rating box corresponding to the statement which most accurately reflects his level of performance.29 APR 1964RATINGLETTERSFORM4-62 45OBSOLETE PREVIOUS EDITIONS.SECRET
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# SECRETMEMORANDUM IN LIEU OF FITNESS REPORTSUBJECT: Birch D. O'NEAL(1 April 1963 - 31 March 1964)There has been no change in duties during the reporting period and the caliber of the performance of this career officer has continued at a high level without interruption. He is thorough and analytical and makes a material contribution to the accomplishment of the Counter-Intelligence mission of the Agency. He is alert to the necessity for economy and performs capably as a supervisor.![signature of James R. Hunt, Jr.]James R. Hunt, Jr.Deputy ChiefCounter Intelligence Staff![signature of Birch D. O'Neal]EMPLOYEE SIGNATUREREVIEWING OFFICIAL:![signature of J. Angleton]James AngletonChief, Counter Intelligence StaffSECRET![stamp Excluded from automatic downgrading and declassification]
[104-10291-10014.pdf — page 128]
MEMORANDUM IN LIEU OF FITNESS REPORTSUBJECT: Birch O'NEAL(1 April 1962 - 31 March 1963)15 April 1963Mr. O'Neal has continued in the position of Chief, Special Investigations Group, Counter Intelligence Staff during this reporting period. He capably performs and directs the work of this group, and during the past year has performed commendably in the handling of certain sensitive matters. He is thorough and reliable. Mr. O'Neal's continuity in this job increases the value of his services to the Agency.![signature of James R. Hunt, Jr.]James R. Hunt, Jr.Deputy Chief, Counter Intelligence Staff![signature of Birch O'Neal]Employee SignatureReviewing Official:![signature of James Angleton]James AngletonChief, Counter Intelligence Staff25 APR 1963
[104-10291-10014.pdf — page 129]
23 August 1962MEMORANDUM IN LIEU OF FITNESS REPORTSUBJECT: Birch O'NEAL1 April 1960 - 31 August 19621. There has been no change during the reporting period in the highly efficient performance of Mr. O'Neal in his position as C/CI/SIG.2. We recommend his continuation in this assignment where continuity is a requirement.![Signature of James R. Hunt, Jr.]James R. Hunt, Jr.Acting Chief, Counter Intelligence StaffMemorandum has been seen by employee.
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POPKOMAREON FUR: Director of PersomalOBJECT : FireGas Report3 April 19611. 1 report vee absisted in sosorsan fora on 80 Doosetur 1300 for tira fuliovias persoai:O'NEAL, Birch8. Pero has been no change in craignant and the evaluation rematan the are for the reparting period endin 31 March 1961.meta S..M. Koruno FortonDeputy ChiefComter Intelligence tiff10HA011 11МОЛЯ ПЛИDELICE PI DEB20NME
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MEMORANDUM IN LIEU OF FITNESS REPORTSUBJECT: Birch O'Neal1 April 1959 - 31 March 19601. Mr. O'Neal is in the same position, doing the same job, in the same efficient manner as was reflected in his last fitness report.2. At some point in the future Mr. O'Neal would like to go overseas again. The CI Staff is perfectly happy to have him remain here indefinitely.![signature]S. H. HortonActing ChiefCounter Intelligence Staff
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## SECTION E NARRATIVE DESCRIPTION OF MANNER OF JOB PERFORMANCESECRETStress strengths and weaknesses demonstrated in current position. Indicate suggestions made to employee for improvement of work. Give recommendations for his training. Describe, if appropriate, his potential for development for assuming greater responsibilities. Amplify or explain, if appropriate, ratings given in SECTIONS B, C, and D to provide the best basis for determining future personnel actions.Employee is and has been a senior employee for some time. No training recommended; he is already a senior and experienced officer.Employee is an intense person, who does not relax enough. He should not be chief of a large station, nor supervise a large number of employees engaged in diverse work and having numerous problems.![office of personnel]## SECTION F CERTIFICATION AND COMMENTS1. I certify that I have seen Sections A, B, C, D and E of this Report.DATE SIGNATURE OF EMPLOYEE2. MONTHS EMPLOYEE HAS BEEN UNDER MY SUPERVISION36BY SUPERVISORIF THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEE, GIVE EXPLANATIONHas outstanding rating; no weaknesses to discuss. Orally advised of contents.IF REPORT IS NOT BEING MADE AT THIS TIME, GIVE REASON.EMPLOYEE UNDER MY SUPERVISION LESS THAN 90 DAYS REPORT MADE WITHIN LAST 90 DAYSOTHER (Specify):DATE OFFICIAL TITLE OF SUPERVISOR TYPED OR PRINTED NAME AND SIGNATURE28 Sept. 1959 Deputy Chief, CI Staff S. H. Horton3. BY REVIEWING OFFICIAL✓ I WOULD HAVE GIVEN THIS EMPLOYEE ABOUT THE SAME EVALUATION.I WOULD HAVE GIVEN THIS EMPLOYEE A HIGHER EVALUATION.I WOULD HAVE GIVEN THIS EMPLOYEE A LOWER EVALUATION.I CANNOT JUDGE THESE EVALUATIONS. I AM NOT SUFFICIENTLY FAMILIAR WITH THE EMPLOYEE'S PERFORMANCE.COMMENTS OF REVIEWING OFFICIALDATE OFFICIAL TITLE OF REVIEWING OFFICIAL TYPED OR PRINTED NAME AND SIGNATUREChief, CI Staff James AngletonSECRET
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# SECRETOFFICE PERATING period.State in the spaces below up to six of the most important SPECIFIC duties that rating period.Share the most important first. in not include minor of unimportant duties.For supervisors, ability to supervise will always be rated as a specific duty (do not rate as supervise thosec. For supervisors a secretary only)Compare in your mind, when possible, the individual being rated at the same duty at a similar level of responsability.Two individuals with the same job titles may be performing different duties. If so, rate them on different duties.Be specific. Examples of the kind of duties that might be rated are:ORAL BRIEFINGHAS AND USES AREA KNOWLEDGEMAIL ROOM PRODUCTS INTERROGATIONSGIVING LECTURESDEVELOPS NEW PROGRAMSPREPARES SUMMARIESCONDUCTING SEMINARSANALYZES INDUSTRIAL REPORTSTRANSLATES GERMANWRITING TECHNICAL REPORTSMANAGES FILESDEBRIEFING SOURCESCONDUCTING EXTERNAL LIAISONOPERATES RADIOKEEPS BOOKSTYPINGCOORDINATES WITH OTHER OFFICESDRIVES TRUCKTAKING DICTATIONWRITES REGULATIONSMAINTAINS AIR CONDITIONINGSUPERVISINGPREPARES CORRESPONDENCEEVALUATES SIGNIFICANCE OF DATAFor some jobs, duties may be broken down, even further if supervisor considers it advisable, e.g., evalua key and phone operation, in the case of a radio operator.1 - INCOMPETENT IN THE PERFORMANCE OF THIS DUTY2 - BARELY ADEQUATE IN THE PERFORMANCE OF THIS DUTY4 - PERFORMS THIS DUTY IN A COMPETENT MANNER5 - PERFORMS THIS DUTY IN A FINE MANNER6 - PERFORMS THIS DUTY IN AN OUTSTANDING MANNER FOUND IN VERY FEW INDIVIDUALS HOLDING SIMILAR JOBS7 - EXCELS ANYONE I KNOW IN THE PERFORMANCE OF THIS DUTYDESCRIPTIVERATINGComplete reliability in handling sensitive mattersRATING7General DD/P ops abilityRATING6Unusually good judgmentRATING6Ability to evaluate and analyze CE dataRATING6Alert for new ideas and leadsRATING6DiscretionRATING6Stress strengths and weaknesses, particularly those which affect development on present job.No weaknesses. He is an outstanding employee.SECTION D. SUITABILITY FOR CURRENT JOB IN ORGANIZATIONTake into account here everything you know about the individual... productivity, conduct in the job, pertinent personal characteristics or habits, special defects or talents...and how he fits in with your team. Compare him with others doing similar work of about the same level.1 - DEFINITELY UNSUITABLE - HE SHOULD BE SEPARATED2 - OF DOUBTFUL SUITABILITY...WOULD NOT HAVE ACCEPTED HIM IF I HAD KNOWN WHAT I KNOW NOW3 - A BARELY ACCEPTABLE EMPLOYEE...BELOW AVERAGE BUT WITH NO WEAKNESSES SUFFICIENTLY OUTSTANDING TO WARRANT HIS SEPARATION4 - OF THE SAME SUITABILITY AS MOST PEOPLE I KNOW IN THE ORGANIZATION5 - A FINE EMPLOYEE - HAS SOME OUTSTANDING STRENGTHS6 - AN UNUSUALLY STRONG PERSON IN TERMS OF THE REQUIREMENTS OF THE ORGANIZATION7 - EXCELLED BY ONLY A FEW IN SUITABILITY FOR WORK IN THE ORGANIZATIONRATING6IS THIS INDIVIDUAL BETTER SUITED FOR WORK IN SOME OTHER POSITION IN THE ORGANIZATION?YES.SECRET
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SECRET(when Filled In)26. CAN THINK ON HIS FEET27. COMES UP WITH SOLUTIONS TO PROBLEMS.28. STIMULATING TO ASSOCIATES: A "SPARK PLUG".29. TOUGH MINDED.30. OBSERVANT.31. CAPABLE.32. CLEAR THINKING.33. COMPLETES ASSIGNMENTS WITHIN ALLOWABLE TIME LIMITS.34. EVALUATES SELF REALISTICALLY.35. WELL INFORMED ABOUT CURRENT EVENTS.36. DELIBERATE.37. EFFECTIVE IN DISCUSSIONS WITH ASSOCIATES.38. IMPLEMENTS DECISIONS REGARD-LESS OF OWN FEELINGS.39. THOUGHTFUL OF OTHERS.40. WORKS WELL UNDER PRESSURE.41. DISPLAYS JUDGEMENT.42. GIVES CREDIT WHERE CREDIT IS DUE.43. HAS DRIVE.44. IS SECURITY CONSCIOUS.45. VERSATILE.46. HIS CRITICISM IS CONSTRUCTIVE.47. ABLE TO INFLUENCE OTHERS.48. FACILITATES SMOOTH OPERATION OF HIS OFFICE.49. DOES NOT REQUIRE STRONG AND CONTINUOUS SUPERVISION.50. A GOOD SUPERVISOR.SECTION VA. WHAT ARE HIS OUTSTANDING STRENGTHS?The ability to analyze a complex problem, arrive at a plan of action, and then implement the plan without omitting any detail relevant to the case.B. WHAT ARE HIS OUTSTANDING WEAKNESSES?None observed.SECRET
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Statement re Change 1 umber ofDependents:I hereby certify that on 16 July, 1947,there was born to me and my wife a son,the name of whom has been previouslyfurnished to Washington.
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# ELECTION, DECLINATION, OR WAIVER OF LIFE INSURANCE COVERAGEFEDERAL EMPLOYEES GROUP LIFE INSURANCE PROGRAMTO COMPLETE THIS FORM-1. FOLLOW THESE GENERAL INSTRUCTIONS:*   Read the back of the "Duplicate" carefully before you fill in the form.*   FIII in BOTH COPIES of the form. Type or use ink.*   Do not detach.2. FILL IN THE IDENTIFYING INFORMATION BELOW (please print or type):NAME (last) (first) (middle) DATE OF BIRTH (month, day, year).O'NEAL, BIRCH DILWORTH JUNE 1, 1913EMPLOYING DEPARTMENT OR AGENCY LOCATION (City, Stat6, ZIP Code)HAVE YOU EVER BEFORE FILED AN "ELECTION, DECLINATION, OR WAIVER OF LIFE INSURANCE COVERAGE"? YES NOIf "YES." your last such form remains so effect and you should not file this new form unless you want to change the old one. (Dee Instructions for Employees on page 4)3. MARK AN "X" IN ONE OF THE BOXES BELOW (do NOT mark more than one):Mark hore if you WANT BOTH optional and regular insurance(A) ELECTION OF OPTIONAL (IN ADDITION TO REGULAR) INSURANCEI elect the $10.000 additional optional insurance and authorize the required deductions frorn my salary, compensation, or annuity to pay the full cost of the optional insurance. This optional insurance is in addition to my regular insurance.Mark here if you DO NOT WANT OPTIONAL but do want regular insurance(B) DECLINATION OF OPTIONAL (BUT NOT REGULAR) INSURANCEI decline the $10,000 additional optional insurance. I understand that I cannot elect optional insurance until at least 1 year after the effective date of this declination and unless at the time I apply for it I am under age 50 and present satisfactory medical evidenc of insurability. I understand also that my regular insurance is not affected by this declina. tion of additional optional insurance.Mark here if you WANT NEITHER regular nor optional insurance(C) WAIVER OF LIFE INSURANCE COVERAGEI desire not to be insured and I waive coverage under the Federal Employees Group Life Insurance Program. I understand that I cannot cancel this waiver and obtain regular insurance until at least 1 year after the effective date of this waiver and unless at the time I apply for insurance I am under age 50 and present satisfactory medical evidence of In- surability I understand also that I cannot now or later have the $10,000 additional optional insurance unless I have the regular insurance.4. DATE AND SIGN. RETURN THE ENTIRE FORM TO YOUR EMPLOYING OFFICE.SIGNATURE (do not print)Birch D. O'NealDATE December 2, 1968ORIGINAL COPY-Retain in Official Personnel FolderFOR EMPLOYING OFFICE USE ONLY(official receiving date stamp)![official receiving date stamp]See Table of Effective Dates on back of OriginalSTANDARD FORM No. 176APRIL 1968FPM Supplement 870-1
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ELECTION, DECLINATION, OR WAIVEROF LIFE INSURANCE COVERAGEFEDERAL EMPLOYEES GROUP LIFE INSURANCE PROGRAMIMPORTANTAGENCY INSTRUCTIONSON BACK OF ORIGINALTO COMPLETE THIS FORM-1 FOLLOW THESE GENERAL INSTRUCTIONS:*   Read the back of the "Duplicate" carefully before you fill in the form.*   Fill in BOTH COPIES of the form. Type or use ink.*   Do not detach any part.2 FILL IN THE IDENTIFYING INFORMATION BELOW (please print or type):NAME (last) (first) (middle) DATE OF BIRTH (month, day, year) SOCIAL SECURITY NUMBERO'NEAL BIRCH DILWORTH JUNE 1,1913 258 056267EMPLOYING DEFARIMENT OR AGENCYSerial #058553 LOCATION (City, State, ZIP Code)3 MARK AN "X" IN ONE OF THE BOXES BELOW (do NOT mark more than one):Mark hereif youWANT BOTHoptional andregularinsurance[Figure]![Mark here if you want both optional and regular insurance]ELECTION OF OPTIONAL (IN ADDITION TO REGULAR) INSURANCEI elect the $10,000 additional optional insurance and authorize the required deductionsfrom my salary, compensation, or annuity to pay the full cost of the optional insurance.This optional insurance is in addition to my regular insurance.Mark hereif youDO NOT WANTOPTIONAL butdo wantregularinsurance[Figure]![Mark here if you do not want optional but do want regular insurance]DECLINATION OF OPTIONAL (BUT NOT REGULAR) INSURANCEI derline the $10,000 additional optional insurance. I understand that I cannot elect optional insurance until at least 1 year after the effective date of this declination and unlessat the time I apply for it I am under age 50 and present satisfactory medical evidenceof insurability. I understand also that my regular insurance is not affected by this declina-tion of additional optional insurance.Mark hereif youWANT NEITHERregula: noroptionalinsurance[Figure]![Mark here if you want neither regula: nor optional insurance]WAIVER OF LIFE INSURANCE COVERAGEI desire not to be insured and I waive coverage under the Federal Employees Group LifeInsurance Program, I understand that I cannot cancel this waiver and obtain regular in.surance until at least 1 year after the effective date of this waiver and unless at the timeI apply for insurance I am under age 50 and present satisfactory medical evidence of in.surability. I understand also that I cannot now or later have the $10,000 additionaloptional insurance unless I have the regular insurance.4 SIGN AND DATE. IF YOU MARKED BOX "A" OR "C",COMPLETE THE "STATISTICAL STUB." THEN RETURNTHE ENTIRE FORM TO YOUR EMPLOYING OFFICE.SIGNATURE (do not print)[Figure]![Signature of Birch D. O'Neal]Birch D. O'NealDATE[Figure]![Date February 16, 1968]February 16, 1968ORIGINAL COPY-Retain in Official Personnel FolderFOR EMPLOYING OFFICE USE ONLY(official receiving date stamp)[Figure]![For employing office use only]See Table of Effective Dates on back of OriginalSTANDARD FORM No. 176-7JANUARY 1968(for use only until April 14. 1968,176-101)