[180-10093-10162.pdf — page 4]
OTHER RELATIVES AND ALIEN FRIENDS LIVING IN FOREIGH COUNTRIES (Lint grandparents, first cousing, kunta, uncles, brothers- and sistera-in-law, and other persons with whom a close relationship existed or exists)| RELATIONSHIP AND MANE | AGE | OCCUPATION | ADDRESS | CITIZENSHIP || --------------------- | --- | ---------- | ------- | ----------- || N/C                   |     |            |         |             || N/C                   |     |            |         |             |FOREIGN TRAVEL (Other than as a direct result of United States militery duties)| DATES   | COUNTRY VISITED | PURPOSE OF TRAVEL || ------- | --------------- | ----------------- || FROM-TO |                 |                   || N/C     |                 |                   |EMPLOYMENT (Show every employment you have had and all periods of unemployment)| MONTH AND YEAR    | NAME AND ADORESS OF EMFLOVER                                              | NAME OF IMMEDIATE SUPERVISOR | REASON FOR LEAVEIS || ----------------- | ------------------------------------------------------------------------- | ---------------------------- | ------------------ || 30SEPT70 CURRENT  | (NOSIC) NAVAL OCEAN SURV INFO CENTER 4301 SUITLAND RD., SUTTLAND.MD.20390 | Mr Donald Noble              | MASS TRANSFER      || JULY 1965 30SEP70 | (NIPSSA) "B" BLDG RT 50, ARLINGTON HALL, STA, ARLINGTON, VA               | Mr Donald Noble              | NIPSSA TO NOSIC    ||                   | (((((SEE SUPPLEMENT)))))                                                  |                              |                    |# DO ANY OF THE ABOVE EMPLOYMENTS REQUIRE A SECURITY CLEARANCE? YES ☐ NO DO YOU HAVE ANY FOREIGN PROPERTY OR BUSINESS CONNECTIONS, OR HAVE YOU EVER BEEN EMPLOYED BY A FOREIGH GOVERNMENT, FIRM, OR AGENCY? ☐ YES NO HAVE YOU EVER BEEN REFUSED BOND? YESIF THE ANSWER TO ANY OF THE ABOVE IS "YES," EXPLAIN IN ITEM 20.SOCIAL SECURITY NO.022-30-2275CREDIT AND CHARACTER REFERENCES (Do not include relatives, former employers, or persons living outside the United States or its Territorisa.| NAME (Licet 3 credit and 3 character) | YEARS KNOWN                      | STREET AND NUMBER (Dishes adress preferred). | CITY     | STATE OR TETORY || ------------------------------------- | -------------------------------- | -------------------------------------------- | -------- | --------------- || Virginia Investment Co Ind74-74       | 4600 Lee Hwy                     | Arlington                                    | Va 22207 |                 || John Hancock Life Ins Co 60-75        | FO BOX 236 (ATTH MR MARGULIES)   | Falls Church va                              | 22046    |                 || Virginia National Bank 71--79         | PO BOX 1359                      | Norfolk                                      | Ma 23501 |                 || Me?Mrs Lawson Pilkinton 74-75         | 110 Howard Street                | Dumfries                                     | Wa 22026 |                 || Mr&Mrs Robert Lutes 71-79             | 15110 Concord Drive(DaleCity)    | Woodbridge                                   | va 22191 |                 || Mr&Mrs Carl Haller 69--79             | 3921 North Forestdale (DaleCity) | Wocabridge                                   | Va 22191 |                 || MichMrs. Kenneth Malzi 69-74          | 4517 Weyburn Drive               | Annandale                                    | Va 22003 |                 || Mr Sidney Maddux. 164-74              | 801. Karen Ct NO 102             | Lamel                                        | 20810    |                 |