[194-10005-10140.pdf — page 6]
# 12. FOREIGN TRAVEL (Other than as a direct result of United States military duties)| DATES    | COUNTRY VISITED                       | PURPOSE OF TRAVEL || -------- | ------------------------------------- | ----------------- || FROM-    | TO-                                   |                   || Aug 1960 | Sep 1960 Cuba                         | To learn to write || Jan 63   | Mar 1963 England, France, Poland,     | Write             ||          | Hungary, Soviet Union & Czechoslavkia |                   || Feb 1965 | Mar 1965 Vietnam, Combodia, Indonesia | Write             |# 13. EMPLOYMENT (Show every employment you have had and all periods of unemployment)| MONTH AND YEAR | NAME AND ADDRESS OF EMPLOYER | NAME OF IMMEDIATE SUPERVISOR | REASON FOR LEAVING || -------------- | ---------------------------- | ---------------------------- | ------------------ || FROM-          | TO-                          |                              |                    || Soring         | Jan 1953 S. Kleins           | Unknown                      | Christmas over     || 1952           | 14th St., New York, New York |                              |                    || 1956           | 1957 U. S. Post Office       | Unknown                      | School             ||                | New York City, New York      |                              |                    || Sep 58         | Jun 59 Syracuse University   | Unknown                      |                    ||                | Syracuse, New York           |                              |                    || Sep 60         | Jun 61 University of Calif.  | Unknown                      |                    ||                | Berkeley, Calif.             |                              |                    || Sep 61         | Dec 63 City Lights Bookstore | Mr.L.Ferlinghetti            |                    ||                | 261 Columbus, S.F., Calif.   |                              |                    || Jun 65         | Present Rampert's Magazine   | W. Hinckle                   |                    ||                | 301 Broadway, S.F., Calif.   |                              |                    |DID 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 FOREIGN GOVERNMENT, FIRM, OR AGENCY? YES **NO** HAVE YOU EVER BEEN REFUSED BOND? YES **NO** IF THE ANSWER TO ANY OF THE ABOVE IS "YES," EXPLAIN IN ITEM 20.SOCIAL SECURITY NO.112-28-1134# 14. CREDIT AND CHARACTER REFERENCES (Do not include relatives, former employers, or persons living outside the United States or its Territories.| CREDIT    | NAME            | YEARS KNOWN | STREET AND NUMBER (Business address preferred) | CITY          | STATE OR TERRITORY || --------- | --------------- | ----------- | ---------------------------------------------- | ------------- | ------------------ ||           | None            |             |                                                |               |                    || CHARACTER | Robert Avekian  | 2           | Unknown                                        | Berkeley      | Calif.             ||           | David Welsh     | 1           | 301 Broadway                                   | San Francisco | Calif.             ||           | Sol Stern       | 10          | 301 Broadway                                   | San Francisco | Calif.             ||           | Robert Truehaft | 2           | Trushaft & Walker                              | Oakland       | Calif.             ||           | Malcolm         | 2           | Trushaft & Walker                              | Oakland       | Calif.             ||           | Bernstein       |             |                                                |               |                    |