104-10222-10042
2025 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992
14-00000
SENTIMED AT CIA HEADGEARTLES FĮ
HOUSE SELECT LONGHITE ON ASSASSINATIONS STAFF MIMETERS
MATERE
SECRET
FILF TITLE/MIMBER/VOLUME: Bustos-Videla, C. Z.
INCLUSIVE DATES: 14
CUSTODIAL UNIT/LOCATION:
DELETIONS, IF ANY:
Feb 1950 - 16 JAN 1978
of Personnel
Office
ROOM: 5E13.
DATE
RECEIVED
DATE
RETURNED
REVIEWED BY
(PRINT NAME)
SIGNATURE OF
REVIEWING OFFICIAL.
NO DONENTS MAY BE COPIED OR REMOVED FROM THIS FILE
BUSTOSVIDELA CZ
5069-24-3138
{{menrrmi2? !! ruct¢4%u!Haz, Lute
ERMSLATEY
01/12/29.
14-00000
SECRET
#ben-Filled in)
REQUEST FOR PERSONNEL ACTION
1. SERIAL NUMBER 3 NAME 1200-Fill-Middle)
DATE PREPARED
31 July 1973
007667
Bustos Videla, Charisse 2.
3. NATURE OF PERSONNEL ACTION
Reassignment
6. FUNDS
X
♥ TO V
♥ 10 σ
CF TO V
α TO α
19. ORGANIZATIONAL DESIGNATIONS
DDO/WH Division
FI Staff
11. POSITION TITLE
OPS Officer
14. CLASSIFICATION SCHEDULE (G\, J,B, etc.)
10. REMARKS
GS
Home Base: Wil
4. EFFECTIVE DATE REQUESTED
MONTH
03
DAY
YEAR
03 73
7. PAN AND, NSCA
4235-4525 0000
10. LOCATION OF OFFICIAL STATION
3 CATEGORY OF EMPLOYMENT
Regular
LEGAL AUTHORITY (Completed by Office of
Personnel)
(13)
Washington, D.C.
12. POSITION NUMBER
13. CAREER SERVICE DESIGNATION
0640
D
15. OCCUPATIONAL SEMES
16. GRAU AND STEP
17 SALARY OR RATE
0136.01
13
7
$ 23642
نے
18A, SIGNATURE
REGULATING OFFICIAL
DATE SIGNED
H. Berthold Pers 31 Jul 73
19. ACTION 70 EMPLOY. 91.
CODE
CODE
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DATE SIGNi20
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OFFICE CODING
NUMERIC
ALPHABETIC
SPACE BELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL
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CODE
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1973
8.72
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PREVIOUS F
SECRET
CLASSIFIED 31
01-0332
31
28-2
APGIR
18.114
14)
14-00000
SEORET
EYES ONLY
17 JAN 1973
MEMORANDUM FOR: Chairman, GS-13 Evaluation Board
SUBJECT
: Recommendation for Promotion to GS-14
Charlotte Bustos-Videla
1. It is recommended that Charlotte Bustos-Videla be promoted
from GS-13 to GS-14.
2. The performance of this officer has been characterized for
many years by all of her supervisors as consistently strong to out-
standing. She has been able to establish herself as indispensable in
each Headquarters Branch or Field Station ass gnment, usually
functioning as the backbone of the unit to which assigned. Since return
to Headquarters in September 1972 from her field assignment in Mexico,
her performance has been entirely congruent with the thrust of the
Field Station's enthusiasm over her ability, performance, attitude and
growth potential. She is currently chief of the Cuban and CA Secțion
of her branch, and has established once again her mastery over her
assigned duties. She is the kind of sound, dependable, yet
imaginative officer greatly appreciated by her supervisors. In
short, she is a true professional who performs beyond her grade level.
3. In regard to her potential, she has served in the Agency
since 1951, starting as a secretary/stenographer, and advancing
brilliantly with each new challenge offered. She achieved professional
status in 1953 and has spent the bulk of her time since then specializing
in Latin American affairs, demonstrating total flexibility in assignments,
a voracious appetite for work and a penchant for exceptionally precise
and thorough production. A review of her career to date can lead to the
conclusion that she has always risen successfully to each new
professional challenge, and is still far from reaching her maximum
capacities. While she has had little supervisory experience in the
field, her supervisor was of the opinion that she is a "natural leader”.
This has been borne out in her performance in her current capacity
as a Branch Section Chief, in which she has demonstrated exemplary
supervisory ability. Notwithstanding her drive, aggressiveness and
professional aplomb, she is a popular co-worker, is receptive to guidance
and sensitive and responsive to the needs of her subordinates,
SEURET
EYES CALY
☐
14-00000
i
1
SECRET
EYES ONLY
4. This employee has utilized her fluency in the Spanish language
to maximum advantage in her work. Formal testing recently confirmed
her high proficiency in that language. Coupled with a comprehensive
training record and her invaluable experiences over a twenty year
period, she has become particularly effective in Latin American
operations and operational support, demonstrating excellence in each
of several recognized specializations, including CI operations,
functional support, reports and requirements, area support and varied
covert action activities.
5. The officer's adaptability, high intelligence and mastery over
her trade was of inestimable value to Mexico City Station, and over a
five year period from 1967 to 1972, she functioned as the Station's
internal troubleshooter. Her duties included the maintenance of
watchlists, screening of travel documents, processing of raw
technical take, target analysis, reports writing, operational support,
handling of outside contract agents, and special assignments as the
Chief of Station's Executive Assistant.
6. The employee is occasionally called upon by the Office of
Training to administer specialized training, and she was chosen
recently to attend the Mid-Career Course ending in December 1972.
Meanwhile, her absence from her new job is felt sorely by the
Branch. It is expected that her current assignment will last about
two years,
7. In summary, we have here an exceptional officer who has
been performing at the level of a GS-14 for some years; it is now
time to promote her to that grade commensurate with her performance
and which she so justly deserves.
Then Sie
Theodore G. Shackley
Chief
Western Hemisphere Division
SECRET
EYES ONLY
આ મ
14-00000
1.
:
SECRET
MEMORANDUM FOR: Chairman, QSI - Honor and Merit Awards Panel
SUBJECT
:
Request for Quality Step Increase (HR 20-37)
Mrs. Charlotte Bustos-Videla
1. On the basis of the information presented below,
it is recommended that a Quality Step Increase be approved
for Charlotte Bustos-Videla.
2. As noted in the attached fitness report, Subject's
performance of her duties has been uniformly outstanding.
In addition to her responsibilities in the Cuban section of
the Mexico City Station, she has recently been made the exec-
utive assistant to the Chief of Station at Mexico City. In
this job, she screens all incoming material for matters of
interest to the Chief and Deputy Chief of Station. She also
continues performing her past functions in the Cuban section
for the Station.
3.
Subject's present high quality of performance is
typical of her performance since she entered the Agency in
1951, It is fully expected that this level of performance
will be maintained.
4. Although the present Chief of Station was not the
reviewing official on the attached fitness report, he has
commented that he considered Subject an outstanding officer
and has recommended that she be considered for a Quality
Step Increase,
Lilliam Kane
(.
william V. Broe
Chief
Western Hemisphere Division
SECRET
14-00000
EYES ONLY
SECRET
16 MAR
MEMORANDUM FOR: Secretary, CBCS Panel (Section A)
SUBJECT:
Recommendation for Promotion to Grade 08-13
Charlotte Z. Bustos-Videla
1. The promotion of Charlotte Z. Bustos-Videla from GB-12 to
GS-13 is hereby recommended.
2. This exceptional officer has now been performing at a
senior level for several years and, while recognition through a
Quality Step Increase was granted her last year, her sustained
performance clearly exceeding the requirements of a CS-13 qualifios
her for a promotion at this time. Subject is one of the outstanding
women who have demonstrated their capacity for even further
advancement within the Agency and will probably continue to advance
in the future. The present recommendation is based on already
demonstrated ability to operate at a senior level.
3. Dbject is 36 years old and has been in grade as a 03-12
for the past five and one-half years.
EYES ONLY
SECRET
R. w Wenke
Desmond FitzGerald
Chief,
کیا
Western Hemisphere Division
Excit
CINDE
14-00000
075
RET
115 bow Filled la)
REQUEST FOR PERSONNEL ACTION
Bustosvidela, C/ Z.
I SERIAL NUMBER
2. MANE (LAN-First-Maddie)
007667
3. NATURE OF PERSONNEL ACTION
Reassignment and Transfer to
Vouchered Funds
6. FUNDS
♥ TO V
X στον
✓ to σ
σ TO σ
?
4. EFFECTIVE DATE REQUESTED
DAY
MONTH
FLAS
09 17 72
7. FINANCIAL ANALYSIS NO.
CHARGEABLE
DATI PREPARED
30 August 1972
S CATEGORY OF EMPLOYMENT
Regular
6. LEGAL AUTHORITY (Completed by Office of
Pernand)
3235-0620.
10. LOCATION OF OFFICIAL STATION
9. ORGANIZATIONAL DESIGNATIONS
DDP/WH Division
Branch 1
CA Section
11 POSITION TITLE
Wash.
D. C.
12 POSITION NUMBER
13 CAREER SERVICE DESIGNATION
Ops Officer
(D-13)
1294
14. CLASSIFICATION SCHEDULE (GS, LB, ek.)
13 OCCUPATIONAL SERIES
16. GRADE AND STEP
17 SALARY OR RATE
GS
0136.01
.13
7
$ 22,487
10. REMARKS
FROM:
DDP/WH/BR 1/MEXICO CITY STATION/0418
2 - Security
✓ HOME BASE:
Security Asscorial Gronted by Pars, 5010305 Sept. 12
1 -
Finance
Issue Army W-2 (Concur: CCS
Ch
SEP
STING OF KIAL
DATE SKINTO
D
WH
229972
66/525 SEP 1972
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IMPDET
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16A SIGNATURE OF CASSLE VON EARN PICER
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Henry
Berthold, C/W/
SPACE BELOW FOR EXCLUSIVE USE
22
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14-00000
SECRET,
18 DEC 1909
MEMORANDUM FOR: Charlotte Bustos-Videla
THROUGH
$ Chief, WH Division
SUBJECT
Quality Step Increase
1. I was pleased to learn that you have been
granted a Cuality Step Increase.
Buch recognition is
proof of the high esteem in which you are held by your
supervisors in the Clandestine Bervice.
2.
Please accept my personal best wishes.
I am
confident that your future performance will be of a
continuing high quality.
Thomas H. Karamossiped
Deputy Director for Plans
SCORED
(170
*
1
14-00000
SECRET
12 DEC 1969
MEMORANDUM FOR: Head, Clandestine Service
SUBJECT
Career Service
: Notification of Approval of
Quality Step Increase
Charlotte Bustos-Videla
-
1. I am pleased to send to you the attached official
notification of the approval of a second Quality Step Increase
to be awarded to this employee. The previous Quality Step
Increase was effective March 1964.
2. May I again ask that you arrange an appropriate
ceremony for the presentation of this Quality Step Increase
which is in recognition of her continuing excellent performance.
por
B.Bund B. Brennan
Robert S. Wattles
Director of Personnel
-
SECRET
14-00000
SECRET
-2-
SUBJECT:
Request for Quality Step Increase (HR 20-37)
Mrs. Charlotte Bustos-Videla
APPROVAL RECOMMENDED:
Chairman, DDP: QSI PaneI
APPROVED:
98269
Date
for all
Director of Personnel
12 Doc 1969
3
SECRET

14-00000
APUTA
1 SERIAL NUMBER
SECRET
13 hen belled in)
DATE PREPARED
17 OCTOBER 1968
REQUEST FOR PERSONNEL ACTION
2. MAME --Middle)
BUSTOS VIDELA, CE Z.
007667
3 NATURE OF PERSONNEL ACTION
REASSIGNMENT
• FUNDS
651
♥IOV
▼ 10 α1
α TO Y
X
σ TO σ
ORGANIZATIONAL DESIGNATIONS
DDP/WH
FOREIGN FIELD
BRANCH 1
MEXICO CITY, MEXICO STATION
11. POSITION TITLE
OPS OFFICER
14 CLASSIFICATION SCHEDULE (GS (B, ok)
(13)
GS
18 REMARKS
"STAFF EMPLOYEE SPECIAL
FROM: POSTION # 1528
Finance
4 EFFECTIVE DATE REQUESTED
MONTH
DAY
TIM
11 0368
7 FINANCIAL ANALYSIS NO
CHARGEABLE
9135 0990
10. LOCATION OF OFFICIAL STATION
S CATEGORY OF EMPLOYMENT
REGULAR
LEGAL AUTHORITY (Completed by Office of
Personal)
MEXICO CITY,
12 POSITION NUMBER
0418
MEXICO
13 CAREER SERVICE DESIGNATION
D
13 COOLPATIONAL SERIES
16 GRADE AND STEP
17 SALARY OR RATE
0136.01
13 4
$ 158.19
LEA SENATURE OF Questing r
DATE SIGNED
[185 SIGNATURE OF CAREER SERVICE APPROVING OFFICE
DATE SIGNED
MINIC
Henry L. Bertholdy
- C/WH/Personnel
1939 amor (21
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14-00000
ལས་གལྷན
SECRET
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REQUEST FOR PERSONNEL ACTION
11 SERIAL NUMBER
17 NAME (addle
A07667
13 NATURE OF PERSONNEL ACTION
BUSTOS VIDELA, CHARLOTTE 2.07-17-67
REASSIGNMENT
6. FUNDS
ΥΠΟΥ
✓ 10 a
CP TO Y
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• EFFECTIVE DATE REQUESTED
MONTH
DAY
4748
CATE PADIO
13 OCTOBER 1967
FINANCIAL ANALYSIS HD
CHARGEABLE
8135 0990
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FOREIGN FIELD
BRANCH 1
MEXICO CITY, MEXICO STATION
11 POSITION TITLE
OPS OFFICER
14 CLASSIFICATION SCHEDULE (GS, FA, rk.)
GS
18 REMARKS
MEXICO CITY,
MEXICO
13 CAREER SERVICE DESIGNATION
13 POSITION NUMBER
1528
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16 GRADE AND STEP
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Honry L. Berthold
C/WH/Personnel
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Joyce Mayelin
°C SPS/ Agant Branch
1 - Finance
188 SIGNATURE OF CARLES EV
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SPACE BELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL
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14-00000
SECRET
MELIORANDUM FOR: Central Cover Group
23 June 1967
SUBJECT
•
Cover for Charlotte #. Dustos-Videla
Mrs. Charlotte 22. Dustos-Videla is being transferred
PCS to Mexico City in staff capacity. She will fill slot
1523.
2. Hrs. Dustob-Videla is traveling under Travel Order
No. 39-00. (See copy attached) Mer cover will be that of
a dependent wife entering Mexico on the Visitante visa of
New huchand, Dr. Comir Euston-Videla, who is receiving a
Visitante visa in connection with a teaching contract he has
with the Las Américas University, Mexico City. The
University is paying for the travel of Dr. Bubtos-Videla
only and for all documentation. The University alco will
provide no quarters or quarters allowance. Under the
travel order Mrs. Dustos-Videla will receive mileage and
gle perdica for the trip to Mexico City. Limited
haubehold effects will be sent, the remaining items (also
11.ited) will be stored at Government expense.
The toy to be used by Mrs. Bustos-Videla is
111 vel to mexico with
New husband, where she will meet friends and obthin loand
employment with the U.S. Embassy.
Cactive 15 July 1007.
Actually, Mrs. Dustos-Videla will remain in pay
status as a Staff Employee.
5, Due to the change in cover stories, it is requested
the CCG/NC take appropriate steps to wee that the salary
received through 15 July 1007 be covered by an Arny 1-2,
and that effective 15 July 1957, D.C. In tax no longer
be withheld, and all subsequent salary be covered by a
notional Department of Bute 14-2.
lery government
checks should continue to be deposited to the National
an of Washington. Dupoar Circle Branch, Account No.
3 200 36 G. the will receive a field lletruat.
SECRET
Kotort D. Cashma
Chinel
14-00000
SERIAL NUMBH
007667
SECRET
1 lied to)
REQUEST FOR PERSONNEL ACTION
2 NAME last-set-Middle )
BUSTOS VIDELA, CHARLOTTE
3 NATURE OF PERSONNEL ACTION
REASSIGNMENT AND TRANSFER TO
CONFIDENTIAL FUNDS
.
DATE PREPARED
10 JULY 1967
Z.
EFFECTIVE DATE RECONSTED
S CATEGORY OF EMPLOYMENT
MONTH
DAT
16
67
6 FUNDS
V TO V
XXX 100
CP TO V
C10 C
07
17 FINANCIAL ANALYSIS
NO. CHARGEABLE
8135 0990
10 LOCATION OF OFFICIAL STATION
REGULAR
LEGAL AUTHORITY (Completed by Office of
Personnel)
51
34
• ORGANIZATIONAL DESIGNATIONS
DDP/WH
FOREIGN FIELD
BRANCH 1
MEXICO CITY, MEXICO STATION
11. POSITION TITLE
OPS OFFICER
14. CLASSIFICATION SCHEDULE (GS, L.II, rtc)
ĠS
18 REMARKS
MEXICO CITY, MEXICO
12 POSITION NUMBER
13. CAREER SERVICE DESIGNATION
1528
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13 OCCUPATIONAL SERIES
15 GRADE AND $*!?
17 SALARY OR RATE
0136.01
13 3
* OPS OFFICER Occupying
INTEL ANALYst position
FROM: DDP/WH/1/Pos. No. 1201
-
-
13,769
PRA IN ACCORDANCE WITH HR20-17d (b), NOT TO EXCEED TWO YEARS.
ISA bgt.
Finance
Robert D. Cashman
GATE SCHED
188 SNATURE DES SERVICE APPROVING OFFICER
DATE SIGURD
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REQUEST FOR PERSONNEL ACTION
DATE PREPARED
19 OCTOBER 1966
1 SERIAL NUMBER
2 NAME (Last-Fort-Moddie)
007667
BUSTOSVIDELA, C.Z.
✓
3 MATURE OF PERSONNEL ACTION.
PROMOTION
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10. REMARKS
FROM:
4. EFFECTIVE DATE REQUESTED
DAY
MONTH
1748
66
10 23 60
7. FINANCIAL ANALYSIS
NO. CHARGEABLE
7235 0620
10. LOCATION OF OFFICIAL STATION
3 CATEGORY OF EMPLOYMENT
REGULAR
( LEGAL AUTHORITY (Completed by Office of
Personnel)
WASHINGTON, D.C.
12 POSITION NUMBER
13 CAREER SERVICE DESIGNATION
(13)
1201
13 OCCUPATIONAL SERIES
16 GRADE AND STEP
0136.01
13 3
GS-12/6 ($12,822)
D
17 SALARY OR RATE
$
13,769
کے
2910
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10TURE OF REQUESTING OFFICIAL
DATE SIGNED
tes 21 Det bl
Robert D. Cashman C/WH/Pers
188 SIGNATURE OF CARTER SERVICE APPROVING OFFICER
SPACE BELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL
19 ACTION 20 EMPLOY 21
(001
CODE
OFFICE CODING
NUMERIC
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27 STATION 23 INTEGREE
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10/21/66
177
YR.
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DATE OF LEL
9.
01 12/29/10/23/66/10/23/66
37. CORRECTION/CELLATION DATA
TYPE
410.
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1
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45 POSITION CONTROL CERTICATION
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NO TAX STATE CODE
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2-80
1.. YES
#90
40 OF APPROVAL
DATE APPROVED
1152
0-2166N
SES FUCTION
SECRET
14)
Alica
14-00000
MEMORANDUM FOR:
SUBJECT
CSPS/A
:
1 SEP 1966
Recommendation for Promotion of
Charlotte Bustos-Videla
1. The promotion recommendation to GS-13 of Mrs.
Charlotto Bustos-Videla is hereby submitted. Mrs. Bustos-
Vidola entered the Agency in August 1951 as a GS-5 and
rapidly and deservedly rose to a GS-12 by 1959. She has
now boon almost seven years in grade and has been recom-
monded for promotion to the CSPS/B by WH Division five
times previously.
2.
This outstanding officer has continued to per-
form at the exceptional level which has by now become her
standard of performance. Her past four annual Fitness
Reports have each given her an overall rating of outstanding.
In this connection it is noteworthy that no two Fitness Re-
ports wore written by the same rating officer. She con-
tinues to occupy a GS-12 officer slot and her performance
cloarly continues to exceed the requirements for that
position. Sho is considered to be one of the outstanding
women who have demonstrated their capacity for further
advancement within the Agency.
3. Mrs. Bustos-Videla not only continues to bring
continuity to the Mexican Branch through her long experience
on Mexican affairs, but consistently contributes to the
smooth functioning of the Branch through her highly efficient
organizational capabilities. She has been called upon to
handle all manner of difficult desk problems, She invariably
responds quickly, cheerfully, and effectively. She has been
instrumental in on-the-job training of a number of officers,
both for desk assignments and in preparation for field assign-
ments. She has excellent rapport with innumerable persons in
other areas and staffs, thus adding to the efficiency and
speed with which she accomplishes her daily tasks.
motion at this time is urged.
Approved by CS Co
13767
Her pro-
William V. Broe
Chief,
Western Hemisphere Division
14-00000
n * =r=NPtv
SECRET
(When Filled In)
11 August 1966
MEMORANDUM FOR: Charlott 4. Bustos-Vilela
THROUGH
:
Head of
63
Career Service
SUBJECT
:
Notification of Non-eligibility for Designation as a
Participant in the CIA Retirement and Disability System
1. As you may know, we are in the process of reviewing the employment
history and current career field of all employees in the Agency to identify
those who are eligible for designation as a participant in the new CIA
Retirement and Disability System. In this process, the initial review of
each case is made by the individual's Career Service. If the Head of his
Career Service nominates him for participation in the System, this nomina-
tion is reviewed by the CIA Retirement Board which recommends final action
to me. However, if the Head of the Career Service advises that the employee
does not meet the basic requirements of HR 20-50 for participation, I have
accepted this finding without further review by the CIA Retirement Board.
This practice has been adopted in the interest of expediting this screening
process so that those employees who are eligible to participate in the Sya-
tem may be designated participants as soon as possible,
2. In your case, the Head of your Career Service has advised me that
you do not meet the requirements of HR 20-50 for designation as a partici-
pant and I have accordingly made the formal determination required by the
regulation that you are not eligible for designation. From a review of your
record it appears that the decision of your Career Service was based upon
the fact that you do not have sufficient time prior to completing 15 years
of service with the Agency in which you could complete a minimum of 60 months
of qualifying service as required by regulation. My determination that you
are not eligible at this time for designation in no “ay affects your current
status under the Civil Service Retirement System, nor does it preclude recon-
sideration of your eligibility to participate in the CIA System if you should
meet the requirements for designation in the future.
3. Should you desire further information concerning the requirements
for designation as a participant in the CIA Retirement System, I suggest that
you read paragraph of HR 20-50 and paragraph 5 of the i̇mployce Bulletin
dated 30 July 1965, entitled "Public Law 88-643, The Central Intelligence
Agency Retirement Act of 1964 for Certain Employees."
4. It is always possible that the records upon which the determination
made in your case may have been incomplete or inaccurate regarding your actual
employment history with the Agency. If, after studying the materials cited
above, you have questions regarding the determination that you are not eligi-
ble to participate in the CIA Retirement System, please feel free to contact
officials of your Career Service. They are familiar with the details of your
case and will gladly discuss them with you. In addition, you may wish to dis-
cuss your case with the CIA Retirement Staff located in Room 205, Magazine
Building (extension 2847). If such discussions do not resolve any questions
you have regarding your eligibility, you may request that your case be formally
considered by the CIA Retirement Board. However, this request must be made
within 30 days of the date of this memorandum.
ED. Echols
Director of Personnel
*འཚ:་*q ཡ
A
SECRET
14-00000
EL GRAY
SEGO
1 MAR 1366
}
MEMORANDUM FOR: - Secretary, CS/CS Panol (Section A)
SUBJECT
1.
: Recommendation for Promotion to
Grade GS-13, Charlotte Z. Bustos-Videla
The promotion request from GS-12 to GS-13 on
Mrs. Bustos-Videla is hereby submitted.
2.
This outstanding officer has continued to
perform at the exceptional level which has by now
become for her a standard of performance. She now
formally occupies a senior (GS-13) FI Officer slot in
the Mexican Branch and her performance clearly continues
to exceed the requirement for that position. She is
still considered to be one of the outstanding women who
have demonstrated their capacity for further advancement
within the Agency, independently, of the experience on
Mexican affairs acquired through continuity in her
present assignment.
3. The comments made in connection with the four
previous promotion recommendations continue to be
entirely applicable.
4. Subject is 37 years old and has been in grade
85 a 08-12 for the past six years.
Ch
Ext
EYES CI
Binarilis
for William V. Broe
Chief,
Western Hemisphere Division
то
14-00000
SPCKET
CEP 1965
:
MEMORANDUM FOR:
SUBJECT
:
Secretary, CS/CS Panel (Section A)
Recommendation for Promotion to
Grade GS-13, Charlotte Z. Bustos-Videla
1. The promotion request from GS-12 to GS-13 on
Mrs. Bustos-Videla is hereby resubmitted.
2. This outstanding officer has continued to
perform at the exceptional level which has by now
Sho now
become for her a standard of performance.
formally occupies a senior (GS-13) FI Officer slot in
the Mexican Branch and her performance clearly continues
She is
to exceed the requirement for that position.
still considered to be one of the outstanding women who
have demonstrated their capacity for further advancement
within the Agency, independently of the expertise on .
Mexican affairs acquired through continuity in her
present assignment.
3.
The comments made in connection with the
three previous promotion recommendations continue to
be entirely applicable.
1. Subject is 36 years old and has been in grade
as a GS-12 for the past six years.
öst
by Cut Bh
William V. Broe
Chief,
Western Hemisphere Division
14-000001
led in
DATE PREPARED
SECRET
REQUEST FOR PERSONNEL ACTION
↑ SESEMBER
2 NAME t test=Middle }
007667
3 NATURE PERSONNEL ACTION
BUSTOS VIDELA, CWB Z.
REASSIGNMENT
6 PUROS
XVTOV
♥ TO σ
Of to v
G10 G
ORGANIZATIONAL DESIGNATIONS
DDP/WH
BRANCH 1
MENTOO SECTION II Section
11 POSITION TITLE
OPS OFFICER
14 CLASSICATION SCHEDULE (GN, ER, etc.)
GS
4 EFFECTIVE DATE REQUESTED
MONTH
AUG
DAT
TEAR
☐ 65
7 COST CENTER NO CHARGE.
ABLE
6235 0620
10 LOCATION OF OFFICIAL STATION
28 JULY 1965
3 CATEGORY OF EMPLOYMENT
REGULAR
LEGAL AUTHORITY (Completed by Oher of
Periment
WASHINGTON, D.C.
12. POSITION NUMBER
13 CAREER SERVICE DESIGNATION
(13)
1201
15 OCCUPATIONAL SERIES
16 GRADE AND STEP
0136.01
12 45
D.
17 SALARY OR RATE
$11,915 11670
18 PEARS
FROM:
DDP/WII/MEXICO SECTION/1202/
MRS. BUSTOS-VIDELA WILL REPLACE MR. RICHARD SCUTT WHO WILL BE
REASSIGNED TO DDP/EE.
TO BE EFFECTIVE 1 AUGUST 1965
Recor By
1-Security.
Reginance. 1.
ROBERT D. CASHMAN
C/TH/PERS
DATE SIGNED
1168 SIGNATURE OF CAREER SERVICE APPLOVING
SIGNED
walley Brituly
SPACE DELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL
22 STATION 23, gare 24 MO12 24 DATEN.
2014
NUMERIC
ALPHABETIC
LODE
CODE
1008
DATE OF GRADE, lak.
MO.
DA.
MO.
04
14
40
BATTLE
DA.
VR.
112/29
29 SPECIAL
REFERENCE
30
---
#C
RETIREMENT DATA
COLL
24 Y (0) DATE
MU.
7-18 PT
141
37. SEPARATION 132 CORRECTION CANCELLATION DATA
DATA CODE
TYPE
10.
33 SECURITY
34 52%
REQ 40
CA.
"
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1-800
37 (CS (ON? SALE
CAREER CATEGORT
39
re.
MO
A.
LODE
COD
FEGLI NEALTH INSURANCE
40 SOCIAL SECURITY NO
HEALTH INS. cont
PROV
1-165
17 LLAVE CAT
4!
FEMRE: TAR GATA
44.
STATE TAX 04'S
1008
FORM VECUrbicoce
MO TAX EARNOTIONS
FORM PRECUTED
fron STATE COOL
1-783
1-40
1-its
2-AC
42
YOUS GOVERNMENT SERVICE Data
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SEARC
7 niss Tue 3 ¥2485}
13. 6 a 8 | FA
POSITION CONTROL CERTIFICATION
11/10/65
2. 03
1117
15 OP APPROVAL
PRIVICUS FOTON
SECRET
APPROVED
14

14-00000
4 SEP 1964
MEMORANDUM FOR:
SUBJECT
Secretary, CSCS (Panel A)
:
Recommendation for Promotion to GS-13
Mrs. Charlotte Bustos-Videla.
1. The promotion to GS-13 of Mrs. Charlotte Bustos-Videla
is recommended. Mrs. Bustos-Videla entered the Agency in
August 1951 as a GS-5 and rapidly and deservedly rose to a
GS-12 grade by 1959.
2. This recommendation is based on Mrs. Bustos-Videla's
performance during the past three years as the senior assist-
ant to the various chiefs of the Mexican desk/branch, who
unanimously have found her to be extremely competent and re-
liable both in her routine assignments and special tasks
occasionally levied on her, such as country studies, compila-
tion of programs, requirement reviews, etc.
3. Mrs. Bustos-Videl, has consistently responded with
intelligence and clarity and has materially contributed to
orderly imaginative administration of Headquarters support to
a most active station. In the process, she has been instru-
mental in training on-the-job innumerable officers both for
desk assignments and in preparation for field assignments.
4.
For her outstanding performance she received a quality
step increase in April 1964. This deserved recognition should
now be followed up at this time by a promotion to the next
grade in accordance with the consistently good performance at
the GS-13 level over a prolonged period of time.
!
Desmond FitzGerald
Chief
Western Hemisphere Division
14-00000
CONFIDENTIAL
14 APR 1964
MEMORANDUM FOR:
SUBJECT
:
Head, Clandestine Services Career Service
Notification of Approval of Quality Step Increase –
Mrs. Charlotte Bustos-Videla
1. I am pleased to send to you the attached official notification
of the approval of the Quality Step Increase which you recommended
for this employee.
2. The salary increase accomplished by the award of a Quality.
Step Increase is important and tangible evidence of the esteem in
which the employee so recognized is held. However, I believe the
commendatory and incentive benefits of this award will be partially
lost unless it is presented in an appropriate ceremony which will
afford the individual recognition among co-workers and supervisory
officials. Also, I believe such recognition serves to inspire other
employens to aspire to wiring such recormition,
3. May I ask, therefore, that you arrange to have this Quality
Step Increase presented at an appropriate ceremony.
Presented in
а середину
4/24/14
Emmett D. Echols"
Director of Personnel
CONTIDES FAL
14-00000
i
SECRET
20 March 1964
MEMANDUM FOR: DDP/OP
THROUGH
: Chief, Clandestine Services Personnel Office
: Charlotte 2. Bustos-Videls -- Bequest for
Quality Stop Increase
2. It is recommended that a Quality Step Lcrease for
Mrs. Charlotte 2. Bustos-Videla be endorsed by you for the reasons
presented in the attached memorandum prepared by the Chief, Western
Hemisphere Division.
2. A review of Mrs. Bustos-Videla's al Personnel File
wagen coadaj repparte the platerals of dele et sink. Without exception.
age of this officer
hag been Sdentified by various and Apervisors 85
"perior" and "Outstanding." Likewise, nothing in other records
maintained by the office of Personnel contradice or modifies the
impressive record made by Mrs. Bustos-Videla.
3. Testimony to the high regard whien schietals of MII Division
this officer's work is furnished by noting that. Bustos-Videla
is the first female officer to be proposed for a QUX by and one of
a total of but three officers nominated by that Division for the award
sins the Q1 provision of the Federal Salary Form Act of 1962 became
effective in CIA approximately fifteen months ago.
PARCE
Pete
L
*
14-00000
6 March 1964
MEMORANDUM FOR:
Deputy Director of Plans
:
DDP/OP
ATTENTION
SUBJECT
: Request for Quality Step Increase for
Charlotte Bustos-Videla
1. On the basis of the information presented below,
it is recommended that a quality step increase be
approved for Charlotte Bustos-Videla.
2. As stated in the accompanying Fitness Report,
Subject's performance of her duties has been uniformly
outstanding, In addition to her responsibilities as the
desk officer for Mexico FI and Operational Support Projects,
she carries a heavy burden in the areas of administration,
preparation of special reports and training of personnel.
She frequently represents the Mexico Section in dealings
with other elements of the Agency and acte for the Chief
of Section in his absence, subject's performance clearly
exceeds the normal requirements of the assignment and of
her present GS grade level.
3. Subject's present high quality of performance
typifies her performance over a period of several years
and it is fully expected that this level will be maintained,
4. Consideration was given to the granting of a
Merit Award but the quality step increase seems more
appropriate in this caso. Subject has been passed over
for promotion in the past, and due to limitations as to
14-00000
532
-2-
area of assignment, it is unlikely that a promotion to
grade GS-13 can be obtained. The salary increase is
therefore thought to be the most fitting reward for her
outstanding service.
jok
C/WHD
KING
CONCUR:
that
EDP/OP
In March 64
Date
APPROVED:
Lite 24 MARGY
Director of Personnel
14-00000
SECRET
(When Pilled in)
REQUEST FOR PERSONNEL ACTION
" SERIAL NUMBER 3. NAME (Lect-Pirat-Middle)
1007667
BUSTOSVIDELA,_C_Z
3. NATURE OF PERSONNEL ACTICA
CATE PREPARED
_IS_November_1963
REASSIGNMENT
⚫. FUNDS
X
" TO V
✓ TO CE
CF TO V
CF TO CF
9. ORGANIZATIONAL DESIGNATIONS
[DDP
WHI
3
BRANCH
MEXICO SECTION
11. POSITION TITLE
4. EFFECTIVE DATE REQUESTED: 5. CATEGORY OF EMPLOYMENT
པ་་་་
121
SAV
163
1. COST CENTER NO. CHARGE •
4048
4235 1000 1000
REGULAR
8. LEGAL AUTHORITY (Completed by
Office of Personnel,
10. LOCATION OF OFFICIAL STATION
WASHINGTON, D. C.
12. POSITION SUMBER
13. CARLER SERVICE Designath
OPS OFFICER
☑
0321
14. CLASSIFICATION SCHEDULE (GS, LB, ofc,) 10. OCCUPATIONAL SERIES 16. Ghate 500 STEP
DD.
17. SALARY OR RATE
GS
18. REMARKS
FROM:
386
0136.01
DDP/WII/3/607/Mexico Sec/lqs
12_4
Recorded by
CSPD
$10,420
190. SIGNATH OF OUT
ROBERT CASIMAN_C/11/Pers
ILM
DATE SIGHTO
11/19/67
100. ST OF CARSEN SERVICE APPROVING DATE USED
0701205
SPACE BEDĆ OF UP FERSONNE
513
་བས་
3710 SINGDO
10
•
25SPEL
45, Pear (ya, Casa s
43
1/422163401
(
SECRET
27
317229
FOD DALA
--
SKA ZELLE
لا تخالات هاستلال الكاستر احمد
14-00000
SIGFET
15 March 1963
MENORAHDUM FOR: Secretary, 08/CS Panel (Section A)
SUBJECT:
Recommendation for Promotion to Grade GB-13
Mrs. Charlotte Bustos-Vidala
1. Mrs. Charlotte Bustos-Videla entered on duty with WH
Division in August of 1951. She has served on a variety of
desks covering South American as well as Mexican and Central
American affairs. In each of her assignments she has demonstrated
exceptional competence and devotion to duty.
2. Since December 1957 Mrs. Bustos has been assigned to
the Mexican Desk and at present is Acting Chief. She is the
soul and notor of that desk, managing many of its operations and
supervising its staff, many of whom she has trained. She is
past mistress of administrative presed and the age with
which the chialus elesaan, mitatais les ant secures
necessary approvals vile handling the most complicated operational
aspects of projects is phenomenal. Her work output is enormous
and yet everything is done simply and modestly with a minimum of
arcasa otion. She is an outstanding employee and should be
deserving of recognition.
3. It is recommended that Mrs. Buster be promoted to
grade 08-13.
:
Not Approved
June 63
J. C. KIGO
Chier,
Western Haisphere Division
SECRET
14-00000
"
SECRET
When Filled in)
REQUEST FOR PERSONNEL ACTION
SERIAL NUMBER 2. NAME (Last-Pirot-Middle)
CATE FREPARED
1 June 1961
207667
BUSTOS-VIDELA, C. Z.
3. NATURE OF PERSONNEL ACTION
NAME CHANGE FROM-CHARLOTTE L. ZEHRUNG
☑
V TO V
V TO CF.
6. FUNDS
CF TO V
CF TO CF
..
ORGANIZATIONAL DESIGNATIONS
DDP WH
BRANCH 3
3.
MEXICO SECTION
4. EFFECTIVE DATE REQUESTED S. CATEGORY OF EMPLOYMENT
NORTH
06
DAY
TEAD
7. COST CENTER NO. CHARGE.
ABLE
1235 1000 1000
REGULAR
8. LEGAL AUTHORITY (Completed by
(Office of Personnel)
10. LOCATION OF OFFICIAL STATION
WASH., D. C.
11. POSITION TITLE
OPS OFFICER
D
12. POSITION NUMBER
12 PCR CONTROL NO. 13
BA-607
$4. CLASSIFICATION SCHEDULE (GS, LB, ofc.) 15. OCCUPATIONAL SERIES 13. GRADE AND STEP
GS
12
0136.01
12
32
17. SALARY OR RATE
CAREER SERVICE
DESIGNATION
DI
• 8955-9215
14. REMARKS
By Marriage.
100.
SIGNATURT OF REQUESTING OFFICIAL
20130.
100
SIGNATURE OF
CARFER GE7 ICF APPROVING OFFICER
O
C D
ན་ན་ཨ་པ་2།
SPACE BELOW POP EXCLUSAL USE OF THE OFFICE OF PERSONNEL
3074
EXPIRES
2 SPECIAL
REFERENCE
".
25
6367
NO SAP in scotch
AWDER IN CO
30
4. POSITION CONTROL FATIG
Wa
C
1574
09
1152
71320
اشان
7824
+
27. LATE OF LEI
رعه
CA.
SENZANCELLATION SATA
3. SEX
260. %.
FOD DATA
43 O.P. #PPROVAL
CC Scien
SECRET
'' ch
14-00000
SECRET
MEMORANDUM FOR: WH/Personnel
SUBJECT: Change of Name
2 May 1961
It is requested that all records in the Agency,
including the section which issues payroll check, to changed
to reflect my married name: Charlotte Z. Bustos-Videla.
This change is effective immediately.
:
Charistic (Bustor Relela
Ch. rlotte 274dela
Kn/3/Mexico
T
14-00000
SENSKERELATE
JEURES
REQUEST FOR PERSONNEL ACTION
1. Stral No.
2. Name (Last-First-Middle)
7.
07667
SCO
Mo. Da. Ye.
04
02 51
13. Date Of Birth
4
✓ at Prol. 5. Sox
6. CS.EOD
ZEHRUNG CHARLOTTE
1
8. CSC Rotmt. 9. CSC Or Other Legal Authority
Yes 1 Codo
No.8
50 USCA 403 J
12
Code F 2271
10. Apmt. Affidav. 11. FEGLI ||12. LCD
Mo. Da. Yr. Not.
PREVIOUS ASSIGNMENT
Code
13.
Code M8 27 51 No: 120
15. Location Of Official Station
Station Code
14. Organizational Designations
DOP WH
BRANCH 111
MEXICO SECTION
16. Dopt. Field 17. Position Title
4613 WASH., D. C.
75013
18. Position No. [19 Serv. 20. Occup. Sorios
Doss-
USIN.
fign
Codo
12
XXXXXXXXX
OPS OFCR
21. Grade & Stop 22. Salary Or Rate 23. SD
11824
$
7759
from 9519.
DI
27. Nature Of Action
PROMOTION
Desgons
Codo
30
24. Date Of Grade 25. PSI Due
GS
BA-321.
24 Appropriation Number
Mo. Da. Yr. Mo. Da. Yr. 0235-1000-1000
104 110 155 104 105 158 1807888037
ACTION
28. Eff. Dato
Mo. Da. Ye.
10-113119
29. Type Of Employee
REGULAR
PRESENT ASSIGNMENT
Coda 17 Location Of Official Petion
14213
0136.51
Code] 30. Separation Data
☐
(Station Cod..
How
16-
Cola
Pestion fitla
12 OPS CFOR
3. Crade & Stop 32. Salary Or Pato
135. Position No
607
22-331
40. SD
11. Date Of Grade 142, PSI Due
Mo. Do. Yr. Mo.
DL
mage
[30. Serv. 37. Occup. Series
GS
43. Appropriation Number
112 1
3
2330.
A. Requested by (Ham And Tile))(
121315961
SOURCE OF REQUEST
P. C. Bowers ML Personnel Officer
9. For Aditional Information Coll (Name a Telephone Ext.)
John Washtako 8242
0235-1000-1000-
C Request Approved By (Signature And litle)
Clearance
A. Carver Board
(a Pos Control
C. Clonhouton
Recad
FON F 1152
1 MAR /
Sippature
CLEARANCES
Date
Clearance
10. Placemont
RIH-12-11-575
IF Approved By
SECRET
0136.01
Signature
Date
(4)

14-00000
SECRET
Presto Pisces (f
MEMORANDUM FOR: Secretary, CS/CS Panel (Section B)
SUBJECT:
Recommendation for Promotion
Miss Charlotte L. Zehrung
It
-
16 July 1959
1. Miss Charlotte L. Behrung entered on duty with CIA on 27 August 1951.
She was assigned to the Mexican Section of WH Division, Branch III, in June
1957. During the past two years she has been the responsible Case Officer
for several FI and CE Projects.
2. Miss Zehrung is a loyal and dedicated employce. She has displayed
considerable initiative and has been able to carry out her duties with a
minimum amount of support. She readily accepts responsibility and is a high-
ly efficient worker who thinks clearly and logically. Her knowledge of Head-
quarters and Field procedures in addition to her ability to organize her
work greatly facilitates the smooth functioning of the Mexican Desk. She
han demostrated a superior comprehension of the numerous and varied projects
of the Mexico City Station which has contributed to the ovrecall Hendesertina.
support of the stations performance. Because of her sound understanding of
operations and her outstanding capacity for work, Miss Zehrung has an excel-
lent potential for assuming greater responsibilities.
3. In recognition of her outstanding performance it in recommended that
Miss Zehrung be promoted to grade 05-12.
acking
C. KING
chief
Western Hemisphere Division
རྣ་:
14-00000
S-E-C-R-E-T
MEMORANDUM FOR: Charlotte Zehrung
VIA
: Chief, WH/3/Mexico
17 Maren 1953
1.
You have been selected by your division, and authorized by the
Clandestine Services Records Committee, to act as Records Officer for your com-
ponent. Your appointment is based on your professional qualifications to carry
out an assignment requiring experience, Judgment, and a knowledge of the
Clandestine Services objectives for your component.
2. You are to act on behalf of your Division or Staff element in authori-
zing the destruction of material of no value to the Clandestine Services in
accordance with criteria established for this purpose. You are empowered to
authorize the destruction of documents and Index cards recommended for destruc-
tion by other members of your branch, and to desensitize KAPOK and RYBAT material
which is no longer sensitive or which has been restricted in error. Your signa-
ture will be recognized by RI as that of an officially appointed Records Officer.
3. A series of meetings will be held in Roon 10?, [ Building to brier
you and your colleagues on the details of your duties as Records Officer. You
have been scheduled to attend the meeting to be held on Wednesday, 2 April 1958,
1300 1645 hours if it is not possible for you to attend on the date
designated, please call Extension 8325 to arrange for an alternate date.
Please review the attached materials prior to this meeting.
7463.
HUGH T. CUNNINGHAM
DDP Records Policy Officer
Attachment
As stated
CC:
Personnel Jacket of Addressee
S-E-C-R-E-T
14-00000
SECRET
REQUEST FOR PERSONNEL ACTION
Clovelly According
To Content.
1. Serial No.
2. Nome (Lost-First-Middle)
3. Date Of Birth
4. Vat. Prof.
ZEHRUNG, Charlotte L.
7.
Mo
SCD
Do Y
Code
21
8. CSC Rett 9. CSC Or Other Legal Authority
Yea
No
Mo De
1 12 29
10
10. Apmt. Affidav. 11.FEGLI
13. Sox
12. LCD
No. Code Mo Do
6. CS EOD
No Do Y
13. Se
Scedie LCR
Not Code
PREVIOUS ASSIGNMENT
14. Organisational Designations
DDP/WH
Branch III
Mexico Section
16. Dept. Field [17. Position Title
Dept Code
Usild-
Fran
Reports Officer
21. Grade & Stop 22. Salary Or Rate 23. SD
3
11-2
6720
$ 6605
Codo 15. Location Of Official Station
Station Code
Washington, D.C.
$
18. Position No. 19. Sarv 20. Occup. Series
BA-0072.01 GS
26. Appropriation Number
0132.44
24. Date Of Grade [25. PSI Due
Mo Do
Mo Da
DI
07/1050706
ACTION
Coda
28. Eff. Date
Mo Da
29. Type Of Employee
Ye
58
REGULAR
27. Nature Of Action
REASSIGNMENT
2,
3 Orginia Designtions
DDP/WH
Branch III
Mexico Section
33 Dept. Field 134. Position Titlo
× Codo
Usild-
Fran
1.O. (FI)
مات
39. Grade & Stop 139. Salary Or Rate 140. 50
3
11-3
6605
'8-3500-20
Code 30. Separation Data
PRESENT ASSIGNMENT
22. Location Of Official Station
Station Coda
1413
Washington, D.C.
75013
35. Position No.
36. Serv. 37. Occup. Series
BA-521-42
CS
0136.51
41. Core Of Gado 142. PST Duo
43. Appropriation Number
DI
M45 Dc " Mo Do Yr
心
8-3500-20
SOURCE OF REQUEST
A. Requested By (Nimo And Titio),
P.C. DOWERS WH/1rsonnel Officer
B. For Additional information Call (Name & Tolaphane Ext.)
JOHN MACHINKO K 6242
C. Request Approved By (Signature And Title)
Clearance
A. Career Board
B. Pus. Control
C. Classification
Ramorka
FORM 11520
3-57
Signature
CLEARANCES
Date
Clowanco
20. Placemang
E.
¡F. Approved By
LISTERET
bafist
FERIODIC T
Signature
Quie
14-00000
SECRET
REQUEST FOR PERSONNEL ACTION
1. Serial No.
2. Name (Last-First-Middle)
ZEHRUNG, Charlotte 4.
7.
SCD
8. CSC Rotmt 9. CSC Or Other Legal Authority
[ D
[14. Organizational Designations
DDP/WH
Branch II
Argentina Section
16: Dept.- Field 17. Position Title
3. Date Of Birth-
4. Vof. Prol. S. Sox
Classify Acconting
To Content.
8 Nov 1957
1 12 29 0 F
10. Apmt. Affiday, 11.FEGLI 12. LCD
Dodo o D
6. CS EOD
13.
STILLCO
PREVIOUS ASSIGNMENT
VOUCHERED
Code
15. Location Of Official Station
Station Code
Washington, D. C.
18. Position No.
19. Sarv, 20. Occup. Saries
Dept. X Code
Usild.
Fran
Reports Officer
BA=313
21. Grude & Step 22. Satory Or Rate 23. SD
24. Date Of Grade 25. PSI Duo
Mo Da Yo Mo Do
28-11-2 $ 6605.00
DI
27. Nature Of Action
Reassignment
31 Segundational Desgesting
ACTION
Codo
28. Eff. Dato
29. Type Of Employee
Mo Do Y,
CS
0132.44
26. Appropriation Number
8-3500-20
Coda 30. Soporation Data
56/201571
Regular
PRESENT ASSIGNMENT
VOUCHERED
C.4. 132. Location Of Official Station
Station Cada
DOP/WH
Branch III
Mexico Section
33. Dept. Field 34. Position Title
Dent x
Uslid.
Lan...
Codo
2,
38. Grade & Stop (39.
4613
Washington, D.C..
the pe
120013
135. Position No. 36. Sarv. 37. Occup. Sarlos
Reports Officer
BA-72.01
CS 0132.44
ryto 140. SD
Mo Da
141. Date of Gros 137. PST D
Ye Ato Da
43. Appropriation Number
93-11-2 $ 6605.00
DI
A. Requested By (Name And Title)
104/10/55
SOURCE OF REQUEST
P.C. BOWERS WH/Person of C. Request Approved By (Signature And Title)
B. For Additional Information Calf (Name & Tolephono Ext.)
H.C. MONTAGUE
X 8242
04/06/58
2-3500-20
Clearance
(A. Caroor Board
B. Pos. Control
C. Classification
Remari.s
5-17
1152
Signature
KAL
CLEARANCES
Clearance
Data
11/12/17/D. Plorament
Signature
E.
F. Approved By
Robert W. Seay
SECRET
Data
(4)
amp 21 {"
14-00000
SECERT
REPRODUCTION MASTERS
SECR
Handle
With
Care
BIOGRAPHIC PROFILE
--
SECRET
☐
14-00000
Charlotte BUSTONS-VIDELA
LEFT HAND SIDE
(numbered top to bottom)
1
1.
Admin and finance documents - March 1974
Jan 1978
2.
Admin and finance documents
May 1951
April 1956
3.
Bio profile (sanitized form in file)
ཐཱ་ག་འགའ་བཅུ་ ག་ ལས་འདུ
14-00000
·Charlotte BUSTOS-VIDELA
RIGHT HAND SIDE FILE
Personnel/cover
(numbered top to bottom)
after 1973
1.
2.
"Actions"
-
Personnel actions after 1973
-
"Actions" Personnel Actions
Before 1957
3.
-
4. "Fitness Reports" - May 1973 Nov 1977
S.
"Fitness Reports" prior to 1957
6.
"Other" admin material after 1973
7.
"Other"-admin material-prior to 1957
8.
"Medical" all medical material related to clearances
9.
"PHS-SEC"
document related to cover legend
14-00000
ME CUPOR
SECRET
NOTIFICATION OF ESTABLISHMENT OR CANCELLATION
OF OFFICIAL COVER BACKSTOP
་་་་་ 3་
რას
FILT NO.
CHIEF, CONTROL DIVISION
x
TO:
(Check)
ATTN:
CHIEF, CONTRACT PERSONNEL DIVISION
CHIEF, OPERATING COMPONENT (For action)
Edmond A. Sullivan
'
11 Sep 72
SS NUMBER
069-24-3138
EMPLOYEE NUMBER
007667
HE CARD NUMBER
NH
2010
☑
ESTABLISHED
REF:
OFFICIAL
COVER
DISCONTINUED
Form 1322 dated 5 May 72
UNIT
3190
SUBJECT
X
BUSTOS-VIDELA, Charlotte Z
Joint Operations Group
KEEP ON TOP OF FILE WHILE COVER IN EFFECT
ESTABLISHMENT OF OFFICIAL COVER BLOCK RECORDS
BASIC COVER PROVIDEO
EFFECTIVE D'ATE
10€ Aug 62
OPERATIONAL COVER PROVIDED
FOR TOY _ OTHER (Specify)
CANCELLATION OF OFFICIAL COVER UNBLOCK RECORDS
EFFECTIVE DATE:
SUBMIT FORM 3254
-2
TO BE ISSUED. (MNP 20-11)
X
SUBMIT FORM 642 TO CHANGE LIMITATION CATEGORY.
(HHB 10-7)
SAMT FORM 3254'
HRB 10-11)
ARMY
W-2 10 OF ISSUED.
SUBMIT FORM 1322 FOR ANY CHANGE AFFECTING THIS
X LOVER. (HR 240-29)
✗
SUBMIT FORM 1323 FOR TRANSFERRING COVER
RESPONSIBILITY. (HR 240-24)
SUBMIT FORM 642 TO CHANGE LIMITATION
CATEGORY. (AND 20-7)
EAA: CATEGORY 1
☐ CATEGORY 1
RETURN ALL OFFICIAL DOCUMENTATION TO CCS
SUBMIT FORM 2688 FOR
HP
DO NOT WRITE IN
CARD
✗. CATEGORY 1
CATEGORY H XX
AGE
.SUBMIT FORM 2683 FOR
HEMANKS AND/OR COVER HISTORY
-
Aug 51 Aug 62
Aug 62
Jul 67
Sep 72
-
Jul 67
Aug 72
Present
_ HOSPITALIZATION CARD
Has/OVERT
Hqs/DAC
Mexico/State.
HQ/DAC
CD/kas
DISTRIBUTICA.
1. OPERATING CampLNENT
COPTI
ō
•
- FORM
2.74
1551***
to
SECRET
CHIM
12950
*1
☐
"
(13-3-431
14-00000
SECRET
DATE
TO: ☑
(Check)
ATTN:
REF:
NOTIFICATION OF ESTABLISHMENT
OF MILITARY COVER BACKSTOP
CHIEF, RECORDS AND SERVICES DIVISION
CHIEF OPERATING COMPONENT WH
WH/SS Mr. Mullane
Verbal Request for Cover, Form 1322 Dated 31 Jul 62
MILITARY COVER BACKSTOP ESTABLISHED
U.S.Army Element, Joint Operations. Group (8739)
7 August 1962
ESTABLISHED FOR
(NEE: ZEHRUNG)
BUSTOSVIDELA, Charlotte Ze
FILE NO.
3190
ID CARD NO.
X
BLOCK RECORDS:
(OPHEMO 20-800.11)
a.
TEMPORARILY FOR
DAYS, EFFECTIVE.
X CONTINUING, EFFECTIVE 7 August 1962..
SUBMIT FOPM 642 TO CHANGE LIMITATION CATEGORY TO 3.
(HB 20.800.3)
ASCERTAIN THAT ARMY 7-2 BEING ISSUED.
(HB 20.661.1)
SCHMET 101; AND CHANGE ATING COVER.
(R 240 240)
SUBMIT FORM 1323 FOR TRANSFERRING COVER RESPONSIBILITY.
( 740.250)
REMARKS:
COPY TO CPO/OP
43688
BIS
$7.44
15513187700871038
01710
< 0.
I AND
CECRET
320-44)
14-00000
THIS EXPLOYER HAS BEEN IDENTIFIED AS
A C.I.A. EMPLOYER FOR PURPOSES OF
WITHOLDING STATE AND FEDERAL TAXES
DATE DESIGNATED
JANUARY 03 .1961
:
07667 CHARLOTTE L ZEHRUNG 235100010
✓
63

14-00000
1
Fox
QJGS 07/21/73
5 SERIAL NURBER
2. KAME LAST FIRST MIDDLE)
མ ཀཏྠཱི'
SECRET
[When filled in)
NOTIFICATION OF PERSONNEL ACTION
067657
3 NATURE OF PERSONNE ACTION
REASSIGNMENT
FUNDS
BUSTOSVIDELA C Z
4 EFFECTIVE DATE
DA
"O.
0701 73
5 CATEGORY OF SRASTRENT
4235 4525 boool
30 LOCATION OF OFFICIAL STATION
& EN ER ODER LEGAL AUTHORITY
x
7 FAN AND NSCA
V TO V
▼ TO σ
σ 10 V
σ to σ
95GANIZATIONAL DESIGNATIONS
000/#H DIVISION
11. POSITION TITLE
OPS OFFICER
14 CLASSIFIKATION SCHEDULE (G1 1 )
GS
1 DES
:
WASH., D.C.
17 POSITION BE
1294
IS OCCUPATIONAL SERIES
16 GRADE AND STEP
0136.01
13
SIGNATURE TICATION
Live Fräsmƒ &
Jus
PLANE
SPORET
ار الحرمين :
0
17. SALARY OR RATE
102
54
1 + i
14-00000
"PAY ADJUSTMENT IN ACCORDANCE WITH 5 L.S.C. 530° AND EXECUTIVE ORDER
1169Í PURSUANT TO ALTMUNITY OF 
ECT AS PROVICED IN THE CIA ACT OF 1949,
AS AMENDED, AND DCT DIRECTIVE DATED 
CS OCTOBER 1962."
EFFECTIVE DATE OF PAY ADJUSTMENT: 07 JANUARY 1973
EFFECTIVE PATS OF FAY ADTMENT CORRECTED FROM
7 JAN 1973 70 1 OCT 19.2 UNDER EXECUTIVE ORDER
NAM 1777, DATED 12 aro
• SCHIAL ORGN. FUNDS GR-STEP
NEW
SALARY
BUSTOSVICELA C Z
007667
51 300 ✓ GS 13 7
323,642
MOP:
OCF
26 SEPT 72
1 SERIAL NUMBER · 2 NAME (LAST-FIRST-MIDDLE)
SECRET
(When filled in)
NOTIFICATION OF PERSONNEL ACTION
007667
BUSTOSVIDELA C Z
3 NATURE OF PERSONNEL ACTION
4 EFFECTIVE DATE
5 CATEGORY OF EMPLOYMENT
REASSIGNMENT AND TRANSFER
TO VOUCHERED FUNDS
40
DA
09
72
V TO V
V TO Cr
a FUNDS
X
CF TO Y
CF TO CF
9. ORGANIZATIONAL DESIGNATIONS
REGULAR
Financial A Any No Chargeable CSC OR OTHER LEGAL AUTHORITY
3235 0620 0000
TTO LO ATION OF OFFICIAL STATION
50 USC 403 J
DUP/WH DIVISION
BRANCH 1
CA SECTION
11. POSITION TIRE
OPS OFFICER
تھا
18 REMARKS
W2 INFO: DEPT OF ARMY
HOME BASE; WH
R
COXY
16
WASH., U.C.
12. POSITION NUMBER
13 SERVICE DESIGNATION
U
1294
1 CX (PATIONAL SERIES
14 GRADE AND STEP
12 SALARY OF RATE
0192101
15 7
SPACE BELOW FOR FUN OF THE OFFICE OF PERSONNA
(239
FIX
11
A
Wi
7013
12
* 2.
A
farby
MLH
CATHO
Tw
14-00000
"PAY ADJUSTMENT IN ACCORDANCE WITH SALARY SCHEDULES OF PL 92-210 AND
EXECUTIVE ORDER 11537 PURSUANT TO 
AUTHORITY OF OCI AS PROVIDED IN THE
88A ACT OF 1969, AS AMENDED, AND A OCI 
DIRECTIVE DATED 6 OCTOBER 1962
"
EFFECTIVE DATE OF PAY ADJUSTMENTS 9 JANUARY 1972
NAME
SERIAL
OPGN, FUNDS GR-STEP
NEW
SALARY
BUSTOSVIDELA C Z
007667
51 620 CF
G5 13 7
$22,487
382.12
2
HAME
1007667
BUSTOSVIDELA C ?
CLO SALARY RATE
Crede
notery
3 ORGANIZATION
FUNDS
TWO HOU
7.
ley L. Dom
Grade
Stay
51 620
NEW SALADY DATE
Sutury
CF
TYPE ACTION
EFFECTIVE PATE
31
65 1620,721 10/19/695 137 $21,313 10/17/91
CERTNICATION AND AUTHENTICATION
17 THAT THE WORK OF THE ABOVE NAMED EMPLOYEE IS OF ACCEPTABLE LIVEL OF COMPETENCE.
Dalf
LIS (NET
☐ no xastawd*
°
IN PAY STATUS AT NO OF WRITINGS FERIÇO.
TWO STATUS AT END OF WAITING PERIOD
1433
:བས་་འ
PAY CHANGE NOTIFICATION
7 in
L
36
14-00000
"PAY ADJUSTMENT IN ACCORDANCE WITH SALARY SCHEDULES OF PL 01-650 AND
EXECUTIVE ORDER 11975, PURSUANT TO AUTHORITY OF UCI AS PROVIDED IN THE
CIA ACT OF 1769, AS AMENDED, AND A DCI DIRECTIVE DATED 8 OCTOBER 1962”
EFFECTIVE DATE OF PAY ADJUSTMENTS 10 JANUARY 1971
NAKE
SERIAL
DPGN, FUNDS GR-STEP
BUSTOSVIDELA C Z
007567
51 620 CF GS 13 6
NEW
SALARY
$20,721
22
A w
"PAY ADJUSTMENT IN ACCORDANCE WITH SALARY SCHEDULE OF PL 91-231 AND
EXECUTIVE ORDER 11526 PURSUANT TO AUTHORITY OF 001 AS 
PROVIDED IN THE
CIA ACT OF 1949, AS AMENDED, AND 
A DCI DIRECTIVE DATED 
& OCTOBER 1962"
EFFECTIVE DATE OF PAY 
ADJUSTMENT! 28 DECEMBER 1969
NAME
BUSTOSVIDELA C Z
SERIAL
037667
ORG. FUNDS GR-STEP
51 620 CF
G5 13 0
:
4
NEW
SALARY
$19,595
1
14-00000
•
"PAY ADJUSTMENT IN ACCORDANCE WITH THE PROVISIONS OF SECTION 5305 OF
TITLE 5, U.S.C. AND 
EXECUTIVE ORDER 11739 PURSUANT TO AUTHORITY OF 
OCI
AS PROVIDED IN THE CIA ACT 
CF 1949, AS AMENCED, AND OCI DIRECTIVE
DATED 08 OCTOBER 1962."
EFFECTIVE DATE OF PAY ADJUSTMENT: 14 OCTOBER 1973
NAME
SERIAL
ORGN. FUNDS GR-STEP
NEW
SALARY
BUSTOSVIDELA C Z
007667 51 100
V
GS 13 7
$24,811
Se
5.
007667
Granda
Step
OS 13
1
-
BUSTOSVIDEIA C 2
OLD SALARY RATE
53 620
CF
NEW SALARY RATE
Salary
Los Date
Grada
Step
Sulary
Ettache Date
7,
75:
TYPE ACTION
LSI
$17,920 10/19/69 05 13
tamarks und Authen when
6 610,447 12/14/69.
QUALITY STEP INCREASE
"
/a/ n & HATTIES
gua
12 DECEMBER 1969
PAY CHANGE NOTIFICATION
$5.103
941 560 Ay as tw
2551)
1
1
14-00000
Us
SERIAL NO.
007667
A.
Grata
Step
69.55 41
2.
3 GIGANIZATION
FUNDS
TWO HOURS
NAME
651
BUSTOSVIDELA C 2
OID SALARY RATE
51 620
CF
7.
Salary
Last (1) Date
Orode Step
NEW SALARY RATE
batory
TYPE ACTION
EFFECTIVE DATE
51
ADJ.
GS 13 4 817;393 10/22/67 GS 13 S $17,920 10/19/69
CERTIFICATION AND AUTHENTICATION
I CERTIFY THAT THE WORK OF THE ABOVE NAMED EMPLOYEE IS OF ACCEPTABLE LEVEL OF COMPETENCE.
SIGNATURE
" J. J.
CLERKS INITIALS
FORM
7-66 560 E
NO EXCESS LWOP
°
IN PAY STATUS AT END OF WAITING PERIOD
SWOP STATUS AT END OF WAITING PERIOD
2.02
n
Uso provious
editions
J I J U T T L H
g 0
22
PAY CHANGE NOTIFICATION
P
DATE
111/6935
AGDULD BY
°
JBR
UCI 13
C
UWUN
(4-51)
"PAY ADJUSTMENT IN ACCORDANCE WITH SECTION 212 GF PL 90-206 AND EXECUTIVE
OPDER 11474 PURSUANT TO AUTHORITY 
OF CCT AS PAGIDED IN THE CITA ACT OF 1949,
AS AMENDED, AND A DCI 
DIRECTIVE DATED 8 OCTFP 1962"
EFFECTIVE DATE OF PAY ADJUSTMENT: 13 JULY 1969
NAVE
SEPIAL
GSTOSVIDELA CZ
007667
CHON FUNDS ST57
51 620 CF 25 13
SALARY
4
$17,393
14-00000
‹ YO:
31 OCT 08
SECRET
(When Filled in)
NOTIFICATION OF PERSONNEL ACTION
OLF
1. SERIAL NUMBER
007667
2 NAME (LAST FIRST-MIDDLE)
BUSTOSVIDELA C Z
3 NATURE OF PERSONNEL ACTION
REASSIGNMENT
FUNDS
ORGANIZATIONAL DESIGNATIONS
JUP/WH
V TO V
V TO CF
CF TO V
X
CF TO CF
4 EFFECTIVE DATE
NO
DA
11
"
0368
3 CATEGORY OF EMROY WENT
REGULAR
7. Financial Analysis No Chargeable CSC OR OTHER LEGAL AUTHORITY
9135 0990 0000
10 LOCATION OF OFFICIAL STATION
50 USC 403 J.
FOREIGN FIELD
BRANCH 1
MEXICO CITY, MEXICO STATION
IT POSITION TITLE
MEXICO CITY, MEXICO
12 POSITION NUMBER
0418
13. SERVICE DEVGNATION
D
OPS OFFICER
14. CLASSIFICATION SCHEDULE (GS LB etc)
13. OCCUPATIONAL SERIES
16 GRADE AND STEP
17, SALAG OR CATE
18. REMARKS
GS
STAFF EMPLOYEE SPECIAL
0136.01
13 4
15843
Cook
51620
Wi
45075
RETIREMENT DATA
SPACE RFLOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL
17 ACTION 20 Employ 21 OFFICE CODING
cofit
Conte
37
10
28 Mit tariRES
29 SPECIAL
REFERENCE
STATION
.3 INTEGRES 12 M 25 DATE OF BIRTH
LODE
25 A
Cate
34
13
1212
31 SEPARATION
DATA CODE
32 Correction Concetha an Durg
34.55%
2:0 NO
440
24
55
cout
Dr
24
"
FOD DATA
35 VET PREFERENCE
root
MAN
26 SEAN COMP DATE
0
37 COM COMP DE CAREER CATEGORY
FEQUE HEALTH INSURANCE
SOCIAL SECURITY NO
15
50
123×
1-5 PT
13 P
rov
"W
41
PREVIOUS CIVILIAN GOVERNMENT SERVICE
42 LEAVE CAT 43
CODE
TECERAL AT DATA
E
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2 HATIT
HANNON
+25
44
STA TAN DATA
FU
C
setress THAN PES
, POLE IN MAN;
2016
1150
My D
SIGNATURE OR OTHER AUTHENTICATION
ATTLES
SECRET
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3 W
POSTED
FVD
144
kay
F7
14-00000
"PAY ADJUSTMENT IN ACCORDANCE WITH SECTIONS 212 AND 216 OF PL 90-206 AND
EXECUTIVE CRUER 11613 PURSUANT 
TO AUTHORITY OF CCI AS PROVIDED IN THE CIA 
ACT
OF 1949, AS AMENDED, AND A-
CCI DIRECTIVE DATED 6 OCTOBER 1962"
EFFECTIVE DATE OF PAY ADJUSTMENT:
14 JULY 1968
NAME
SERIAL
BUSTOSVIDELA C Z
007567
51 620
CRGN. FUNDS GR-STEP
CF GS 13 4
OLD
SALARY
NEW
SALARY
$14,857
$15,849
OLF
1. SERIAL NUMBER 2 NAME (LAST FIRST-MIDDLE)
007007
3. NATURE OF PERSONNEL ACTION
LADOTS ML)
FUNDS
SECRET
(When filled in)
NOTIFICATION OF PERSONNEL ACTION
CUSTOCVIDELA C Z
4 EFFECTIVE DATE
5. CATEGORY OF EMPLOYMENT
MO
DA
та
Y 10 Y
V 10 (F
( 10 V
人
(F TO (F
9. ORGANIZATIONAL DESIGNATIONS
DUP/WH
OKEIGN FIELD
OKANCHI
MEXICO CITY, MEXING STATION
16 POSITION TITLE
REGAR
7. Financial Analysis No. Chargeable (SC OR OTHER LEGAL AUTHORITY
6130 0000
50 036 403 J
10. LOCATION OF OFFICIAL STATION
MEXICO CITY, MEXICO
12 POSITION NUMBER
113 SERVICE DESIGNATION
14. CLASSIFICATION SCHEDULE (55, 13, etc)
15. OCCUPATIONAL SERIES
16 GRADE AND P
1/ SALARY OR RATE
[0159.01
1370
13 PEMARKS
PLOYEE
SPACE BELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL
1Z STATION 23
CODE
24 Magtes 25 DATE OF BIRTH 74 DATE OF CEADE
CODE
Code
ALFABETIC
Un
19 ACTION 20 Employ 71 OFFICE CODING
CODE
ipde
PAGE OF E
23 43 7825
29 SPECIAL 27 RETIREMENT DATA
REPERFACE
IN SEPACATIng
CAIA FOOL
CORRECT, CAVELLATION PAIN
34 56%
A
622 *
EOD DATA
02
35 VET PREFFENCE
36 SERY, CATE 37 104G COMP BAIL 136 CAREER CATEGORY
it.
SEGLE HEALTH INSURANCE
SOCIAL SECURITY NU
Copt
0 704
1
07
LIDE
DALIES
45
41
CODE
PREVIOUS CYRIAN GOVERNMENT SERVICE
40 PNÁLIS
» ChEAR IN SERVIS
42 LEAVE CAT 43
(008
"
FEDERAL TAX T
1004
OTHER AUTHENTICATION
Un
SECOFT
(150
2
40
STATE TAL PATA
POSTED
ادر می کرده میگیرند.
LU
14-00000
i
THAI
3CX
3
11 SERIAL NO.
007667
2.
NAME
MUSTUSVIDELA C Z
Grade
OLD SALARY RATE
Solary
651
3 ORGANIZATION
fast Eff. Date
Nimite Step
58 620
NEW SALARY RATE
Solaty
FU140S
3. WOP HOURS
CF
B. TYPE ACTION
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WEALTHFAS COPE
40. SOCIAL SECURITY NO
3244
J. AD PREVIOUS SERVICE
SIN SERVICE
FEDERAL TAX 04TA
TED COSE
16h
44.
STATE TAX DATA
TORN EISCUIta
1. YER
COO NO PARA
EXEMP
12 IN SERVICE THE OS)
BREAKI
SIGNATURE ON OTHER AUTHENTICATION
Forg
600
Chaclete Previous
SECRET
1152
Extitions
2. no
POSTED
06/14/61.2K
13.300
0
C
1.1

14-00000
Bare Fo.
2.
Name
SECRET
(When filled in)
107667
ZEHRUNG CHARLOTTE
OLD SALARY RATE
Salary
S.
Oraso
Step
0.
Last Eff. Date
Grade
12
GS 12 1}$ 8,935 12/13/kg
1. Remarks and Authentication
Cost Center Numbat
4.
LWOP Hours
3
V-20
NEW SALARY RATE
Selery
Effective Date
7. TYPE ACTION
1.31
ADJ.
289,215 06/11/61
Jai
ホ
NO EXCESS LWOP
IN PAY STATUS AT END OF WAITING PERIOD
IN LWOP STATUS AT END OF, WAITING PERIOD
EDECHOLS
Form
760 560
Ubaciate Previous
Edition
PAY CHANGE_NOTIFICATION
SECRET
2jK
(4-51)
L
IN ACCORDANCE WITH THE PROVISIONS OF P. L. 96-568 AND DCI MEMO DATED
1 AUGUST 1056, SALARY IS ADJUSTED AS FOLLOWS EFFECTIVE 10 JULY 1960.
SD
HAVE
SERIAL ORGN GR-ST
OLD SALARY NEW SALARY
DI
ZEHRUNG CHARLOTTE 107667
46 13 GS-12 1 $ 8,330.
$ 8i955
151
EMMETT D. SCHOLS
DIRECTOR OF PERSONNEL
14-00000
PAS:
11 DEC 1959
1. Serial No.
SECRET
(When Filled In)
NOTIFICATION OF PERSONNEL ACTION
2. Name (Last-first-Middle)
ZEHRUNG CHARLOTTE
107667
7. SCD
Mo. | Do. Yr.
10402 51 No. 2
13. Date Of Birth
4. Vot. Prol.
5. Sox
M1 12 29 15
6. CS EOD
F2 08 2751
10. Apmt. Alliday. 11. FEGLI 18. LCD
13. to
Mo. Da. Yr. You 1 Colo Mo. 27 11 4:2 Code
A
8. CSC Rotint. 9. CSC Or Other Logal Authority
Yos. 1 Code
50 USCA 403
PREVIOUS ASSIGNMENT
Code
15. Location Of Official Station
14. Organizational Designations
DOP
WH
BRANCH 111
MEXICO SECTION
[16: Dept. - Field_
17. Position Tito
Dapt 2 Codol
und - 4
i
Figo -6
2 1.0. FI
21. Grado & Stop 22. Salary Or Rate
11 4
27. Nature Of Action
PROMOTION
7750
31. Organizational Designations
DOP WH.
BRANCH 111
MEXICO SECTION
33. Dept.-old (34. Position Tille
Part-2
luchd-4
Codo
From 6 2 OPS OF CR
38. Grade Stap 39 Salary Or Roto
12 1
144. Yomares
FGAN N3
1 MAR 57
8330
Station Code
4613
WASH., D. C.
75013
18. Position No.
19. Serv. 20. Occup. Serios
0521
GS.
0136.51
23. SD
Da. Yr. Mp.
24. Date Of Grade 125. PSI Dug
Mo.
DI
T
126. Appropriation Number
10550806588 3500 20
29. Typo Of Employee
ACTION
Codo
28. Elf. Dato
Mo.
Da. Yr.
30
12 13 59
REGULAR
PRESENT ASSIGNMENT
Codo 32 Location Of Official station
Code] 30. Separation Data
01
4613
WASH., D.C.
75013
[35. Position No.
36. Sorv. 37. Occup. Series
0607
GS
0136.01
40. SD
41/Date ClGrade 42 PSI Due
Mo. Da. Yr. Mo. Da. Yr.
DI
43. Appropriation Number
1213159 0611 161 0235 1000 1000
1150
13-147-57
SECRET
1-7-60
(4)
☐☐
14-00000
ઓ
1. EDP SERIAL NO.
8.
NAME
SECRET
(WHEN FILLED IN)
".
ASSIGNED ORGAN.
107667
ZEHRUNG CHARLOTTE
Ꮎ .
OLD SALARY RATE
7.
GRADE
STEP
SALARY
MO
DA
LAST EFFECTIVE DATE
7.
GRADE
STEP
4 FUNDS
3 ALLOTMENT
V-20
DDP/WH 3
NEW SALARY RATE
EFFECTIVE DATE
SALARY
BO
DA
"
GS 11 3 3 7,510 04 06 58 65 11 4 $7,750 10 04 59
TO BE COMPLETED BY THE OFFICE OF COMPTROLLER
3. CHECK ONE
DO EXCED LOO
IF EXCESS LYOP, CHECE FOLLOWING.
☐ EXCESS LWOP
9. NUMBER OF HOURS LWOP
11. AUDITED ST
IN PAT STATUO AT END OF WATTING PESION
IN-LWOP STATUS AT END OF WASTING PERIOD
10. INITIALS OF CLERK
TO BE COMPLETED BY THE OFFICE OF PERSONNEL
18. TYPE OF ACTION
☐ P... ☐ 1.S. ☐ PAY ADJUSTMENT
14. AUTHENTICATION
FOON
8-50
ارد
13. REMARKS
6. M STEWART
°
PAY CHANGE NOTIFICATION
560 LTE VOUS EDITION
REPLACES FORN 3509. AND 560b.
SECRET
OFFICIAL PERSONNEL FOLDER
(4)
IN LIFH OF FORM 1150 THIS NOTIFICATION EFFECTS RESLOTTING RESULTING
FROM R-20-250
SER #
NAVE
SD
OLD SLOT NEW SLOT
107667 ZEHRUNG CHARLOTTE
DI 0521
:
DATE
321
04/28/59
-
14-00000
SEC PET
GENERAL SCHEDULE SALARY INCREASE PETROACTIVELY EFFECTIVE
12 JANUARY 1950 AUTHORIZED BY P. L. 85 -
462 AND DCI
DIRECTIVE. SALARY AS OF 15 JUNE 1958 ADJUSTED AS FOLLOWS
NAME
SERIAL
GRADE-STEP
OLD SALARY
NEW SALARY
○ ZEHRUNG CHARLOTTE
107667
GS-11-3
$ 6,820
$ 7,510
BAL NO
107667
8.
GRADE
STEP
GS 11
2
SECRET
STEWART
GORDON M.
/S/ DIRECTOR OF PERSONNEL
i
0
C
0
510
SECRET
(WARTE FILLED IN
KAKE
3
ASSIGNED C85AN.
FUNDS
5. ALLOTMENT
ZEYRUNG CHARLOTTE
OLD SALARY RATE
DDR WH
V#20
7
NEW SALARY RATE
LAST EFFECTIVE DATE
EFFECTIVE DATE
SALARY
GRACE
STEP
SALARY
BO.
DA.
TR
BC.
DA.
Ya.
$ 6,605 10 07 56
GS 11
3
15 6.820
04 06
58
TO BE COMPLETED BY THE OFFICE OF COMPTROLLER
9. CHECK ONE
NO EXCESS LOP
IF EXCESS LEAVE LWOP, CHECK FOLLOWING:
☐ IN PAY STATUS AT END OF WAITING PERIOD
INLOP STATES AT END OF WAITING PERIOD
EXCESS LWOP
9. NUMBER OF HOURS LWOP
10. INITIALS OF CLERK
TO BE COMPLETED BY THE OFFICE OF PERSONNEL
PROJECTED SALARY MATE AND EFFECTIVE DATE
12.
GRADE
STEP
SALARY
MO
13. REMARKS
DA
YR
14. AUTHENTICATION
сало. 5605
1 NAS. *4
HONVER 770BATE
11. AUDITED BY
M. STEWART
PERIODIC STEP INCREASE - AUTHENTICATION
SECRET
PERSONNEL FOLDER
(4)
"
14-00000
SECRET
(When filled In)
NOTIFICATION OF PERSONNEL ACTION
2. Name (Last-First-Middle)
ZEHRUNG CHARLOTTE
[3. Date Of Birth [4. Vet. Prof. 5. Sex
01 12 29 151
6. CS-805
F2082751
10. Apmt. Affidav, 11. FEGLI |12. LCD
Mo. Da.
3 APRIL 58
HCH
1. Serial No.
107667
7.
0402
Yr.
|B. CSC katmt. 19. CSC Or-Other Legal Authority
Yes-1 Code
No -2
51
50 USCA 403
PREVIOUS ASSIGNMENT
Code
15. Location Of Official Station
Mo.
13..
b. Da. Yr. Kos-1 Code Mo. 22 31 - Ce
Station Code
14. Organizational Designations
DDP WH
BRANCH 111
MEXICO SECTION
16. Dept. Fiold
17. Position Title-
Dopt - 2
Code
Usild 4
Fran 6
2
REPORTS OFF
21. Grade & Step 22. Salary Or Rate
11 2
27. Nature Of Action
REASSIGNMENT
6605
31. Organizational Designations
DDP
WH
BRANCH 111
MEXICO SECTION
133. Dept - Field
Dopt. 2-
134. Position Titlo
Code
Usfid - 4
Fran ō 12 1.0. FI
39 Grado & Step 139. Salary Or Rate
s
112
6605
144, Remarks
FORM NO 1150
1 MAR 57
4613
WASH
D C
75013
18. Position No.
19. Serv. 20. Occup. Series
0072.01
GS
0132.41
23. SD
24. Date Of Grade 25. PSI Due
Mo. Da. Yr. Mo. Da. Yr.
DI
26. Appropriation Number
04/10155 040658 83500 20
40. SD
DI
ACTION
Codo 28. Eff. Date
Mo.
29. Type Of Employee
Da. Yr.
56
041 031 58 REGULAR
PRESENT ASSIGNMENT
Ccdo
32. Location Of Official Station
Code 30. Separation Data
01
Station Code
4613
WASH
D. C.
75013
35. Position No..
136. Serv. 37. Occup. Sories
0521
GS
0136.51
141. Date Of Grado 42. PSI Due
Mo.
Da. Yr. Mo. Do. Yr.
143. Appropriation Number
04 11055 04106158 83500 20
SECRET
POSTED
DP 5/1/18
(F)
6
14-00000
SECRET
(When Filled In)
NOTIFICATION OF PERSONNEL ACTION
MYL
1. Serial No.
2. Name (Last-First-Middle)
3. Date Of Birth. 14. Vot. Prof. 5. Sex
6. CS-EOD
01 12 29 510F203 2751
10. Apmt. Affidav. 11. FEGLI 12. LCD
13.
Mo. Da. Vr. Yes.1 Code Mo. Da se
PREVIOUS ASSIGNMENT
Code
15. Location Of Official Station
Station Code
107667
7. SCD
ZEHRUNG CHARLOTTE
Mo. Da. Yr.
8. CSC Rutmt. 19. CSC Or Other Legal Authority
Yes-1 Code
04 02 51
No - 81
150 USCA 403 J
14. Organizational Designations
DOP WH
BRANCH 11
ARGENTINA SECTION
16. Dept. Fiold
17. Position Tito
Dept - 2
Code
Usild. 4
Fran6
REPORTS OFFICER
21. Grade a Step 92. Salary Or Rate
23. SD
11.2
$6605
01
27. Nature Of Action
REASSIGNMENT
[31. Organizational Designations
DDP WHI
BRANCH 111
[MEXICO SECTION
33. Dept. Field
34. Position Tite
Dopt - 2
USAld. 4
Code
+
Frun 6
12
[REPORTS OFF
38. Grade & Stap 39. Salary Or Rate
s
11 2
44. Remarks
6605
FORM NO
1 MAR 07
1150
WASH
D C
18. Position No.
19. Serv. 20. Occup. Serios
313
GG
¨0132.44-
24. Date Of Grado 25. PSI Duo
Mo. Da. Yr. Mo. Da. Yr.
26. Appropriation Number
8 3500 20
ACTION
Code
28. Elf. Date
Mo. Da.. Yr.
129. Type Of Employoo
Codo 30. Separation Data
156
12 101 157 REGULAR
PRESENT ASSIGNMENT
01
Code
Location Of Official Station
Station Codu
4613 WASH DC
175013
35. Position No.
36 Serv. 37. Occup. Series
0072.01
GS
0132.44
40. SD
41. Date Of Grade | 42. PSI Due
Mo. Du. Ye Mo. Da. Ye.
DI
43. Appropriation Number
104 110 155 104 105 158 18 3500 20
POSTED
10957
SECRET
(4)
☐
14-00000
:
SECRET
CLASSIFICATION
FITNESS REPORT
GENERAL INFORMATION
SECTION A
1. EMPLOYES NUMBER
007667
2. NAME (Lost, first, middle)
Bustos-Videla, Charlotte Z.
7. OFFICIAL POSITION TITLE.
DDO/WH/1
8. DATE OF BIRTH 4. SEX. GRADE 6. SD
12 Jan 29
F GS-13 D
НО. НО СО
8. OFF.DIV/BR OF ASSIGNMENT B. CURRENT STATION
Operations Officer
11. TYPE OF APPOINTMENT
13. TYPE OF REPORT
☐ CAREER RESERVE CONTRACT OTHER (SPR) TEMPORARY ANNUAL REASSION SPECIAL
13. REPORTING PERIOD (from-80-)
14. DATE REPORT DUE IN OF
* 1 August 1972
-
.30 April 1973
QUALIFICATIONS UPDATE
SECTION B
IF QUALIFICATIONS UPDATE FORM IS BEING
SUBMITTED WITH CHANGES, AND IS ATTACHED TO THIS REPORT, PLACE THE
WORD "YES" IN THE BOX TO THE RIGHT. IF NO CHANGES ARE REQUIRED. PLACE THE WORD "NO" IN THE BOX AT RIGHT.
SECTION C
U-Unsatisfactory
M-Marginal
P-Proficient
-Strong
O-Outstanding
PERFORMANCE_EVALUATION
Performance is unacceptable. A rating in this category requires immediate and 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 D.
Performance is deficient in some aspects. The reasons for assigning this rating should be stated in Section D and remedial actions
taken or recommended should be described:-
Performance is satisfactory. Desired results are being produced in the monner expected
Performance is characterized by exceptional proficiency.
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 DUTIES
List up to six of the most important specific duties performed during the rating period. Insert rating lette, which best describes the manner in which employee
performe 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. 1
Functions as Chief of the WH/1/SA and Cuba Section, supervising.
one case officer, one IA and one secretary.
SPECIFIC DUTY NO. 2
Analyzes all traffic pertaining to Branch and Station SA and Cuban
Operations, performs all operational support, project actions, corres-
pondence, coordination, memoranda and file maintenance. ):-
Prepares studies, file analyses and special reports such as budget
and program call and correspondence with the White House,
SPECIFIC DUTY NO. $
SPECIFIC DUTY NO. 4
RATING
LETTER
RATING
LETTER
0
RATING
LETTER
RATING
LETTER
SPECIFIC DUTY NO. 8
SPECIFIC DUTY NO.
RATING
LETTER
RATING
LETTER
OVERALL PERFORMANCE IN CURRENT POSITION
Toke into account everything about the employee which influences his effectiveness in his current position noch as performance of specific detas,
productivity, conduct on job, cooperativenous, pertinent personal traits or nobin, and purricular limitations tolents. Based on your knowledge
of employee's overall performance during the rating period, place the fourer in the tuning box correspassing to the statement which most not
rately reflects his level of performance.
Form
0-12
45
OBSOLETE PREVIOUS
EDITIONS
CLASSIFICATION
SECRET
055272
22 HPDE CL B
RATING
LATTER
S
MAY)
1973
4160 1800 3800
14-00000
1.
C -
:
SECTION D
CLASSIFICATION
NARRATIVE COMMENTS
Indicate significant strengths or weaknesses demonstrated in current position keeping in proper perspective their relationship to overall performance State
suggestions made for improvement of work performance. Give recommendations for training Comment on foreign language competence, it required for
current position. Amplify or explain ratings given in Section C provide be best for degimining future personnel action Monner of performance of
managerial or supervisory dubles and cost consciqueñess in the use of personnel, space, equipment and funds, must be commented on A applicable. It
extra-space is needed to complate: Section D, attach a separate sheet of paper.
In the 8 months during which she was under my supervision, Mrs. Bustos has
performed in that same hard-working, highly-productive style which has become
her trademark over the years. She understands the intelligence process from
start to finish and is personally experienced with each step along the way, save the
agent handling aspects. She excels in each phase of the work.
As chief of the Branch SA and Cuban activities section; she has once again
demonstrated her mastery over her assigned duties. She is a sound, dependable,
yet imaginative and energetic operations officer, whose performance leaves little
to be desired. While she had had little previous supervisory experience, she has
in this assignment demonstrated exemplary supervisory ability. Notwithstanding
her drive, tenacity and attention to detail, she is a popular co-worker, is receptive
to guidance and is sensitive to, and responsive to the needs of her subordinates.
In her performance of specific duty No. 2, she has brought to bear upon her
daily duties her broad experience, high intelligence-and good operational sense,
functioning with practically no need of close supervision. It is comforting to
know that an assignment given to this employée is always done promptly, pro-
fessionally and cheerfully.
Her adaptability was demonstrated in her specific duty No. 3. Despite the
press of normal daily activity, she was often called upon to produce "crash"
SECTION E
1.
2.
DATE
CERTIFICATION AND COMMENTS
BY EMPLOYEE
(continued)
I CERTIFY THAT I HAVE SEEN SECTIONS A, B, C AND D OF THIS REPORT
ma, 1973
MONTHS EMPLOYEE HAS BEEN
UNDER MY BUTENVISION
SIGNATUR
W
EARN OVER
Car
BY SUPERVISOR
-
IF THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
8
DATE
21 May 1973
3.
COMMENTS OF REVIEWING OFFICIAL
OFFICIAL TITLE OF SUPERVISOR
DC/WH/1
BY REVIEWING OFFICIAL
TYPED OR PRINTED NAME ANGALIGNATURE
Raymond J. Swider
The rater has written an accurate and thorough evaluation
of Mrs. Bustos. I concur without reservation in the ratings provided subject,
She is an exceptional officer. Her ability to perform a variety of ass giments
in Headquarters and the Field has measured up to an outstanding record. Her
work with subordinates clearly indicate she is a good supervisor. Mrs. Bustos
performs all facets of her work in an exemplary manner and in my judgement
rates in the upper percentile in the A Category.
DATE
21 May 1973
1 OFFICIAL TITLE OF REVIEWING OFFICIAL
C/WH/1
SEENOT
TYMED
NAME AND SIGNATURE
John C. Murray
14-00000
Y
- 2 -
Narrative Comments (continued):
(Charlotte Z. Bustos-Videla)
papers for the Branch because of her innate talents and
established reliability. She never failed to impress her super-
visor with her production, writing ability and energy. Her overall
performance is clearly in excess of her grade level.
In terms of true cost and security-consciousness, she must also
be considered very strong because she has a positive and aggressive
attitude towards these subjects. It is with deep regret that the
Branch parts with this employee who now moves up to the Division
front office staff.
14-00000
C-O-N-F-1-D-E-N-T-1-A-L
Covert Action Operations Seminar 112.
35 hours, full time
"
2-73
Participant : Bustos-Videla, Charlotte
Year of Birth: 1929
Grade
: GS-13
EOD Date
: 08/51
Office
WH
:
Service Designation:
No. of Students
20
COURSE OBJECTIVES, CONTENT AND METHODS
The objective of the Seminar is to give the participant a familiarization
with the major fields of covert action. These are viewed as:
Political Operations, Including Propaganda;
Operations Against Priority Targets and
Denied Areas..
("Priority targets" is taken to include
Soviet Bloc, Chinese Communist, Cuban,
and North Vietnamese officials and
other personnel in third countries,
and other designated targets)
The Seminar includes a discussion of the "political animal" and
on analytical look at the political personality.
The technique of instruction is one of talks by Operations Officers
experienced in various specific kinds of operation, followed by questions
and discussion. Participants are encouraged and exsected to ask questions
and engage in the discussions, drawing upon and relating their experience
to that under discussion. One of the incortant values to be gained from
the Seminar is this exchange of experience.
ACHIEVEMENT RECORD
This is a certificate of attendance. No further assessment of individual
capacity or performance is made in this course.
FOR THE DIRECTOR OF TRAINING:
2/26/23
Richard A. Fuller
Daze
Chief Instructor
C-O-N-F-1-0-¿-N-T-1-A-L

14-00000
Midcareer Course No. 34
CONFIDENTIAL
TRAINING REPORT
Student
: Bustos-Videla, Charlotte
Date
: 11/5-12/22/72
Year of Birth: 1929
Office
: WH/1
Grade
: 13
Service Designation: D
No. of Students
: 30
COURSE OBJECTIVES
--
CONTENT AND METHODS
The Midcareer Course is designed to enable potential executive
officers to develop and widen their understanding of management
practices, of the Agency and the Intelligence Community, and of the
Government's involvement in international affairs.
The Course consists of three major segments of varying lengths.
The topics covered through lectures, seminars, group discussions
and field trips are:
1.
2.
Effective managerial behavior as derived through study
of the Managerial Grid.
The functions, relationships and problems of various
Agency components and of members of the Intelligence
Community.
3. Selected elements of national power and current develop-
ments in key international affairs.-
ACHIEVEMENT RECORD
No evaluation of the student is made during the Course, and no
final grade is given upon course complation.
FOR THE DIRECTOR OF TRAINING:
22 081972
John C. Morit
Midcarcer Course Chairman
Date
Classified by: 17-1626
EX-2, APDCI.
WSISM
CONFIDENTIAL
14-00000
SECRET
(Bhon Pilled In)
FITNESS REPORT
EMPLOYEE SERIAL NUMBER
007667
SECTION A
GENERAL
(Middle)
8. DATE OF BIRTH
3. De x
4. GRADE
S. SU
12 Jan 29
P
D
(Lost)
(Firet)
Bustos-Videla, Charlotte Z.
6. OFFICIAL POSITION TITLE
Operations Officer
0.5 MBC (A) TYPE OF APPOINTMENT
X CAREER
RESERVE
TEMPORARY
CAREER PROVISIONAL (See Instructions - Section C)
SPECIAL (Specify);
TF, DATE REPORT DUB IN O.P.
SECTION B
Whitishactory
_
thegind
1.2.fcient
ΣStrong
CQuistanding
7. OFF/DIY/BR OF ASSIGNMENT
DDP/WH/1
| 10. CHECK (X) TYPE OF REPORT
INITIAL
✗
ANNUAL
SPECIAL (Specify);
GS-13
8. CURRENT STATION
Mexico City
XX REASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOYEE
18. REPORTING PERI00 (From 100)
1 January
PERFORMANCE EVALUATION
-
31 July 1972
*
Performance is unacceptable. A rating in this category requires immediate and positive remedial action. The nature of the action
could range from counseling, to further training, to plowing sa probation, to reassignment or to separation. Describe action taken
or proposed in Section C
Performance is deficient in some aspects. The reasons for sugning this rating should be stated in Section C and remedial actions
taken or recommended should be described.
Performance is satisfactory. Desired results are being produced in the manner expected. -
Performance is characterized by exceptional proficiency.
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 DUTIES
Lise up to six of the most important spacific duties performed during the rating period. Insert rating letter which best describes the
ee to which employee performs EACH specific duty. Consider ONLY effectiveness in performance of that duty. All employees
Supervisory responsibilities MUST be rated on their ability to supervise (indicate number of employees supervised).
IFIC DUTY NO. I
Prepares operational target studies on PBRUMEN officials and
assists in the planning of operations against those targets.
CUTY MO. I
Screens all agent and technical reports dealing with PBRUMEN
targets for operational and positive information and puts in
retrievable form.
CUTTINO. 1.
Assists Case Officers in preparation of operational reports
by doing all basic research such as tracing and file reviews and
presents the results in exploitable form.
UFOWIC BUTY NO. 4
Prepares draft intelligence reports from raw agent reports,
technical operations and defector debriefings.
RATING
LETTER
RATING
S
RATING
LETTER
0
RAT 17AG
LETTER
RECIPIC DUTY NO. B
GOA/DT&O Project Officer
{1**ZAFY DUTY NO.
anagement of the PBRUMEN section files.
RATING
LETTER
S
RATING
Сергея
S
1200
OVERALL PERFORMANCE IN CURRENT POSITION
Tcount overything about the employee which influances kis affections in his current position such as post
Tomas specific duties, productivity, conduts on jub, scoparianas, pertinent povsonal user habits, and
stations or talents. Based on your nowledge of repinyea's wall perince during the roting parlad,,
puke da letter in the rating boe curresponding to the statement which est accurately refiects his level of parless-anco, į
33:47
CONS
SECRET
1
RATING
LETIRA
OPSPL
S
14-00000
SECTION C
SECRET
(When Filled in)
NARRATIVE COMMENTS
Indicate significant strengths or weaknesses demonstrated in current position keeping in proper perspective, their relationship to
overall performance. State suggestions made for improvement of work performance. Give recommendations for training. Come
on foreign language competence, if required for current position. Amplify or explain ratings given in Section B to provide best
basis for determining future personnel action, Monnes of performance of monogerial or supervisory duties and cost consciousress
in the use of ersonas! space, sxvipment and funds, must be commented on if applicable. If extra space is needed so complete
Section C, attach a separate sheet of paper. In reviewing my previous fitness report and
those of my predecessors, on this fine officer, I find myself hard put
not to repeat what has been said so often before. She has been the back
bone of this section and of those where she has worked previously. Her
work has always shown excellent judgement and ingenuity. A self-starter
with tremendous drive and discipline, the amount of work she has produced
has been prodigious. An excellent team worker, she has never shirked when-
as so often happens she is asked to take on additional work or work on
a matter outside of her regular field. While forceful, she is diplomatic
and tactful and is able to present suggestions and criticisms in a plea-
sant manner. She is one of the most dedicated persons I have met in the
Organization, and exceptionally dependable. While, as a woman and a
Specialist, she has had little opportunity to handle agents she has done
very well with those we have given her to handle. She has showed great
ability in the training of two transcribers and in the debriefing of two
female agents and their husbands. This is in large part due to her in-
-depth knowledge of the targets this section is working on. The past few
months have been difficult, requiring the complete reorganization of this
Section and the termination of the majority of our assets. Under this
stress, she has performed in her usual outstanding manner. Perhaps,
even a little better. Her handling of a great deal of file work has been
excellent, probably in part because she was the one who set it up and has
maintained it in its present very good state.
SECTION D
1.
ОАТЕ
2.
7 Aug 1972
MONTHS EMPLOYEE HAS BEEN
UNDER MY SUPERVISION
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I CERTIFY THAT I HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT
SIGNATURE OF EMPLOYEE
(continued)
/s/ Charlotte Z. Bustos-Videla
BY SUPERVISOR
17 THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
DATE
OFFICIAL TITLE OF SUPERVISOR
7 August 1972
Operations Officer
3.
'BY REVIEWING OFFICIAL
COMMENTS OF REVIEWING OFFICIAL
TYPED OR PRINTED NAME AND SIGNATURE
/s/ John M, Burke
Without any hesitation I concur with the outstanding ratings
above. Subject is now up for rotation and we will miss her
immensely. For years she has dedicated her entire time to her job
which she has done so well. She has been creative, thorough and
accurate. Although she has not had supervisory experience at this
station, she has performed in a manner which clearly reflects that
she would have no problem with supervising. A truly outstanding
employee with growth potential.
DATE
OFFICIAL TITLE OF REIKNING OFFICIAL
7 Aug 1972
DCOS
SECRET
PED OR PAINTED NAME AND SIGNATURE
/s/ George A. Fill
XXXMOSKOR
14-00000
ཚོ
:
A
SECRET
(CONTINUED)
SECTION C
NARRATIVE COMMENTS
The one criticism of this Officer's work that I and others
have made in the past still stands. She tries to do everything
and somethings in this business just don't deserve the attention
she gives them.
I have no personal knowledge of her supervisor abilities,
but believe she is a natural leader.
i
14-00000
SECRET
them Pilled In)
SECTION A
1. NAME
(Last)
FITNESS REPORT
(Firol)
Bustos-Videla, Charlotte Z.
6. OFFICIAL POSITION TITLE
Operations Officer
9. CHECK (X) TYPE OF APPOINTMENT
GENERAL
3. DATE OF IRAN.
12 Jan 29
EMPLOYEE SERIAL NUMBER
007667
3.DEX
4. GRADE
5. SO
GS-13
D
7. OFF/DIY/OR OF ASSIGNMENT 6. CURRENT STATION
DDP/WH/1
10. CHECK (N) TYPE OF REPORT
Mexico City
X
CAREER
RESERVE
TEMPORARY
INITIAL
CAREER PROVISIONAL (See Instructions Section C)
SPECIAL (Specify);
XX
ANNUAL
SPECIAL (Specify)!
REASSIGNMENT SUPERVISORY
READSIONMENT EMPLOYER
11. DATE REPORT DUE IN O.P.
SECTION B
U-Unsatisfactory
M-Marginal
P-Proficient
S-Strong
O-Outstanding
12. REPORTING PERIOD (From 10)
January 1971 December 1971
PERFORMANCE EVALUATION
-
Performance is unacceptable. A rating in this category requires immediate and 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.
Performance is deficient in some aspects. The reasons for assigning this rating should be stated in Section C and remedial actions
tatea or recommended should be described.
Performance is satisfactory. Desired results are being produced in the manner expected,
Performance is characterized by exceptional proficiency.
Performance is so exceptional in relation to requirements of the work and in comporison to the performance of others doing similar
wait as to warrent special recognition..
SPECIFIC DUTIES
List up to six of the most important specific duties performed during the rating period. Insort rating letter which best describes the
monnor in which employee performs EACH specific duty. Considor ONLY affectiveness in performance of that duty. All employees
with supervisory responsibilities MUST be rated on their ability to superviso (indicate number of employees supervised).
SPECIFIC DUTY NO. I
Prepares operational target studies on PBRUMEN officials and
assists in the planning of operations against these targets.
SPECIFIC DUTY 40.3
Screens all raw reports dealing with PBRUMEN targets for
operational and positive intelligence.
SPECIFIC DUTY NOJ
Conducts name checks, filo reviews, prepares finished memos,
cables, and dispatches. Assists Caso Officers in preparation
of operational reports.
SPECIFIC OUTY NO. 4
Prepares draft intelligence reports from raw agent reports,
technical operations and defector debriefings.
SPACIFIC DUIT NO. 5
Handles miscellaneous special projects for the Station: screening
and routing to all sections daily audio take; operational report-
ing and project responsibility for COA/D&TO project.
SPECIFIC DUTT AU. &
RATING
LETTRA
0
RATING
LETTER
S
RATING
LEYTER
0
RATING
LETTER
°
RATING
LETTER
S
NATING
1་་་:་
OVERALL PERFORMANCE IN CURRENT POSITION
Take into accoverything about the employee which infances his effectiveness in his current position such as pr
ferman of active productivity, conduct on pala, cooperativesas, pertinent personal traits or habite, and
prestations of talents. Based on your breast amatorea's overall performance during the rating period,
pine the les the rating des carponding to the which most occuotaly saileste his loval of periermones.
$ 40€
U KPMG
SECRET
maining s
RATING
LUTTER
S
Resend Es OP/SPD/PPN
25
>
14-00000
SECTION C
SECRET
(When Killed In)
NARRATIVE COMMENTS
Indicate significant strengths or weaknesses demonstrated in current position keeping in proper perspective their relationship to
overall performance. State suggestions made for improvement of work performance. Give recommendations for training. Comment
on foreign language competence, if required for current position. Amplify or explain ratings given in Section B to provide best
basis for determining future personnel action. Monner of performance of managerial or supervisory duties and cost conscious
in the vagal personnel spoce equipment and funds, must be coiffer il opplicable. If extra space is needed to complete
Section C, attach a separate sheet of 
paper.
8 55 M
She
This supervisor has Worked with a variety of Intelligence
Assistants. Many were good, but none compared with this Subject.
She is the most thorough and fastest working IA I have met. Her
capacity for hard work and long hours is prodigious. Her knowledge
of operational matters is equal to that of most case officers.
has an operationally creative mind and has made many excellent.
suggestions for the improvement of the section's work. Additionally,
her command of the Spanish language enhances all of the above abilities
This officer has found hor very pleasant to work with. She has a
unique ability to make constructive criticism in a tactful manner.
If this Subject has a weakness, it was pointed out by the reviewing
officer in the last fitness report when he said, "in her voracious
appetite for all kinds of facts (she) can at timos put undue emphasis
on them, including factual minutiae as against equally important but
more elusive subjective factors.
Because of her outstanding performanco and abilities the Subject
will be given some activity handling agent porsonnel, during the
forthcoming year.
The
Subject's continued fine performance since her last promotion
merits special consideration by the Promotion Board.
SECTION D
1.
CERTIFICATION AND COMMENTS
BY EMPLOYEE
MATE
2.
1 CERTIFY THAT I HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT
IGNATURE OF EMPLOYER
9 December 1971
-AONTHS EMPLOYEE HAS BEEN
UNDER MY SUPERVISION
/s/ Charlotte Z. Bustos-Videla
BY SUPERVISOR
IP THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEK, GIVE EXPLANATION
DATE
9 December 1971
OFFICIAL TITLE OF SUPERVISOR
Ops Officer.
3.
COMMENTS OF REVIEWING OFFICIAL
DATE
BY REVIEWING OFFICIAL
TYPED OR PRINTED NAME AND SIGNATURE
/s/ John M. Burke
She
I concur with the above ratings and comments. Subject performs all
the tasks outlined above in a very professional and methodical manner.
One does not even sense that the work is going on until the finished
product is produced. It is always excellent. Wo count heavily on her
thoughts and ideas in all operational studies and considerations.
is ops oriented and has an excellent bank of information to call on
when necessary. She is pleasant and has the respect of her co-workers
as well as her supervisors. Her abilities are varied and she can be
counted on to perform extremely well regardless of assignment or target
We will be losing this fine officer soon and we will be hard put to
find someone who will be able to replace her.
9 December 1971
OFFICIAL TITLE OF REVIEWING OFFICIAL TYPED OR PRINTED NAME AND SIGNATURE
Deputy Chief of Station /s/ George A. Fill
SECRET
14-00000
SECRET
(When Tilled In)
EMPLOYEE SERIAL NUMBER
007667
GENERAL
(Middle)
2. DATE OF BIRTH 3. SEX
12 Jan.29
4. GRADE
8. SD
GS-13
D
SECTION A
1. NAME
FITNESS REPORT
"BUSTOS-VIDA, CHARLOTTE Z.
6. OFFICIAL POSITION TITLE
Operations Officer
9. CHECK (X) TYPE OF APPOINTMENT
7. OPP OF ASSIGNMENT S. CURRENT STATION
. Mexico City
DDP/W/Br 1
10. CHECK (X) TYPE OF REPORT
X
CAREER
RESERVE
TEMPORARY
CARESA PROVISIONAL (B00 Instructions Section C)
SPECIAL (Specify)!
11. DATE REPORT DUE IN O.P.
SECTION B
U-Unsatisfactory
1
M-Marginal
P-Proficient
-Strong
O-Outstanding
INITIAL
✗X ANNUAL
SPECIAL (Specify):
12. REPORTING PERIOD (From fox)
REASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOYEE
1 January 31 December 1970
PERFORMANCE EVALUATION
Performance is unosceptable. A rating in this category requires immediate and positive remedial action. The nature of the action
could range from counseling, to further training, to placing on probation, to reosugnment or to separation. Describe action taken
or proposed in Section C
Performance is deficient in some aspects. The reasons for assigning this rating should be stated in Section C and remedial actions
taken or recommended should be described.
Performance.is satisfactory. Desired results are being produced in the manner expected.
Performance is characterized by exceptional proficiency.
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 DUTIES
List 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 ACH specific duty. Consider ONLY effectiveness in performance of that duty. All employees
with supervisory responsibilities MUST be rated on their ability to superviso (indicate number of employees supervised).
SPECIFIC DUTY NO. 1 Preparos operational target studies on PBRUMEN
officials of interest and helps in the preparation of operational
planning re target porsonnel.
SPECIFIC DUTY HO Z
154)
Screens the raw reports from technical operations and agents for
operationally useful information.
SPECIFIC DUTY NO. 3
Provides operational and administrativo support for
station PBRUMEN activities. This includes name checks, file
reviews, preparation of memos, cables and dispatchos, and helps in
the preparation of project reports, outlines, and renewals.
Supervises the handling of the station PBRUMEN watch-
list and in general monitors travel of interest to and from PBRUMEN
for our station, Headquarters and other stations.
SPECIFIC OUTY NO. 4
SPECIFIC OUTY NO. 5
RATING
LATTER
0
MATING
LETTER
RATING
LETTER
0
RATING
LETTER
S
RATING
Helps the station intelligence chief in the preparation LETTER
of finished intelligence reports from a PBRUMEN refugee debriefing
center (only part of the reporting period).
S
SPECIFIC DUTY NO. 6
RATING
S
Handles miscellaneous special projects for the station LETTER
in addition to her PBRUMEN duties (examples: organization of
station watchlists during a presidential visit, screening certain
raw reports for whole station, preparation of DOA/DTO project renewal).
OVERALL PERFORMANCE IN CURRENT POSITION ཨགས་ཥས་རིས་
431
Take into accourt everything about the employed which Influences his affectiveness in his current position such as par
formance of specific duties, productivity, conduct on job, cooperativeness, pertinent personal traits of hybits, 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.
RATING
LETTER
#112
45
0030687S PARVIO. #317109
7 #3
SECRET
14-00000
SECTION C
SECRET
(When Filled.In)
NARRATIVE COMMENTS
Indicate significant strengths or wooknesses demonstrated in current position keeping in proper perspective their relationship to
overall performance. State suggestions made for improvement of work performance. Give recommendations for training. Commmeni
on foreign language competence, if required for sunt position. Amplify or explain ratings given in Section B to provide best
basis for determining future personnel action. Monner of performance of managerial or supervisory duties and cost consciousness
in the use of personnel, space, equipment and funds, must be commented on if applicable. If extra space is needed to complate
Section C, attach a separate sheet of paper.
Sho
Subject workod most of my
the station PBRUMEN section.
was clearly outstanding in collating information from all sources
during a recent intensified "PBRUMEN" month, determining as a result
the overall pattern of the PBRUMEN mission here, spotting operational
leads and updating target studies on all PBRUMEN officials as a result.
Her final writeup regarding both new information obtained and the gaps
that remain was thorough and useful.
Subject is extraordinarily rapid and efficient in researching for
info, organizing files and other material and writing up any kind of
resulting memo or dispatch. The same might be said perhaps of some
other real pros in the IA field. However, in addition, Subject has a
good, tough, operations-oriented mind and positively contributes ideas ·
and suggestions re new oporational techniques which the station has
used profitably. Subject has natural managerial abilities as recently
demonstrated in her organizing TDY help in a station-wide file and
watchlist offort in connection with a presidential visit. Her Spanish
is more than adequate for reading reports, and handling operational
messages in that language. In sum, Subject is a tremendous station
asset and would be extremely hard to replace without noting a serious
loss in station officiency.
-continued
SECTION D
1.
LATE
5 March 1971
2.
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I CERTIFY THAT I HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT
SIGNATURE OF THE LORE
// Charlotte ?. Dustos-Videla
BY SUPERVISOR
MONTHS EMPLOYER HAS BEEN
UNDER MY SUPERVISION
IP. THIS HEPGAY HAS NOT DEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
UATE
5 March 1971
3.
COMMENTS OF REVIEWING OFFICIAL
OFFICIAL TITLE OF SUPERVISOR
Operations Officer
BY REVIEWING OFFICIAL
TYPED OR PRINTED NAME AND SIGNATURE
/s/ John Isaminger
Although in my opinion there is an excessive use of "outstanding"
by the rating officer, I am in accord with his narrative comments.
Subject is definitely more than an IA and has performed as such when
the station has required an individual with in-depth knowledge of
station procedures, operational awareness combined with an ability to
prepare studies in a short period of timo. She's thorough, conciso
and rapid. One of our hardest workers and most dependable employees.
DATE
25 March 1971
OFFICIAL TITLE OF REVIEWING OFFICIAL
| Deputy Chief of Station
TYPED OR PRINTED NAME AND SIGNATURE
/s/ George A. Fill
SECRET
14-00000
1
SECTION C
NARRATIVE COMMENTS
-continued
Three rather personalized comments might add meaning
to this fitness report. Anyone, particularly a female,
fitting the above description of efficiency and achievement
can be, and often is a little overbearing and difficult to
work with as a person. Subject, withall, is a pleasant
personality who knows how to make her contributions and
comments in a forthright but tactful manner. Secondly, and
this one is a little hard to say, Subject in her voracious
appetite for all kinds of facts can at times put undue
emphasis on them including factual minutiae as against
equally important but more elusive subjective factors.
Thirdly, this rating officer has personally observed Subject
only working on station premises at an office job, and
frankly has no idea how she might function in outside
operational work (cultivating poople, working under outside
cover).
4
Reward by CP FPD/7PB
14-00000
CERET/RYCAT
MEMORANDUM FOR THE RECORD
SUBJECT: Overall Outstanding Rating on
Mothod of Recognition
CHARLOTTE BUSTOS VIDELA
1. This memo is being written in accordance with
paragraph three of Book Dispatch 5273 of 12 April 1966.
2.
was last granted a Quality Step Increase
about a year ago in recognition of her very fine performanco..
It is a little early to repeat that kind of recognition even
though it is a most logical and meaningful means to show
recognition of her outstanding work.
3. Consideration should be given to an appropriato
occasion in the fairly near future to grant another
QSI to
DESPIET/RIDAT
Rustears by OPSPD/PP3

14-00000
SECTION A
1. NAME
(Lost)
BustoeVidela
6. OFFICIAL POSITION TITLE
Ops Officer
9. CHECK (X) TYPE OF APPOINTMENT
SECRET
(When Pilled in)
FITNESS REPORT
EMPLOYEE SERIAL NUMBER
007667
GENERAL
(Pirat)
(Michlio)
2. DATE OF BIRTH
Charlotte Z
12 Jan 29
3. SEX
F
4. GRADE
B. 50
GS-13
D
7. OFF/DIV/BR OF ASSIGNMENT 8. CURRENT STATION
DDP/WH/Branch 1
10. CHECK (X) TYPE OF REPORT
Mexico City
CAREER
RESERVE
TEMPORARY
INITIAL
CAREER PROVISIONAL (See metructione Section C)
SPECIAL (Specify):
xx
ANNUAL
REASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOYEE
SPECIAL (Specify);
II. DATE REPORT DUE IN O.P.
12. REPORTING PERIOD (Frum
for)
1 August 1939
-
31 December 1969
SECTION B
28 February 1970
W - Week
A - Adequate
P. Proficient
S-Strong
Outstanding
PERFORMANCE EVALUATION
Performance ranges from wholly inadequate to slightly less than satisfactory. A rating in this category requires
positive ramedial 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.
Performance meets all requirements. It is entirely satisfactory and is characterized neither by deficiency nor
excellence.
Performance is more than satisfactory. Desired results are being produced in a proficient manner.
Performance is characterized by exceptional proficiency,
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 DUTIES
List up to six of the most important specific dution porformed during the rating period. Insert rating letter which best describes the
monnor 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. 1
Completo reorganization of Station files, including
development of new procedures, revision of file categories,.
consolidation, purging and destruction.
DUTY NO 2
.
Provides overall guidance to Station and TDY personnel
engaged in reorganization of Station files. Supervision of
Secretary-Receptionist..
SPECIFIC DUTY NO.3
Special assistance to COS/DCO's an revamping the paper flow
within the Station and between the Station and other Government
agencies.
SPECIFIC DUTY NO. 4
Preparation of special studies for the COS/DCOS concerning the
effectiveness of Station paper handling procedures, personnel
economies related thereto and the improvement of Station
SPECIFIC DUTY NO. S utilization of minpower, space and funds as a result
of the reorganization of Station Registry functions
and personnel.
LAA
RATING
LETTER
0
NATING
S
RATING
LETTKA
S
RATING
LETTER
RATING
LETTER
S
SPECIFIC DUTY NO. 6
RATING
LETTER
OVERALL PERFORMANCE IN CURRENT POSITION
Take into account everything about the employoo which influences his effectiveness in his current position such as per-
formance of specific duties, productivity, conduct on job, cooperativeness, pertinent personal traits or habits, and
particular limitations of talents.sed on your knowledge of ompinyon's overall performance during the rating period,
place the latter in the rating bos corresponding to the statement which most accurately reflects his lovol of performance.
RATING
LETTER
S
3024
4-40
45 USE PREVIOUS EDITIONS
SECRET
timing was
14-00000
SECTION C
SECRET
(When Filled In)
NARRATIVE COMMENTS
Indicate significant strengths or weaknesses demonstrated in current position keeping in proper perspective their relationship to
overall performance. Stare suggestions made for improvement of work performance. Give recommendations for training. Comment
on foreign language competence, if required for current position. Amplify or explain ratings given in Section 8 to provide best
basis for determining future personnel action. Manner of performance of managerial or supervisory duties and cost consciousness
in the use of personnel space, equipment and funds, must be commented on, if applicable. If extra space is needed to complete
Section C, attach a separate sheet of poper.
In July 1969 Subject was transferred from the Cube Section to the
Station front office to serve as an executive assistant to the COS with
special responsibility for ensuring that the paper flow of the Station
remained under effective control during the period of transition re-
sulting from the assignment here of several senior officers. This
transition period necessitated or gave rise to a number of changes in
the management and administrative areas of the Station. Subject's
performance in this assignment under these circumstances was clearly
outstanding. Her sound judgement, imagination and responsiveness to
guidance not only contributed to maintaining the stability and momentum
of the Station but also made possible an early effort to come to grips
with many of the problems which an inflated Registry and a highly dis-
tinctive records system created for the new Station management tean.
. During the ensuing six month period, Subject has recommended and
implemented a number of changes which have produced a more effective
and less costly records system. Paper holdings have been reduced sub-
stantially, input has been reduced and now conforms to basic CS pro-
cedures and requirements. Personnel savings have been effected and
supervisory responsibilities more clearly delineated.
To sum up, Subject has made and continues to make a major contribu-
tion in a singularly unsensational area of Station activity. Her advice
is sought and appreciated not only by the COS and myself, but by other
(CONTINUED)
SECTION D
1.'
DATE
2.
15 January 1970
MONTHS EMPLOYER HAS DUEN
UNDER MY SUPERVISION
6 months
CERTIFICATION AND COMMENTS
BY EMPLOYEE
1 CERTIFY THAT I HAVE SEEN SECTIONS A, P. AND C OF THIS REPORT
SIGNATURE OF EMPLOYEŁ
/s/ Charlotte Bustos-Videla
BY-SUPERVISOR
IN THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
DATE
3.
15 January 1970
OFFICIAL TITLE OF SUPERVISOR
.
DOOS
BY REVIEWING OFFICIAL
TYPED OR PRINTED NAME AND SIGNATURE
/s/ Paul V. Harwood
COMMENTS OF REVIEWING OFFICIAL
It would be difficult to overstate the contri-
bution made by Subject to this Station during the past six month
period, and I concur fully in the ratings and comments of the Rating
Officer. I might add that Subject is one of the more versatile,
conscientious and productive employees with whom I have worked in
this organization, and that in aditition to the administrative/
management role outlined above, continued to provide valuable
operational/analytical assistance to the Cuban and other operational
sections of the Station. The initiative and imagination shown by
Subject in the very complicated administrative management assign-
ment have been particularly commendable and her complete familiarity
with the country, the language, and the background of the Station
has been invaluable during this period of change.
15 January 1970
CATE
COS
PRINTED NAME AND SIGNATURE
/s/ James B. Noland
SECRET
}
14-00000
SECTION C
SECRET/RYBAT
2
-
NARRATIVE COMMENTS
CONTINUED
personnel who appreciate her personal and professional qualities.
Subject is aware that her current assignment is an unusual one and
that she soon may have worked herself out of her current job. Since
she speaks fluent Spanish, has a unique ability to get along with
people and to get things done, there will be no problem in assigning
her back into a position more closely supporting operations.
operations are certain to benefit thereby.
Our
SECRET/RYBAT
14-00000
GECTION A.
1.NAME
(Last)
(When Filted 8-)
FI? SS REPORT
(Firal)
(Middle)
GENERAL
BUSTOSVIDELA, Charlotte Z.
6. OFFICIAL POSITION TITLE
Ops Officer
D. CHECK (X) TYPE OF APPOINTMENT
☑
CAREER
RESERVE
TEMPORARY
CAREER PROVISIONAL (See instructions Section C)
SPECIAL (Specify):
11. DATE REPORT DUE IN O.P.
October 1969
SECTION B
W-Week
A - Adequate
P-Proficient
S - Strong
2. DATE OF BIRTH
12 Jan 29
EMPLOYEE SERIAL NUMBER
007667
3. SEX
4. GRADE
3. SD
F
13
D
7. OPF/DIVOR OF ASSIGNMENT B. CURRENT STATION
DDP/WH/FF/1
10. CHECK (X) TYPE OF REPORT
INITIAL
ANNUAL
SPECIAL (Specify):
12. REPORTING PERIOD (From- to-)
Mexico City
REASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOYEĽ
March to August 1969.
PERFORMANCE EVALUATION
Performance ranges from wholly inadequate to slightly less than satisfactory. A rating in this category requiros
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 token or proposed in Section C.
Performance meets all requirements. It is entirely satisfactory and is characterized neither by deficiency nor
excellence.
Performance is more than satisfactory. Desired results are being produced in a proficient manner.
Performance is characterized by exceptional proficiency.
0 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 DUTIES
RATING
LETTER
List up to six of the most important specific duties performed during the rating period. Insort 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. 1
Until she was called to other duties in the front
office of the Station, did analysis on FORUMEN targets of Station
interest, collated information and prepared studies.
(0040,
3PECIFIC OUTY NO. 1
MATING
0
Screened the red product oral schaded op ruti. MILITER
and processed intelligence and operational information in close
cooperation with two full time senior outside transcribers whom
She banned completelye
Handled the Station : BRUMEN watchlist and travel
program, and reported travel information to 10FIRM Stations and
other customers.
SPECIFIC OUTY NO. 3
SPECIFIC DUTY NO. 4
RATING
LETTER
S
RATING
Provided operational support (file checks, operational LETTER
reviews, liaison memoranda, etc.) for various Station activities.
SPECIFIC DUTY NO. Contributed to the reparation of monthly summaries
and project reporting (outlines, renewals, etc.)
SPECIFIC DUTY NO. 5 Wanted special projects for the Station in audition
to her TEREN nuties.
S
RATING
LETTER
RATING
LETTER
OVERALL PERFORMANCE IN CURRENT POSITION
Take into account everything about the employee which influences his effectiveness in his current position such as per-
formance of specific duties, productivity, conduct on job, oporativeness, pertinent personal traits of hate and
particular limitations of talents. Based you know'sdzu ple's overall performance during the rating period.
place the latter in the rating box corresponding to.nor.. Siew most accurately reflects his level of performance.
FORM
4-45
45 USE PREVIOUS EDITIONS
SECRET
RATING
LETTER
0
"
14-00000
SECTION C
SECRET
(Then Filled in)
NARRATIVE COMMENTS
Indicate significant strengths or weaknesses demonstrated in current position keeping in proper perspective their relationship to
overall performence. Site sugions made for improvement of work performance. Give recommendations for training. Comment
on foreign language com frequired : current position. Amplify or explain ratings given in Section B to provide best
basis for determining fu, personnel action. Maine of performance of monagerial or supervisory duties and cost consciousness
in the use of personnel, space, equipment and lunts, must be commented on if applicable. Iextro space is needed to complete
Section C attach a separate sheet of paper.
Subject's performance continued during the period under review
to deserve high praise. Her enormous appetite for work, her
attention to detail, her ability to absorb and digest enormous files.
and complicated cases, her professionalism and devotion to the duties
entrusted to her really deserve the rating of outstanding. Subject
speaks good Spanish, has considerable initiative, much experience
in analytic work and a genuine talent for administrative work.
In view of her past performance, her record at the Station and
her potential, Subject who was recommended for promotion to the GS-14
level should be promoted as soon as possible.
SECTION D
1.
CATE
1 August 1969
2,
MONTHS SI
UNDER MY SUPERVISION
EMPLOYEE HAS BEEN
CATE
1 August 1969
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I CERTIFY THAT I HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT
SIGNATURE OF EMPLOYER
Charlotte Z. Bustosvidela (signed)
BY SUPERVISOR
IP THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
COMMENTS OF REVIEWING OFFICIAL
OFFICIAL TITLE OF IL PERVISOR
Ops. Officer
BY REVIEWING OFFICIAL
TYPED OR PRINTED NAME AND SIGNATURE
Francis Sherry (signed)
Subject is indeed an exceptional officer who is highly deserving
of the foregoing ratings and related accolades. In her new role as
executive assistant to the CUS she has been invaluable during the
difficult and complicated transition from the old regime to the new,
and the related reorganization of the Station. Her organizational
abilities are unsurpassed by anyone known to the undersigned, and
she certainly merits consideration for early promotion.
DATE
1 August 1969
OFFICIAL TITLE OF ING OFFICIAL TYPED OR PRINTED MAKE AND SIGNATURE
Chief of Station
James B. Noland
SECRET
:
14-00000
i
SECTION A
1. NAME
(Look!
SECRET
(When Filled (n)
FITNESS REPORT
Reviewed by 8P/PD/EAB
EMPLOYER SERIAL NUMBER
007667
(Free)
Bustos-Videla,
6. OFFICIAL POSITION TITLE
Ops Officer
9. CHECK (X) TYPE OF APPOINTMENT
XX
GENERAL
(Middle)
2. DATE OF BIRTH 3. 5FX
4. ORADE
8. 30
Charlotte
12 Jan 1929 F
GS-13
D
1. OFF OV/BR OF ASSIGNMENT 6. CURRENT STATION
DDP/WH/1
10. CHECK (X) TYPE OF REPORT
Mexico City
CARFER
TRESERVE
TEMPORARY
INITIAL
CAREER-PROVISIONAL (Sue instructione - Section C)
SPECIAL (Species
xx
ANNUAL
SPECIAL (Specify);
11. DATE REPORT DUE IN O.P.
SECTION B
W-Wesk
A - Adequate
P-Proficient
S-Strong
12. REPORTING PERIOD (From f00)
January 1968
PERFORMANCE EVALUATION
MEASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOYEE
March 1969
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.
Performance meets all requirements. It is entirely satisfactory and is characterised neither by deficiency nor
excellence.
Performance is more than satisfactory. Desired results are being produced in a proficient manner.
Performance is characterized by exceptional proficiency..
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 DUTIES
List up to six of the most important specific duties performed during the rating period. Insert rating latter 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 superviso (indicate number of employees supervised).
SPECIFIC DUTY NO. 1
Handles Station PBRUMEN watchlist and travol program and reports
travel information to WOFIRM stations and other custumers
SPECIFIC OUTY NO. 2 Screens the raw product of several technical opera-
tions and processes intelligence and operational information in
close cooperation with two full time senior transcribers whom she
chandles completely
SPECIFIC DUTY NO. 3
Does analysis on targets of Station Interest, collates
information and prepares studios
SPECIFIC OUTY NO. 4
HATING
LETTER
S
RATING
LETTER
0
RATING
LETTER
RATING
Contributes to the preparation of monthly summaries and project
reporting (outlines, renewals, etc.)
LETTER
SPECIFIC OUTY NO. 3
Provides operational support (file, checks, operational reviews,
liaison memoranda, etc. for various Station activities
SPECIFIC DUIT NO. 6
RATING
LETTER
S
RATING
LETTER
OVERALL PERFORMANCE IN CURRENT POSITION
Take into account everything about the smoloves which influencos his affectiveness in his current position such as pars
formance of spacific advenivity, conduct on job, comparativeness, partiment personal traits of habits, and
particular limitations or talams. Boxed on your kovalarige of employee's overall performance during the rating period.
place the latter in the rating box corcə spoming to the statawent which most accurately milacts his lovel of performance.
RATING
LETTER
0
FOR 45E PREVIOUS 23478343
0.03
SECRET
_..
14-00000
SECTION C
SECRET
(Wham Filled. In)
NARRATIVE COMMENTS ..
I m
Indicato significant strengths or weaknesses demonstrated in current position keeping in proper perspective their relationship to
overall performance. State suggestions made for improvement of work performance. Give recommendations for training. Comment
on foreign language competence, if required for current position. Amplify or explain ratings given in Section 8 to provide best
bols for determining future personnel action. Monnere performance of monofil or supervisory duties and cost consciousness
in the use of personnel soose, eqviamool and funds, must be commented on, it applicable. papaying
pay 
is needed to complete
Section C attach a separate sheet of paper.
Subject's performance during the period of over one year under
review continued to deserve the rating of Outstanding. Her major
contributions during that period were in the fields of operational
research and exploitation of information obtained through technical
means. She was, during this period, given full responsibility for
the handling of two full time senior transcribers including adminis-
trative matters. In view of the difficulty of recruiting target
personnel the task of fully exploiting information obtained from
technical sources is of great importance. Subject handled this task
with her usual enormous capability for work, displaying initiative
and great professionalism. She continued, in addition, to handle the
other tasks listed in this report together with sensative reporting
sent by a separate channel, altogether a much heavier workload than
is usually carried by one person. She was helped in this by her
good knowledge of Spanish, a talent for administrative work, con-
siderable analytic experience and great devotion to her work.
Subject should be considered for promotion to the grade of GS-14 at
the first opportune moment.
SECTION D
1.
DATE
3 April 69
2.
MONTHS EMPLOYEE HAS M
UNDER MY SUPERVISION
CERTIFICATION AND COMMENTS
BY EMPLOYEE
ECEPTIFY THAT I HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT
SIGNATURE OF EMPLOYER
Charlotte Bustos-Videla /s/
BY SUPERVISOR
IF THIS APPORT HAS NOT SEEN SHOWN TO EMPLOYER, GIVE EXPLANATION
19 months
DATE
3.
3 April 62
OFFICIAL TITLE OF SUPERVISOR
Ops Officer.
BY REVIEWING OFFICIAL
TYPED OR PRINTED NAME AND SIGNATURE
Francis Sherry /s/
COMMENTS OF REVENING OFFICIAL
The reviewing officer fully agrees with the ratings and comments
of the rating officer. Subject consistently performs her duties in
an outstanding manner, bringing to her job truly exceptional
qualities of intelligence, reliability, and good humor. She is one
of the most valuable employees in the Station, and the recommendation
for her promotion from GS-13 to GS-14 is fully and enthusiastically
endorsed.
DATE
OFFICIAL TITLE DING OFFICIAL
TIPED OR PRINTED NA AND SIGNATURE
3 April 69
cos,
Winston Scott
/8/
SECRET
17
14-00000
:
S-E-C-R-E-T
TRAINING REPORT
Soviet Bloc Operations Course No,
80 hours, full time
1
516 June 1967
Student
○: BUSTOS-VIDELA, Charlotte
Office
: DDP/WH
Year of Birth: 1929
Service Designation: D
No. of Students
: 34
Grade
: GS-13
EOD Date
August, 1951
COURSE OBJECTIVES
To orient the student on the special nature of the Clandestine Services'
Soviet Bloc target and to train him in the application of clandestine methods
for collecting information on, assessing, and preparing recruitment opera-
tions against Soviet Bloc personalities.
ACHIEVEMENT RECORD
This is a certificate of attendance. No evaluation is made of individual
performance in the course,
FOR THE DIRECTOR OF TRAINING:
Sucks
Rusdell A. Lugelle
Instructor, OTR
S-E-C-R-E-T
Date
YOTES
14-00000
SECTION A
1. NAME
(Loo!)
SECRET
{hen Fillet (a)
FITNESS REPORT
(Ftrat)
EMPLOYEE SERIAL NUMBER
007667
GENERAL
(Midia)
2. DATE OF BIRTH
a. SEX
4. GRAD
9. DO
12 Jan 1929
F
GS-13
D
Bustos-Videla, Charlotte
6. OFFICIAL POSITION TITLE
Ops Officer·
B. CHECK (X) TYPE OF APPOINTMENT
X
7. OPPIDAVOR OF ASSIGNMENT 6. CURRENT STATION
DDP/WH/1
10. CHECK (4) TYPE OF REPORT
Mexico City
CANEAN
RESERVE
TEMPORARY
INITIAL
CAREER PROVISIONAL (Bee Instructions Section C
SPECIAL (Speally)!
XXX
REASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOYER
11. QATE REPORT QUE IN O.P.
29 February 1938
SECTION B
W. Weck
A. Adequatà
P.Proficient
S.Strong
SPECIAL (Specify)!
12. REPORTING PERIOD (From- to-)
August 1967 through January 1968
PERFORMANCE EVALUATION
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 roken or proposed in Section C.
Performance meets all requirements. It is entirely satisfactory and is charactorized neither by deficiency nor
excellence.
Performance is more than satisfactory. Desired results are being produced in a proficient manner,
Performance is characterised 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 DUTIES
List up to six of the most important specific duties performed during the rating period. Insort 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 suporvisa (indicate number of employees supervised),
SPECIFIC DUTY NO. I
Handles Station PBRUMEN program (maintains a watchlist, screens
travel documents and reports travel information to WOFIRM stations
and other interested customers).
SPECIFIC OUTY NO. 2
Screens the raw product of technical operations and processes the
intelligence band operational information,
RATING
LETTER
S
BATING
LETTER.
SPECIFIC OUT Y NO. 3
417
RATING
LETTER
Does analysis on targets of Station interest, pulling documents
together, collating information and preparing studios.
"werps with the preparation of monthly summaries and project
reporting (
outlines, renewals etc.).
MASING
LETTER
SPECIFIC DUTY NO. 5
Provides operational support (file checks, operational reviews,
liaison memoranda etc.) 
for various Station activities.
SPECIFIC DUTY NO. 4
NATING
LETTER
S
RATING
LETTUM
OVERALL PERFORMANCE IN CURRENT POSITION
Take into account everything about the employed which interes his effectiveness in his current position such as per-
formance of specific duties, productivity, conduct on ab. Deprava, partiment 
personal traits of habits, and
particular limitations 
of solenta. Based on your knowlage of employes's 
sell performance during the rating period,
place the lerar in the rating box corresponding to the statement which 
may reflects his lovel of portomance.
Reviewed by P
03M 45, DITIO
8-49
SECRET
RATING
LETTER
14-00000
WOR
SECTION C
SECRET
(When Filled 80)
NARRATIVE COMMENTS
Indicate significant strengths or weaknesses demonstrated in current position keeping in proper perspective their rotationship to
overall performance. State suggestions modo for improvement 
of work performance. Give recommandations for training. Comment
on foreign language competence, if required for current position. Amplify 
or explain rotings oivan in Section B to provide best
basis for determining future personnal action. Manner of performance of mopprettel or fly fisies and cost consciousness
in the use of personnel space, seulemens and 
finds, must be commented on applicable. If extra space is needed to complete
Section C, attach a separate sheet of paper.
Since her arrival at this Station, Subject's performance has truly been
outstanding. She has, on her own initiative
, reorganized many of the
She has made
operational files and procedures of the PBRUMEN 
Section.
particularly useful exhaustive analyses of 
the documents 
concerning a
number of Station targets not only per request 
of this Station but 
also
She has revamped 
the Section's travel program,
on her own initiative.
curtailing the watchlist to more manageable size and expediting the
reporting of travel information to the many 
customers for such 
informa-
tion. Her thorough review of the take of 
several tochnical operations
has increased their usefulness as well as emphasized 
their weaknesses.
,
Subject BATOV, “ALP
talant for administra-
tion, her initiative, sharp analytic mind and good knowledge of Spanish
have greatly facilitated the oporation of the PBRUMEN Section of this
Station at a time of almost complete personnel change. She has not boon
directly involved with the actual running of operations both because
she appears much better suited for the support typo work intrusted to
her and because she frankly would not have the time under present
circumstances to do so. Subject is carrying the workload usually
handled by more than one person.
SECTION D
1.
DATE
2.
16 Jan. 1968
MONTHS EMPLOYER HAS BEEN
UNDER MY SUPERVISION
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I CERTIFY THAT I HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT
SIGNATURE OF EMPLOYER
/s/ Charlotte Bustos-Vidola
BY SUPERVISOR
IF THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYER. GIVE EXPLANATION
5 months
DATE
OFFICIAL TITLE OF SUPERVISOR
16 Jan. 1968
Ops Officer
3.
BY REVIEWING OFFICIAL
COMMENTS OF REVIEWING OFFICIAL
TYPED UN PRINTED HAMK AND SIGNATURE
Francis Sherry
The Reviewing Officer fully concurs in the evaluation of Subject by
the Rating Officer. Subject consistently turns in a superior
performance, whatever her task, and for a Station Chief the only
problem she presents is to determine where best to assign her.
Is a source of strength to her Section, has the knack of making
herself irreplaceable.
She
DATE
OFFICIAL TITLE UREVIEWING OFFICIAL
TYPU UR PAINTED NAME AND SIGNATURE
17 January 1968
Chief of Station
Winston D. Miller
SECRET

14-00000
SECTION A
1. NAME
(Lost)
SECRET.
(then Filled in)
FITNESS REPORT
(Firet)
Bustosvidela, C.Z.
6. OFFICIAL POSITION TITLE
Ops Officer
9. CHECK (X) TYPE OF APPOINTMENT
EMPLOYEE SERIAL NUMBER
007667
GENERAL
(Michio)
2. DATE OF BIRTH
3. SEX
Jan 1929
F
4. GRADE
GS-13
a. 80
D
7. OFF/DIV/OR OF ASSIGNMENT 8. CURRENT STATION
DDP/WH/1
10. CHECK (X) TYPE OF REPORT
HQS
✓ CAREER
RESBAVE
TEMPORARY
CAREER PROVISIONAL (500 mainitions Section C)
SPECIAL (Specify)!
11. DATE REPORT OUE IN O.P.
31 Jan 67
[SECTION B
W. Week
A - Adequate
P-Proficient
S. Strong
INITIAL
X ANNUAL
SPECIAL (Specify):
12. REPORTING PERIOD (From- to-)
1/66
-
PERFORMANCE EVALUATION
12/66
REASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOYER
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 roassignment or to separation. Describe action taken or proposed in Section C.
Performance meats all requirements. It is entirely satisfactory and is characterized noither by deficiency nor
excellence.
Performance is more than satisfactory. Desired results are being produced in a proficient manner.
Performance is characterized by exceptional proficiency.
0 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 DUTIES
List up to six of the most important specific duties performed during the rating period. Insert rating latter which bost describes the
manner in which employee performs EACH specific duty. Consider ONLY offectiveness 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. 1
Handles all aspects of 22 FI/CE/Support projects
including project actions, logistical and financial support,
requiremonts, guidance and review.
SPECIFIC DUTY NO. 2
Handles all matters concerning the agents belonging
to these projects including field agents, Contract, Career, and
Staff Agents. This includes OA/CSA's, contracts, training, travel,
cover and funding. _
SPECIFIC LUTY NO. 3
Prepares, or helps prepare, miscellaneous memoranda
and studies, such as monthly FI achievements, operational program,
budget exercises, responsos to requests on operations or
background info regarding, 
Mexico
.
SPECIFIC DUTY NO. 4
Routes correspondence, supervises tickler system,
maintains project, agent, and subject 201 files.
RATING
LETTER
RATING
LETTER
0
RATING
LETTER
0
RATING
LETTER
S
(SPECIFIC DUTY HO. I
Branch records officer.
SPECIFIC DUTY 40. A
POMAR 1967
OVERALL PERFORMANCE IN CURRENT POSITION
45
Taka into nezount everything about the employoy which Influencas his allactiveness in bi's current position such as per-
formance of specific duties, productivity, conduct on jab, cooperativeness, pertinent personal is or habits, and
particular limitations of talents. Based on your knee of employee's overall performance during the rating period
piece the latter in the roting bea corresponding to the statemon) which most necurately reflects his level of performance.!
+21
FORM 45
08401574 STIONS,
SECRET
and
RATING
LETTER
S
RATING
LETTER
RAYING
LETTEN
1
S
14-00000
ON OF PERSONALL
SECTION C
SECRET
(When Fitted in)
NARRATIVE COMMENTS FEB 16 10:33 AM 267
Indicate significant strengths of weaknesses demonstrated in current position keeping in proper per pocive male relationship to
overall performance. State suggestions made for improvement of work performance. Give recommendations for training, Comment
on foreign language competence, if required for current position. Amplify or explain ratings given in Section B to provide best
bosis for determining future personnal action, Manner of performance of managerial or supPAY 19 jos must be described, if
applicable.
Subject has continued to perform during the period under
review in the same highly competent manner which all who know
her have come to expect of her. She continues to put forth her
best efforts at all times. . She is particularly to be commended
for the manner in which she cheerfully accepts onerous tasks,
usually with very short doadlines, and invariably comes up with
a thoroughly prepared answer within the time allotted. She is
efficient, she is fully knowledgeable and capable in her job, she
has a friendly, warm, and pleasant personality, and is always
ready to respond to her fellow workers with a helping hand.
She has no supervisory responsibility per se, but is frequently
called upon for guidance to new secretaries and case officers
alike and is of real help in such cases. Subject is one of the
strongest Headquarters case officers known to rater, and her.
overall performance certainly borders very closely on being
evaluated Outstanding.
SECTION D
1.
DATE
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I CERTIFY THAT I HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT
SIGNATURE OF EMPLOYEE
2.
MONTHS EMPLOYEE HAS DEEN
UNDER MY SUPERVISION
BY SUPERVISOR
IP THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
18
DATE
OFFICIAL TITLE OF SUPERVISOR
20 January 1967
DC/WH/1
3.
BY REVIEWING OFFICIAL
COMMENTS OF REVIEWING OFFICIAL
TYPED OR PRINTED NAME
Concur. An outstanding officer recognized as such and
appreciated by all.
DATE
OFFICIAL TITLE OF REVISING OFFICIAL
TYPED OR PRINT
RE
31 January 1967
C/WH/1
W.J. Kaufman
SECRFT
14-00000
SECRET
(Then Filled-In)
FITNESS REPORT
EMPLOYEE SERIAL NUMBER
007667
SECTION A
GENERAL
(Firal)
(Middle)
2. DATE OF BIRTH
12 Jan 29
3. 3EX
4. GRADE
8. 30
F
GS-12
D
1. NAME
(Lost)
BUSTOSVIDELA, C. Z.
6. OFFICIAL POSITION TITLE
Ops Officer
9. CHECK (X) TYPE OF APPOINTMENT
CAREER
RESERVE
TEMPORARY
CAREER PROVISIONAL (See Instructions Section C)
SPECIAL (Specify):
11. DATE REPORT DUE IN O.P.
SECTION B
W-Weck
A - Adequate
P Proficient
S-Strong
7. OFF/DIV/BR OF ASSIGNMENT
DDP/WH/1
10. CHECK (X) TYPE OF REPORT
INITIAL
X ANNUAL
SPECIAL (Specify):
8. CURRENT STATION
Headquarters
12. REPORTING PERIOD (From- to-)
1 January
PERFORMANCE EVALUATION
REASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOYER
-
31 December 1965
Performance ranges from wholly inadequate to slightly less than satisfactory. A rating in this category requiros
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.
Performance meets all requirements. It is entirely satisfactory and is characterized noither by deficiency nor
excellence.
Performance is more than satisfactory. Desired results are being produced in a proficient mannor,
Performance is characterized by exceptional proficiency.
O Outstanding Performance is so exceptional in relation to requiroments of the work and in comparison to the performance of
others doing similar work as to warrant special recognition.
SPECIFIC DUTIES
List up to six of the most important specific duties performed during the rating period. Insart rating letter which best describes the
manner in which employee performs EACH specific duty. Consider ONLY offectiveness in performance of that duty. All employees
with supervisory responsibilities MUST be rated on their ability to supervise (indicate number of employers supervised).
SPECIFIC DUTY NO. 1
Handles all aspects of 22 FI/CE/Support projects
including project actions, logistical and financial support,
requirements, guidance and review.
SPECIFIC OUTY NO. 2 Handles all matters concerning the agents belonging to
these projects including field agents, Contract, Career, and Staff
Agents. This includes OA/CSA's, contracts, training, travel, cover
and funding.
SPECIFIC DUTY NO. 3 Prepares, or helps prepare, miscellaneous memoranda
and studies, such as monthly FI achievements, operational program,
budget exercises, responses to requests on operations or background
info regarding Mexico...
SPECIFIC DUTY NO. Routes correspondence, supervises tickler system,
maintains project, agent, and subject 201 files.
RATING
LETTER
RATING
LETTER
0
RATING
LETTER
S
RATING
LETTER
S
SPECIFIC DUTY NO. S
SPECIFIC DUTY NO. 5
Branch records cfficer.
RATING
LETTER
S
RATING
LETTER
OVERALL PERFORMANCE IN CURRENT POSITION
Take into account everything about the employee which influences his effectiveness in his grant position sucidos per
formance of specific duties, productivity, conduct on job, cooperativeness, partinent personal traits of habits, ond
perricular limitations or tolents. Bosed 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.
25 JAN 1955
RATING
LETTER
FORM 45
ble PREVIOUS EDITIONS.
4-02
SECRET
ཡ
__
14-00000
i
SECTION C
SECRET
(When Fitted in)
NARRATIVE COMMENTS
OFFICE OF PERSONNEL
Indicate significant strengths or wooknossos demonstrated in current position keeping in proper perspective their relationship to
overall performance. State suggestions made for improvement of work performance. Give recommendations for training. Comment
on foreign language competence, if required for current position. Amplify or explain ratings given in Section 8 to provide best
busis for determining future porsonnal action. Manner of performance of managerial or suporis dugo. sepribed, if
opplicable.
JAN 23 12° 53° 86°*°
Rose is
Subject continues to render a superior performant
efficient, thoroughly knowledgeable, rapid in her work, well
organized, and greatly facilitates the smooth functioning of
the office. The quality of Subject's work has been recognized
fully in previous fitness reports and in previous recommendations
for promotion from GS-12 to 13. This high quality of work has
continued throughout the period of this fitness report and
Subject continues to merit promotion.
3.
SECTION D
1.
DATE
2.
MONTHS EMPLOYER HAS DCEN
UNDER MY SUPERVISION
Four
DATE
20 Jan. 166
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I CERTIFY THAT I HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT
SIGNATURE OF EMPLOYEE
COMMENTS OF REVIEWING OPPICIAL
BY SUPERVISOR
-----
IP THIS REPORT HAS HOT DEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
OFFICIAL TITLE OF SUPERVISOR
DC/WH/1
BY REVIEWING OFFICIAL
Y PED OF PRINTED NAME AND.
NATURE
J.H.V. Visher
".
i
Reviewing Officer agrees with above report and endorses
Subject's fitness for promotion.
DATE
OFFICIAL TITLE OF REVIEWING OFFICIAL
TYPED OR PRINTED NAME AND SIGILATURE
C/WH/1
W.J. Kaufmap
SECRET
14-00000
:
SECRET
(When Filled (n)
FITNESS REPORT
EMPLOYEE SERIAL NUMBER
007667
GENERAL
(First)
Charlotte
Mind)
2. DATE OF BIRTH
12 Jan 1929
3. SEX
4. ORADE
F
GS-12
B. 50
ย
SECTION A
1. NAME
(Last)
Bustos-Videla,
6. OFFICIAL POSITION TITLE
Ops Officer
9. CHECK (X) TYPE OF APPOINTMENT
7. OFF/DIV/BR OF ASSIGNMENT S. CURRENT STATION
DOP/M/1
10. CHECK (X) TYPE OF REPORT
hus.
x
CANCER
RESERVE
CARKKA-PROVISIONAL (See matructions
SPECIAL (Specify):
11. DATE REPORT OUE IN O.P.
31 Jaruar: 1965
SECTION B
W-Week
A - Adeyvele
i
P-Proficient
S. Strong
.
TEMPORARY
Section C
INITIAL
X
ANNUAL
SPECIAL (Specify):
12. REPORTING PERIOD (From toy)
-
REASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOYEE
1 January 196 31 December 1964
PERFORMANCE EVALUATION
Porformence 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 soporation. Describe action taken or proposed in Section C.
Performance meets all requirements. It is entirely satisfactory and is characterized neither by deficiency nor
excellence.
Performance is more than satisfactory. Desired results are being produced in a proficient manner.
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 DUTIES
List up to six of the most important specific duties performed during the rating period. Insert rating letter which bost 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. 1
Handles all aspects of 21 FI/CE/Support projects including project
actions, logistical support, requirements, guidance, reviews.
SPECIFIC DUTY NO.
Handle all matters concerning the agents belonging to
these projects, including field agents, Contract, Career and Staff
Agents. This includes OA/CSA's, contracts, training, PCS arrange-
ments, cover,-funding.-
SPECIFIC DUTY NO. 3
Prepare, or help prepare, miscellaneous memoranda and
studies, such as monthly FI achievements, Operational Program,
responses to requests from the Senior Staffs on operations and on
Mexico-itself. -
Supervise one Intelligence Assistant in the maintenance of a desk
tickler system and the agent and subject 201 files at the desk.
SPECIFIC DUTY NO. 3
Records Officer
RATING
LETTER
0
RATING
LETTER
.0.
RATING
LETTER
RATING
LETTER
Ο
RATING
LETTER
S
SPECIFIC DUTY NO. 4
RATING
LETTER
OVERALL PERFORMANCE IN CURRENT POSITION
Toho into account everything abear the employee which inventas his effectiveness in his current position such as par-
formance of specific duties, productivity, conduct on job, cocorativeness, pertinant personal trains or habits, and
particular limitations of scients. Based on your knowledge of employee's overall performance during the rating period,
place the lotter in the rating ben corresponding to the statement which most accurately reflects his lovel of performance.
23 MAR 1365
RATING
LETTER
0
FORM 45
SOLETE PAD.10LS ECITION.
4-62
SECRET
14-00000
{
SECTION C
SECRET
(When Filled In)
NARRATIVE COMMENTS
Indicate significant strengths or weaknessos demonstrated in current position keeping in prepor perspecting their relationship to
overall performance. State suggestions made for improvement of work performance, Give recommendations for training. Comment
on foreign language competence, if required for current position. Amplify or explain totings given in Section B to provide bost
duties must be described, if
basis for determining future personnel action. Monner of performance of managerial superv
A 
supervisory duties
applicable.
This exceptionally competent and productive of continued
to perform at a level well above that of the GS-13 slot she occupies.
While a good deal of her tremendous effectiveness, stems from
experience, continuity on the job and her natural fetentive memory.
during the period under review she also demonstrated a flair for,
and applied her talents to, the solution of relatively major and
complex planning and managerial problems in the area of operational
support to Mexico Station activities.
To the list of her previously abudantly acknowledged capacity
for hard, effective work; talent for training on the job younger
officers, diligence, and versatile ability, this rater would like to
add a note of appreciation for her everpresent tactfullness and
discretion. No weaknesses affecting her present assignment have been
noted; she is very careful and realistic in planning for expenditure
of funds.
GS-13.
This officer is separately being recommended for promotion to
WH will review this fitness report with others during a special meeting scheduled
periodically to consider suitable recommendation for outstanding performance.
SECTION D
1.
DATO
CERTIFICATION AND COMMENTS
BY EMPLOYEE
1 CERTIFY THAT I HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT
SIGNATURE OF EMPLOYEE
“༔་་་ (,,:
تش
2.
MONTHS EMPLOYE HAS BEEN
UNDMR MY SUPERVISION
--
BY SUPERVISOR/
IP THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
DATE
13.
3.
17.65
COMMENTS OF REVIEWING OPFICIAL
Coan
TLE OF SUPERVISOR
TYPED OR PRINTED NAME AND SIGNATURE
DC/WH/1
BY REVIEWING OFFICIAL
Alfonso Spera
UATE
OFFICIAL TITLE OF REVIEWING OFFICIAL
C/WH/1
SECRET
TYPED OR PRINT AND SIGNATURE
Kaufman
14-00000
!
424
SECTION A
1. NAME
(Last)
SECRET
(When Filled In)
FITNESS REPORT
(Firet)
BUSTOS-VIDELA, Charlotte Z.
6. OFFICIAL POSITION TITLE
Operations Officer
9. CHECK (X) TYPE OF APPOINTMENT
x
CAREER
RESERVE
EMPLOYEE SERIAL NUMBER
007667
GENERAL
(Middle)
1. DATE OF BIRTH
12 Jan 1929
1. SEX
F
4. GRADE B. 90
GS-12
D
DDP WH 3
TEMPORARY
CAREER-PROVISIONAL (See Instructions Section C)
SPECIAL (Specify)!
11. DATE REPORT DUE IN O.P.
31 January 1964
SECTION B
W. Week
:
A - Adequate
P Proficient
S.Strong
•
7. OFF/DIV/BR OF ASSIGNMENT 8. CURRENT STATION
Headquarters
10. CHECK (X) TYPE OF REPORT
INITIAL
x
ANNUAL
SPECIAL (Specify);
12. REPORTING PERIOD (From t00)
1 January 1963
PERFORMANCE EVALUATION
REASSIGNMENT SUPERVISOR
REASSIGNMENT EMPLOYER
31 December 1963
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.
Performance meets all requirements. It is entirely satisfactory and is characterized neither by deficiency nor
excellenco.
Performance is more than satisfactory. Desired results are being produced in a proficient manner.
Performance is characterized by exceptional proficiency.
0 Outstanding Performance is so exceptional in relation to requirements of the work and in comparison to the performance of
others doing similor work as to warrant special recognition.
SPECIFIC DUTIES
List 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 supörvisory responsibilities MUST be rated on their ability to superviso (indicate number of employees supervised).
SPECIFIC D
Handle Project action, operational correspondence, support for 19
DUTY NO. 1
RATING
LETTER
FI and OPs Support type projects, offecting proper coordination with senior
staffs, other divisions, and offices.
8
SPECIFIC DUTY NO. 2
Handle clearance actions, contracts, and administrative matters for agents
falling under these projects, and for the entire Desk in the absence of the
Intell Analyst.
SPECIFIC DUTY NO. 3
Prepare miscellaneous memoranda, budgets, and reports requested by Senior
Staffs and Division officers from the Mexican desk on Mexican matters in
general.
SPECIFIC DUTY NO. 4
Supervise the clerical and administrative personnel on the desk (averaging 4)
and in general aca to the smooth functioning of the desk and the flow of paper.
SPECIFIC DUTY NO. 53
Records Officer for RH/3/M
RATING
LOTTFA
0
RATING
LETTER
s
RATING
LETTER
0
RATING
LETTER
SPECIFIC DUTY NO. 8
-----
Assume the responsibilities of C/H/3/M when the Chief of the desk is absent,
signing dispatches and cables, coordinating, and supervising 2 Reports Officera
and 5 Case Officers.
OVERALL PERFORMANCE IN CURRENT POSITION
Take into account averything about the employan which influences his effectiveness in his current position such as par-
formance of specific duties, productivity, conduct on jub, cooperativeness, pertinent personal traits er habits, and
particular limitations or talents. Based on your knowledge of employee's overall performance during the rating period,]
plecs the letter in the rating box corresponding to the statement which most necurately reflects his level of performance.
14 FEB 1954
PORN 45 UnSLATE PAVIOUS EDITIONS
4.ez
SECRET
1 Face
RATING
LETTEM
P
RATING
LETTER
0
14-00000
SECTION C
SECRET
(When Pilled 14)
NARRATIVE COMMENTS
indicate significant strengths or weaknesses demonstrated in current position keeping in proper perspective their relationship to
wall performance, State suggestions made for improvement of work performance. Give recommendations for training. Comment
on foreign language competence, if required for current position. Amplily or explain ratings given in Section B to provide best
basis for determining future personnel action. Manner of performance of managerial or supervisory duties must be described, il
syplicable.
Subject's performance during the rating period has been marked by general
excellence. As indicated in Section B her supervision and direction of the Section's
work relating to intel support, administration, preparation of special reports,
training personnel, etc. is uniformly outstanding. The fact that these functions
are handled in addition to her duties as the desk officer for the FI and Ops
Support projects, which she performs with unusual competence, serves to illustrate
her value to this Section. She has an exceptional ability independently to
determine proper courses of action and to initiate action to carry them out. She
has a profound understanding of the area operational program and contributions to
it are imaginative and constructive.
In the opinion of the rater Subject's performance compares favorably with
any (8-13 desk officer within his experience and she performa occasionally at the
CS-14 level. Moreover, she carries out her duties cheerfully, loyally and in
close and amicable cooperation with her fellow employees at all levels.
In those aspects of her duties which involve cost e.g. the review
of operational projects, she has given close attention to the
budgetary matters and has frequently suggested ways in which
economies on the operations might be effected.
SECTION D
"
CATE
28 January 1964
2.
115 EMPLOYEE HAS BEEN
UNDER MY SUPRAVISION
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I CERTIFY THAT I HAVE SPEN SECTIONS A, B, AND C OF THIS REPORT
SIGNATURE OF EMPLOYEE
Alexscatti ? Center bidera
BY SUPERVEOR
IP THIS REPORT HAS NOT BEEN TO EMPLOYEE, GIVE EXPLANATION
CATE
3.
1.28.64
CANENTS OF REVIEWING OFFICIAL
OFFICIAL TITLE OF SUPERVISOR
˚C/WH/3/Mexico
BY REVIEWING OFFICIAL
TYPE OR PRINTO NAME AND SI
Bernard Reichhardt
I concur in the high rating given this employee. She is undoubtedly
the ablest employee in this branch in the performance of her particuler
Job,
CITE
OFFICIAL TITLE OF REVIEWING GEFICIAL
TYPED OR PRINTED NAME AND SIGNATURE
29 Jan 1964
C/WH/3
whit
SECRET
14-00000
(then Tile(n)
RESTANT ON TOI GWITHDE AND EXPERIENCE
or men.
(Date of testing)
The category checked below is an interretation of the scores made by the
urson named above on a battery of foreign lange aptitude tests. The relation-
•hips between test performance and subsequent training performance of trainee in
gency language training courses are indicated by the graphs next to the aptitudo
entegories. The graphs to the left are for vonon and the graphs to the right aro
From these graphs you can read for each aptitude category the trobe
bility that a person in that category will perform in an Agency forcier lampago
Training course at an average or bett, r-than-average level. For example, 22 per
sent of the women who obtain an aptitude rating of "8" can be expected to be
verage or better in course performance, while 5 pur cont of the men with ratings
of "8" can be expected to be average or bobber in course perforance. A man needs
in aptitudo rating of "G" to have about the same wxpectation of success in
language training is a woman with a rating of "8". At the other end of the scale,
10 per cent of either mon or women who obtain optitude ratings of "2" can is
expected to do average or better-than-average work in training. The differences
in relationship are due to differences between men and women in both training
performance and test scores. in the average women are somewhat higher on both,
Percent of on Whose Language
Training Performance Is Expected
to Be Averago or Batter than
verage
100
80 60 40
Percent of Men Whose Language
Training Performance Is Expected
to Be Average or Better than
Average
Aptitude
Category
0
20 40 60
ز کرم
18%
BOX
38
5.
☑
%
3.
J34
☑
3771
Since many things other than aptitudza enter into the determination of traine
ing course perfomance, in any class of students there will usually be me whose
rformance wall be better than would be expected from their test scores, just as
there will likely be nome whose performance in poorer than expected. STRETTI OP
OPIVATION, OR LATERCE 1TH A FOREICH AQUAGE, and other factors anould be
considered in selecting people for language training and in interpreting language
training results. For example, the number of languages previously studica or
Learned and the amount of academic and non-academic language-learning experience
are factors un masured by the tests but are indicative of probable success in
learning a foreign language. Whether such experience was in the sume language
is the one to be studici or in a different one is, of course, an additional
relevant factor.
✓ foreign languages have been stidied or learned by this individual.
Months of Academic Training
Non-cadric Experience (1 year or more)
High School College Ofer
Roading on
18
Sh
22
Speaking
.73
This report may be
"hown to the indi
vidual concerned,
TOWARD A BUY"QUIST
WASH FR Fracowan
14-00000
SECRET
TRAINING REPORT
RECORDS OFFICERS COURSE
30 April - 4 May 1962
Student
: Charlotte 2. Bustos-Vidal, Office
: WH/3
Year of Birth: 1929'
Service Designation: p
Grade.
: 08-12
Number of Students : 34
EOD Date
: Aug 1951
COURSE OBJECTIVES
CONTENT AND MRTHODS
This course, designed for present and prospective Records Officers,
has four principal objectives.
1.
2.
3.
4.
To give an appreciation for the Agency's CS mission.
To describe the role that records play in the discharge
by the Agency of the responsibilities inherent in the
mission.
To emphasize the importance of records and proper records
management in the successful performance of the stated
mission.
To increase awareness of the inter-relationships between
the C3 mission and records; to sharpen Judgement in the
handling and disposition of rusords; and to improve por-
formance of Records Officers.
The student is instructed through the media of lectures, directed
reading, practical exercises and discussions.
ACHIEVEMENT RECORD
This is a certificate of attendance only; no attempt was made to
evaluate student achievement in the course.
FOR THE DIRECTOR OF TRAINING:
L
Augustus F. Schermerhorn 24 July 1962
Chier Instructor
SECRET
Date

14-00000
SECTION A
1. NAME
(Last)
SECRET
(When Filled In)
FITNESS REPORT
(Pirat)
GENERAL
(Middle)
2. DATE OF BIRTH 3. SEX
Bustos-Videla, Charlotte
6. OFFICIAL POSITION TITLE
OPS OFFICER
9. CHECK (X) TYPE OF APPOINTMENT
EMPLOYEE SERIAL NUMBER
407667
4. GRADE 3. SD
12 Jan 29
GS-12
7. OFF/DIV/BR OF ASSIGNMENT B. CURRENT STATION
_DDP_WH_3.
10. CHECK (X) TYPE OF REPORT
D
CAREER
RESERVE
TEMPORARY
CAREER PROVISIONAL (See instructione -Section C)
SPECIAL (Specify)!
11. DATE REPORT DUE IN O.P.
SECTION B
W - Weak
A - Adequate
P-Proficient
5. Strong
31 January 1963
INITIAL
ANNUAL
SPECIAL (Specify);
12. REPORTING PERIOD (From tos)
30 Dec 62
-
1 Jan
PERFORMANCE EVALUATION
REASSIGNMENT SUPERVISOR.
REASSIGNMENT EMPLOYEE
Porformance 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 token or proposed in Section C.
Performance meets all requirements. It is entirely satisfactory and is characterized naither by deficiency nor
excellence.
Performance is more than satisfactory. Desired results are being produced in a proficient manner.
Performance is characterized by exceptional proficiency.
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 DUTIES
List 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 (indicato number of employees supervised).
SPECIFIC DUTY NO, I
Supervises office staff of Mexico Desk in preparing correspondence, keeping
files, carding, and training new personnel.
SPECIFIC DUTY NO. 2
Desk Intelligence officer for important satellite and FI operations in
Mexico, processing projects, handling operational correspondence, conducting
liaison with other divisions.
SPECIFIC LUTY NO. 3
Routing cables, dispatches for the entire Desk, supervising distribution
of work.
RATING
LETTER
RATING
LETTER
S
RATING
LITTER
0
SPECIFIC DUTY NO. 4
Personally handling large number of clearances, project approvals, cable
coordinations, and official negotiations on matters touching all aspects
of the Desk!a_work...
SPECIFIC DUTY NO. 1
Preparation of budget, special papers, surveys, and briefings.
SPECIFIC OUTY NO.
RATING
LETTER
0
NATING
LETTER
0
RATING
LEYTER
OVERALL PERFORMANCE IN CURRENT POSITION
Teko into account everything about the employes which influences his effectiveness in his current position such as per j
formance of specific duties, productivity, conduct on job, cooperativeness, pertinent personal waits of habits, and
particular limitations of talents. Bured on your knowledge of employee's overall performance during the rating period,
place the latter in the rating bos corresponding to the statement which most accurately reflects his lover of performance.
28 FEB 1963
I RATING
LETTER
FORM 45
00504RTE PARVIOUS BUILTIONS.
SECRET
14-00000
SECTION C
SECRET
(When Filled in)
NARRATIVE COMMENTS
Indicate significant strengths or weaknesses demonstrated in current position keeping in proper perspective their relationship to
overall performance. State suggestions made for improvement of work performance. Give recommendations for training. Comment
on foreign language competence, if required for current position. Amplify or explain ratings given in Section B to provide best
basis for determining future personnel action. Manner of performance of managerial or supervisory duties must be described, if
applicable.
This officer is the person chiefly responsible for the Mexico Desk's
deserved reputation for excellence and efficiency. The complicated and
never-ending tasks of project processing, clearances, tracing, and coordination
are handled by her with blinding speed and unerring perfection. Procedural
problems are there to be solved, and the solutions come with amazing rapidity.
Operational problems are worked out thoroughly and conscientiously.
corners are cut and no principles are compromised.
No
Never at a loss for an answer, this officer never shrinks from any
assignment and instinctively wants to take over any vexing problem which is
holding up progress. She is complete mistress of file and record resources
and answers all queries within minutes. The most complex budgetary and
planning projects are handled by her with deceptive ease.
These qualities of rare efficiency and speed are coupled with an even
rarer degree of amiability and cooperativeness. The work which proceeds
under her at such a break-neck pace nonetheless goes on in an air of placidity
and good humor. The large office staff is run without a trace of tension,
Jealousy, or friction. All of this is traceable to this officer's fine
example and catalytic effect on her colleagues.
Finely-educated, handling the Spanish language with fluency, and keeping
up with current events in her area, this officer is a unique asset to
SECTION D organization.
1.
DATE
2.
26 February 1963
MONTHS EMPLOYEE HAS BEEN
UNDER MY SUPERVISION_
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I CEPTIFY THAT I HAVE SEEN SECTIONS A, B, AND C OF THIS REPORT
SIGNATURE OF EMPLOYEE
Chan
BY SUPERVISOR
IP THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
DATE
26 February 1963
3.
COMMENTS OF REVIEWING OFFICIAL
OFFICIAL TITLE OF SUPERVISOR
e/WH/3/MEXICO
BY REVIEWING OFFICIAL
DATE
OFFICIAL TITLE OF REVIEDING OFFICIAL
26 February 1363
AC/WH/3
SECRET
TYPED OR PRINTED,
ohn. M. Whitten
OA PRINAME AND SIGNATURE
B- ངན、、︽༔
Forrest Shivers
14-00000
SECTION A
1. NAME
(Last)
FITNESS REPORT
(Piret)
SECRET
(When Filled in)
EMPLOYER STRIAL
CSFD
GENERAL
(Middle)
2. DATE OF BIRTH
3. Ex
Z
12 January 1929
..
NOT ELIGIBLE
PENDING
10. DATE REPORT DUE IN O.P.
BUSTOS-VIDELA Charlotte
6. SERVICE DESIGNATION 6. OFFICIAL POSITION TITLE
D
Operations Officer
CAREER STAFF STATUS
MEMBER
DECLINED
11. REPORTING PERIOD
Froon
".
DEFERRED
INITIAL
DENIED
☑ ANNUAL
SPECIAL (Specify)
To
31 January 1962
1 Jan 61
-
31 Dec 61
12
1
Fonale
7. OFF/DIV/OR OF ASSIGNMENT
DDP/WH/3/D. C.
TYPE OF REPORT
☑ REASSIGNMENT/SUPERVISOR
REASSIGNMENT/EMPLOYEE
SECTION B
EVALUATION OF PERFORMANCE OF SPECIFIC DUTIES
List up to six of the most important specific duties performed during the rating period. Insert rating number which best describes the
monnor 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).
1 Unsatisfactory
2. Barely adequato
- Acceptable
NO.
SPECIFIC DUTY NO. 1 Responsible for Project RATING
renewals and other correspondence and
action on 12 support tyre projects for 7
Lexico City and Monterrey
NO.
SPECIFIC DUTY NO. 2 Handle niscellaneous adriNATING
and support ratters (requests for tech
equin, studies, training guides, etc) 7
for Nexico and Horterrey
NO.
NO.
4. Compatent 5.Excellent 6. Superior 7. Outstanding
SPECIFIC DUTY NO. 4 Assist the Chief of the RATING
desk in administration of office to
assure the smooth functioning of the
dock. Incluies Hribution of work,
SPECIFISx routing of pouches and RATING
cables, supervision of clerical staff
of 4.
SPECIFIC DUTY NO. Supervise maintenance of RATING SPECIFIC DUTY NO. 6
records at the desk and represent Desk
as Records Officer in discussions with b
201 on 1 Col records problems
SECTION C
EVALUATION OF OVERALL PERFORMANCE IN CURRENT POSITION
NO.
RATING
NO.
Take into account everything about the empleyoo which influences his effectiveness in his current position performance of specific
duties, productivity, conduct on job, cooperativeness, pertinent personal tracts or hobits, particular limitations or talents. Based on
your knowledge of employee's overall performance during the rating period, place the rating number in the box corresponding to the
statement which most accurately reflects his level of performance.
SECTION D
1. Performance in many important respects fails to meet requiremonts.
2- Performance meets most requirements but is deficient in one or more Important respects.
3 Performance clearly mente basic requirements.
4. Performance clearly exceeds basic requirements.
5
6 Performance in every respect is outstanding.
Performance in every important respect is superior.
DESCRIPTION OF THE EMPLOYEE
RATING!
NO.
10
In the rating boxes below, chock (X) the degree to which noch characteristic applies to the employee
1. Least possible degree 12. Limited degree 3. Normal degree 4. Above average degree 5 Outstanding degree
GETS THINGS GONE
CHARACTERISTICS
RESOURCEFUL
ACCEPTS RESPONSIBILITIES
CAN MAKE DECISIONS ON HIS OWN WHEN NEED ARISES
DOES HIS JOD WITHOUT STRONG SUPPGHT
FACILITATES SMOOTH OPERATION OF HIS OFFICE
EXPECTIVELY
SECURITY CONSCIOUS
THINKS CLEARLY
C'SCIPLINE IN ORIGINATING, MADTAINING AND DIFPOSING OP MECONDS
OTHER (Specify).
P091
8-54
45 OBSOLETE PREVIOUS SUITSONA,
SECTION *** ON REVERSE SIDE
SECRET
NOT
APPLI
CABLE
NOT
OD-
SERVED 1
2
RATING
3
$
S
14-00000
SECTION E
SECRET
When Filled in)
NARRATIVE DESCRIPTION OF MANNER OF JOB PERFORMANCE
Stross strengths and weaknesses demonstrated in current position. Indicate suggestions made to employes for indivament of his
work. Givo recommendations for his training. Describe, if appropriate, his potential for development and for assuming greater re-
sponsibilities. Amplify or explain, if appropriate, ratings given in SECTIONS B, C, and D to provide the best basis for determining
future personnel actions.
г 12 11 4 AM 62
This outstanding employed his maintained the high standard of per-
formance set forth in the report of this supervisory. Where
possible, she has exceeded her earlier performance record. Juring the
past year this office acquired considerable now personnel, which Subject
trained in a highly capable manner to guarantee the smooth-functioning
of the office. The undersigned hopes this employee will continue to
serve this organization indefinitely notwithstanding her marriage
during the past year.
SECTION F
1.
DATE
23 Jonry 1962
2.
MONTHS SMPLOYER HAS OREN
UNDER MY SUPERVISION
24
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I certify that I have seen Sections A, B, C, D and E of this Report.
SIGNATURE OF EMPLOYED
BY SUPERVISOR
އހ
IF THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
IF REPORT IS NOT BEING MADE AT THIS TIME; GIVE REASON.
REPORT MADE WIST DAYS
DATE
EMPLOYER UNDER MY SUPERVISION LESS THAN 90 DAYS
OTHER (Specify):
3 Jamars
23 January 1962
34/
OFFICIAL TITLE OF SUPERVISOR
Chief of Desk
BY REVIEWING OFFICIAL
I WOULD HAVE GIVEN THIS EMPLOYEE ABOUT THE SAME EVALUATION.
I WOULD HAVE GIVEN THIS EMPLOYER A HIGHER EVALUATION.
TYPED OR PRINTED RAVE civy
John G. oyn
John A.
I WOULD HAVE OIVEN THIS EMPLOYEE A LOWER EVALUATION.
I CANNOT JUDGE THESE EVALUATIONS, I AM NOT SUFFICIENTLY FAMILIAR WITH THE EMPLOYEE'S PERFORMANCE.
COMMENTS OF REVIEWING OFFICIAL
DATE
OPPICIAL TITLE OF REVIEWING OFFICIAL
67 b 1964.
CH-H17
SECRET
TYPED ON PRINTED AND SIGNATURE
Helmon
14-00000
SECTION A
1. NAME
(Last)
Zehrung
JAN
FITNESS REPORT
(7140)
Charlotte
(Middia)
S. SERVICE DESIGNATION 6. OFFICIAL POSITION TITLE
SECRET
(When Filled m)
GENERAL
2. DATE OF BIRTH
EMPLOYEE SERIAL NUMBER
3. Sex
12 Jan. 1929.
Female
4. GRADE
GS-12
DI
Ops Officer
..
NUT ELIGIBLE
CAREER STAFF STATUS
✗ MEMBER
PENDING
DECLINED
a
DEFERRED
INITIAL
DENIED
ANNUAL
10. DATE REPORT DUE IN O.P.
11. REPORTING PERIOD
From
SPECIAL (Specify)
80
30 Sep 59
-
31 Dec
7. OFF/DIV/BR OF ASSIGNMENT
DDP/AH/3/Nexi/DC
TYPE OF REPORT
AKASSIGNMENT/SUPERVISOR
REASSIGNMENT/EMPLOYER
31 January 1961
SECTION B
EVALUATION OF PERFORMANCE OF SPECIFIC DUTIES
List up to six of the most important specific duties performed during the rating period. Insert rating number 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).
NO.
4. Competent 5. Excellent 6- Superior 7 - Outstanding
SPECIFIC DUTY NO. "Assist the Chief of the RATING
Desk in administration of office to assure
the smooth functioning of the desk. 6
Includes distribution of work, routing
SPECIFIC OUTY NO. 2 Handle miscellaneous adminTING of pouches and cables,
supervision of clerical staff of 4.
1. Unsatisfactory
2. Borely adequate 3- Acceptable
SPECIFIC DUTY NO. Responsible for Project RATING
renewals and other correspondence and
action on 12 supporttypo projects for
Mexico City and Monterrey
NO.
NO.
and support matters (requests for tech
equip, studias, training guides, etc)
for Mexico and Monterrey
7
SPECIFIC DUTY NO. Supervise maintenance of RATING SPECIFIC DUTY NO, A
records at the desk and represent Desk
as Records Officer in discussions with
NO.
EVALUATION OF OVERALL PERFORMANCE IN CURRENT POSITION
RATING
NO.
RATING
NO.
[BTD on Hhs and field records problems,
[SECTION C
Take into account everything about the employoo which influenzas his effectiveness in his current position - performanes of specific
¡duties, productivity, conduct on job, cooperativonen, partiment personal traits or habits, particular limitations or talents. Busad on
your knowledge of employee's overall performance during the rating paried, ploce the rating number in the box corresponding to the
statement which most accurately reflects his loyal of parlerance.
1 Performance in many important refpects fails to meet requirements...
2 Performance meats most requirements but is deficient in one or more Important respects.
Performance clearly ments boste requirements,
3
4. Performance clearly oxcoots basic requirements.
5. Performance in every important rospect is superior.
6. Portormance in every rospect is outstanding.
RATING
NO,
SECTION D
DESCRIPTION OF THE EMPLOYEE
1 - Least possible degree
In the rating boses below, check (X) the degree to which noch characteristic applies to the employao
2. Limited dogros 13 Normal Jagion 14. Above average degree 5. Outstanding degree
CHARACTERISTICS
NOT
APPLI-
NOT
05-
RATING
CABLE SEAVED 1
2
3
4
5
GETS THINGS DONE
RESOURCEPUL
ACCEPT RESPONSIBILITIES
CAN MAKE DECISIONS ON HIS CON WHEN NEED ARISES
000 KIS JOB WITHOUT STRONG SUPPORT
PACILITATES SMOOTH OPERATION OF HIS OFFICA
IT5FFECTIVELY
SECURITY CONSCIOUS
----
THINKS CLEARLY
"
NINCIPIIN IN OB'3.MATING, MAINTAINING AND DISPOSING OF ***S
OTHER (35ectly):
71-4938
3.03
SHE SPCION *E* NPVTRSE 3F
45
08104472 PARTIOUS DI
SECRET
10
14-00000
1.
SECTION E
SECRET
(When Filled In)
OFFICE OF PERSONNEL
NARRATIVE DESCRIPTION OF MANNER OF JOB PERFORMANCE
work. Sive recommendations for his mining. Describe 22 de 1958:12:12. Pl
of his
sponsibilities. Amplify or explain, if appropriate, ratings given in SECTIONS B, C, and D to provide the best basis for determining
future personnel actions.
MAIL ROOM
This is a truly outstanding employee with capabilities far beyond those'
required for her present position. She has an unusually keen mind, makes
decisions that are correct without hesitation and carries out all actions
promptly and efficiently. She is the supervisor of the office staff, who
respect and admire her ability. In addition to her skill, she is possessed
of a most pleasing disposition which ingratiates her with the other members
of the staff. The years of experience she has had at the various jobs to be
done at a country desk make her invaluable as a trainer and supervisor for
new personnel. Her knowledge of Spanish has also been especially helpful at
the Mexican Desk. This supervisor would be most pleased to have her serve
with him on any future assignment.
SECTION F
1.
DATE
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I certify that I have seen Sections A, B, C, D and E of this Report.
31 December 1952
2.
HONTHS EMPLOYEE HAS SEEN
UNDER MY SUPERVISION
12
SIGNATURE, OF EMPLOYER
سعد المال
BY
IF THIS REPORT MAS NOT BEEN CHOON TO EISLOYEE, GIVE EXPLANATION
IP REPORT IS NOT DEING MADE AT THIS TIME, GIK REASON.
AR ORT MADE WITHIN LAST 30 DAYS
DATE
EMPLOYEE UNDER MY SUPERVISION LESS THAN DAYS
OTHER (Specify):
H
OFFICIAL TITLE OF SUPERVISOR
TYPED OR PRINTED AND SIGNATURE
31 December 1950
Dock Chief, W/3/Mexico
John G. Heyn,
3.
SY REVIEWING OFFICIAL
✓ HOULD HAVE GIVEN THIS EMPLOYEE ABOUT THE SAME EVALUATION.
I WOULD HAVE DIVEN THIS EMPLOYPE A HIGHER EVALUATION.
: WOULD HAVE GIVEN THIS EMPLOYER A LOW
VALUATION.
(1 CANNOT JUDGE THESE EVALUATIONS. I AM NOT SUFFICIENTLY FAMILIAR GITH THE EMPLOYEE'S PEMPORDANCE.
COMMENTS OF REVIEWING OFFICIAL
DATE
57an 19611
OPPICIAL ICIAL
TYPED OR PRINTED NAME AND BIONATURE
CHAHB
SECRET
14-00000
SECTION A
1. NAME
(Last)
FITNESS REPORT
(Flat)
(Middle)
SECRET
(When Filled in)
GENERAL
1. DATE OF BIRTH
141950
27.4
EMPLOYEE SERIAL NUMBER
J. * CX
12 Jan. 1929
ZEHRUNG, Charlotte.
6. SERVICE DESIGNATION S. OFFICIAL POSITION TITLE
DI
NOT ELIGIBLE
PENDING
1.0. (FI)
CAREER STAPP STATUS
MEMBER
DECLINED
10. DATE REPORT DUE IN O.P.
11. REPORTING PERIOD
FAXR
°.
DEFERRED
INITIAL
DENIED
ANNUAL
SPECIAL (Specify)
To
31 October 1959
31 May 59 30 Sep 59.
SECTION B
Pemale
4. ORADE
GS-11
7. OPP/DIV/OR OF ASSIGNMENT
[DDP/WH/111/Maxi/DC.
TYPE OF REPORT
REASSIGNMENT/SUPERVISOR
REASSIGNMENT/EMPLOYER
EVALUATION OF PERFORMANCE OF SPECIFIC DUTIES
List up to six of the most important specific duties performed during the rating period. Insert rating number 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).
1. Unsatisfactory
2. Barely adequate
SPECIFIC DUTY NO. 1
]. Accoptable
4. Competent 15. Excellent 6. Superior 7. Outstanding
RATING
NO.
SPECIFIC DUTY NO. 4
Consults
RATING
NO.
tes with viricus
Station's
0
esponsible Officer for several
I and CE/CI Projects
SPECIFIC DUTY NO. 2
Bundles 1rge volume of corresponder.co
wit: Statio in support of Operations)
SPECIFIC DUTY NO. >
Sugarvises • intenance of dook records
and project Stles
SECTION C
5/6 sen eta 17, rdin
RATING
NO.
hojets a
NATING
NO.
SPECIFIC DUTY NO. S
rep res, reviews and coordin-tes
6/7 Remoranda
6
RATING SPECIFIC DUTY NON &
NO,
6/7
EVALUATION OF OVERALL PERFORMANCE IN CURRENT POSITION
RATING
NO.
Take into account everything about the employes which influences his effectiveness in his current position - portarmance of specific
duties, productivity, conduct on job, cooperativeness, pertinent personal traits or habits, particular limitations or talents. Based on
your knowledge of employee's overall performance during the rating period, place the rating number in the box corresponding to the
statement which most accurately reflects his level of pericamance.
SECTION D
1. Performance in many important respects fails to meet requiremonts,
2. Performance meets most requirements but is deficient in one or more limpartent respects.
3. Poriorunce clearly smooth basic sequirements.
4. Parformance clearly oncoods basic requirements.
5 Performance in every important rospect is superior.
6. Parformance in every tossact is outstanding.
In the rating box
1. Least posetio degree
DESCRIPTION OF THE EMPLOYEE
below, check (X) the degree to which each chesectaristie appilas to the employoa
RATING
NO.
4/6
2- Limited degree (J. Normal degree 14. Abasa overage degree 5. Outstanding dogrna
CHARACTERISTICS
NOT
SAVING
RESOURCEFUL
ACCEPTE RESPONSIOILITIES
CAN MAKE DECISIONS ON HIS ONERO ANIDEs
COFS HIS JOU WITHOur st5046 SUPPORT
FACILITATES SMOOTH OPERATION OP ME OFFICE
WRITES FPECTIVELY
2447
ས་མན་ཎྷ་£11:
DISCIPLING IN DRISING, MAINTAINING AND UNIPOLINS OF RELOADI
THE # agrestes
PORS
$5 ***
5
125 Th***WN
SECNET
its
14-00000
SECTION E
SECFEI
When <b
OFFICE
HARRATIVE DESCRIPTION OF ER OF JOB PERFORMANCE wement of his
Stress strengths and weaknetrated in current position are suggestions made to employee for
work. Give recommendations for his training, Describe, of appears potential for development 
got for 
assuming greater re
Vid the best basis for determining
future personnel actions.
sponsibilities. Amplity of appropriate rulings given in SECTIONS B, C. and topi
40 PH '59
MAIL ROOM
Please see previous fitness report. This employee was rated four months
ago. There is no change in the rating; she has continued to give an
outstanding performance.
SECTION F
1.
DATE
з себя
2.
MONTHS EMPLOYEE HAD BEE
UNDER MY SUPERVISION
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I cartely that I have seen Sections A, B, C, D and E of this Report.
SIGNATURE
PLOTEF
Paberna
BY SUPERIOR
IT HAS NOT STEMPLOYER, IVE EXPLANATION
26 months
Pond is not BEING MAGES: wise, GIVE REASON.
REPORT MADE FINY DAY
RMPLOYEE UNDER MY LESS THAN JO LAYE
OTHEA (Specify
CAFE -
ITLE OF SUPR
C/M/111/Maxion
TYPED OR PRINTED AND SIGNATUHE
W
Bar
John B. re
3.
BY REVIEWING OFFICIAL
✓ I COULD HAVE GIVE OUT THE SAME
WOULD HAVE GIVEN PITE HIGHER EVALUATION
ULD HAVE ON
OVER & LOE EVALUAT.
.
JD THESE ATIONS, I AM NOT SURE WITH THE EMNOYEE'S PERFORATER.
KOM OF REVIRDING OF3, 42
DATE
REF.CIAL FIFENO
/P/111
1.
PERSATUre
b. Call
Hurt R. Willeren
'
14-00000
"
FITNESS REPORT
SECRET
(When Filled in)
ав
EMPLOYEE SERIAL NUMBER
GENERAL
(Middle)
L.
2. DATE OF BIRTH
3. Sex
12 Jan 1929
F
SECTION A
1. HAME
(Laat)
ZSHRUNG,
(Pilot)
Charlotte
B. SERVICE DESIGNATION 6, OPPICIAL POSITION TITLE
DI
1.O. (F)
CAREER STAFF STATUS
8.
NOT ELIGIBLE
x MEMBER
PENDING
DECLINED
10. DATE REPORT DUE IN O.P.
28 August 1958
SECTION 8
°.
DEFEANED
DENIED
INITIAL
x ANNUAL
SPECIAL (Specify)
Το
$1. REPORTING PERIOD
Prom
28 August 1957- 81 Kay 59
4. GRADE
11
7. OPP/DIV/BR OF ASSIGNMENT
DDP/WH/III/Mexico/DC
TYPE OF REPORT
REASSIGNMENT/SUPERVISOR
REASSIGNMENT/EMPLOYEE
EVALUATION OF PERFORMANCE OF SPECIFIC DUTIES
List up to six of the most important specific duties performed during the rating period. Insort rating number 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).
1. Unsatisfactory
2. Barely adequate
SPECIFIC DUTY NO. 1
3. Acceptable
4. Competent
RATING
NO.
5- Excollent
SPECIFIC DUTY NO. 4
5/6
Responsible Case Officer for several
FI and CE/CI Projects
SPECIFIC DUTY NO. 2
6. Superior 7. Outstanding
Consults and coordinates with various
Hos components regarding Station's
Projects and perationa
RATING SPECIFIC DUTY NO, 5
NO.
Handles large volume of correspondence
with Station in support of Operations 6/7
SPECIFIC DUTY NO. 3.
Supervises maintenance of deak records
and project files
SECTION C
RATING
NO.
6
RATING
NO.
Prepares, reviews and coordinates
memoranda
6
RATING SPECIFIC DUTY NO. 6
NO.
6/7
EVALUATION OF OVERALL PERFORMANCE IN CURRENT POSITION
RATING
NO.
Take into account everything about the employee which influences his effectiveness in his current position performance of specific
duties, productivity, conduri on [nh, cooperativeness, portiment personal traits or hobits, particular limitations or talents. Based on
you knowledge of employee's overall performance during the rating period, place the rating number in the box corresponding to the
statement which most accurately reflects his level of performance.
1 Performance in many Important respects fails to mopt requirements.
2
Performance meets most requirements but is deficient in one or more important respects.
3. Performance clearly mouts basic requirements,
4 Performance cloorly oxcends basic requirements.
5. Performance in every important respect is superior.
6 Performance in every respect is outatonding.
PATING
MO.
5/6
SECTION D
DESCRIPTION OF THE EMPLOYEE
In the rating boss below, check (X) the degree to which noch characteristic applies to the employe
11. Least possible dogreo 2- Limited dagina 3. Normal degroo 14. Above avarage degree 5. Outstanding degree
CHARACTERISTICS
NOT
APPLI-
CARLE
NOT
ов
SERVEC
RATING
1
3
$
3
SEYS THINGS DONE
A
SOURCEFUL
ACCEPTS RESPONSIBILITIES
CAN MAKE DECISIONS ON HIS DO WHEN NEED ARISES
DOES HIS JOB WITHOUT STRONG SUPPUNT
FACILITATES SMOOTH OPERATION OF HIS OFFICE
#RITES EXPECTIVELY
SECURITY CONSCIOUS
THIS CLEARLY
DISCIPLINE IN ORIGINATING, MAINTAINING AND DISPOSING OF RECORDS
OTHER (Specify):
SHE SECTION "E" ON REVERSE SIDE
DiBM
45 ONSOLETE PREVIOUS RITIONS.
SECRET
2-59
☑
LX
✗
141
14-00000
SECTION E
SECRET
(When Filled ?n)
NARRATIVE DESCRIPTION OF MANNER OF JOB PERFORMANCE OF PERmpnt of his
Stress strengths and weaknesses demonstrated in current position. Indicate suggestions made to employee 'for'
work. Give recommendations for his training. Destribe, if appropriate, his potential for development and for assuming greater re-
sponsibilities. Amplify or explain, if appropriate, ratings given in SECTIONS B, C, and D to provide the best bosis for determining
future personnel actions.
JUL 21 2 51 PH '59
This employee is intelligent, loyal and dedicated to duty. She has an
outstanding ability in getting her job assignments accomplished effectively and
with a minimum of time and support. She readily accepts responsibinom, is a
highly efficient worker who thinks clearly and logically. Her knowledge of
Headquarters and Field procedures plus her ability to organize her work greatly
facilitates the smooth functioning of the Nexican Desk. She has demonstrated a
superior comprehension of the numerous and varied projects of the lexico City
Station hich has contributed to the overall Headquarters support of the Station's
operations. Because of her sound understanding of operations and her outstanding
capacity for work, Miss Zehrung has an excellent potential for assuming greater
responsibilities. Additional training is dependent upon her future assignments.
SECTION F
1.
DATE
CERTIFICATION AND COMMENTS
BY EMPLOYEE
I certify that I have seen Sections A, B, C, D and E of this Report.
TURE OF EMPLOYER
SIGNATUR
2.
BY SUPERVISOR
_
MONTHS &MPLOYEE HAS OCEN
UNDER MY SUPERVISION
IF THIS REPORT HAS NOT BEEN SHOWN TO EMPLOYEE, GIVE EXPLANATION
22 months
IF REPORT IS NOT BEING MADE AT THIS TIME, GIVE REASON.
EMPLOYEC UNDER MY SUPERVISION LESS THAN OD DAYS
REPORT MADE WITHIN LAST DO DAYS
OTHER (Spotify);
DATE
OFFICIAL TITLE OF SUPERVISOR
3.
13. June 1959
TYPED OR PRINTED NAME AND SIGNATURE
C/WH/III/Mexico.
John. Prady
BY REVIEWING OFFICIAL
I WOULD HAVE GIVEN THIS EMPLOYEE ABOUT THE SAME EVALUATION.
I WOULD HAVE GIVEN THIS EMPLOYES 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 OFFICIAL
DATE
11 July 1915
OFFICIAL TITLE OF REVIEWING OFFICIAL
PED OR PRINTED NAME AND SIGNATURE
C/WH/III
1.N. Dubigren
SECRET

14-00000
SECRET
(When Filled in)
FITNESS REPORT (Part I) PERFORMANCE
INSTRUCTIONS
FOR THE ADMINISTRATIVE OFFICER Consult current instructions for completing this report.
POR THE SUPERVISOR: This report is designed to help you express your evaluation of your subordinate and to treasmit
this evaluation to your supervisor and senior officials. Organization policy requires that you inform the subordas
nate where he stands with you. Completion of the report can help you prepare for a discussion with him of his
strengths and weaknesses. It is also organization policy that you show Part 1 of this report to the employee except
under conditions specified in Regulation 20-370. It is recommended that you read the entire form before completing.
any tuestion. If this 15 the initial report оп the employer, it must be completed and forwarded to the Office of
Personnel no later than 30 days after the date indicated in item 8. of Section "A" below.
SECTION A.
1. NAME
(Last)
ZEHRUNG, Charlotte L.
(Pine)
5. OFFICE/DIVISION BRANCH OF ASSIGNMENT
GENERAL
(Middle)
18. DATE OF BIRTH
3. SEX
4. SERVICE DESIGNATION
12 Jan 1929
DDP/WH/II/DC/argention/MERICO
" GRADE
GS-11
6. DATE IN
4 Nov 1957
10. TYPE OF REPORT
(Check one)
SECTION B.
INITIAL
☑ ANNUAL
1. FOR THE RATER: THIS REPORT ☑ HAS
NOT
CHECK (X) APPROPRIATE STATEMENTS:
6. OFFICIAL POSITION TITLE
Reports Officer
PERIOD COVERED BY THIS REPORT (Inclusive dates)
28 August 1956 - 27 August 1957
RIASSIGNMENT SUPERVISOR
FASSIGNMENT EMP LOVEL
CERTIFICATION
-
SPECIAL (Specify)
HAS NOT BLEN SHOWN TO THE INDIVIDUAL RATED. IF NOT SHOWN. EXPLAIN WHY
THIS REPORT REFLECTS MY OWN OPINIONS
of
THIS INDI-
VIDUAL.
IF INDIVIDUAL +S RATED "t" IN C1 OR D. a
ILR WAS SENT TO HIM A COPY ATTACHED
ANNING LETA
01
THIS REPORT.
I
THIS REPORT REFLECTS
AND PREVIOUS SUPERVISORS,
THE COMBINED OPINIONS
F MYSELF
1 CANNOT CERTIFY THAT
RATED
INDIVIDUAL
ALORS NOW
. SALUATE HIS JOA PERFORMANCE BECAUSE (Specify)'
HAVE DISCUSSED
TH THIS EMPLOYEE
( AND WEAKNESSES SO
THAT HE KNOWS HERS
STRENGTH
STANUS.
1
THIS DATE
20 January 1958
c. TYPED OP PRINTED FAVE
THE 
AND SIGNATURE OF SUPERVISOR ". SUPERVISOR'S OFFICIAL TITLE
John B. Brady fo
C/WH/III/Mexico
FOR THE EVITING OFFICIAL RECORD AMY STANTIAL DIFFERENCE OF OffINION WITH THE SUPERVISOR, OR ANY OTHER IN*
FORMATION. ANILH MILL LEAD 199 A
TANDING OF GENREPORT:
FY
75
P.
AN
^
cus
BANGL
1950
CONTINUED ON ATTACH
SHELT
certify that any substantial difference of opinion with the supervisor is reflected in the above section,
3 GATE
OFFICIALR
VIENING
༡IA?༡༣«{J *
5. TYPED OR P
21 January 1958
N. Dahlgren
SECTION C.
JOC PERFORMANCE EVALUATION
1 RATING ON GENERAL PERFORMANCE OF Duties
OFFICIAL TITLE OF REVIEWING OFFICIAL
C/WH/III
DIRECTIONS. Consider ONY the productivity and effectiveness with which the individual being rated has performe !
This duties during the listing period. Compare him (ALY with others doing similar work nt a imilar level of respon
Gility. Factors other than productivity will be taken into recount later in Section D.
" DOES NOT PERFORA DUTIES ADTQUATELY, HE IS INCOMPETENT.
3.
+
-
JASURE
NATING
SUMBER
"
НАДЕСУ ADEQUATE IN REARANCE ALTHOUGH 44 45 42 SPECIFIC GUIDANCE OD TRAINING, ME OFTEN FAIL TO
CARPY OUT RESPONS
PERFORMS MOST OF HIS SITES ACCEPTABLY OCCASIONALLY REVEALS SOME AREA OF EARNESS.
PERFORMS TIES IN A COMPLIENT EFFECTIVE MANNER.
A FINE PERI. COURTES OUT MANY OF HIS RESPONStaILITIES EXCEPTIONALLY
• PERFORMS HIS DUTIES 1% SUCH AN OUTSTANDING MANNER THAT IS EQUALLEG :)
THE SUPERVI532.
• EIL.
PL OTHER PERSONS KNOWNY TO
COEIENTS.
PLACES PRIV
45 (Part 1)
."
10905
15 442
40+
074 17
SECRET
: 307 33
481 cit,་་
Performance
14-00000
CECRET
(when Filled Inj
RATINGS IN PERFORMANTE 119 SPECIFIC DICTIES
PIRICTIONS
13.
EFICE
State in the spaces belos up to six of the more important SPECIFIC duties perts mollyspring this rating period,
Fince the most important first.
b not inciul Minor of unimportant duties.
b. Rate performance on each specific duty considering ONLY effectiveness in performance of this 'specific duty.
For Supervisors, ability to supervise will 
always be rated na
who supervize a secretary onir).
c.
d. Compare in your mind, when possible, the
imster level of responsibility:
e. Two individuals with
duties.
f. Be specific.
a specify
124"
(do not rate as supervisors those
the 2
ing the same duty at a
individual being rated with oth. 09 TN them on different.
the Ame job title may be performing different duties.
MAIL RC
Fxamples of the kind of duties that might be rated are
ORAL BRIEFING
GIVING LECTURES
CONDUCTING SEMINARS
WRITING TECHNICAL REPORTS
CONDUCTING EXTERNAL LIAISON
TYPING
TAKING DICTATION
SUPERVISING
HAS AND USES AREA KNOWLEDGE
DEVELOPS NEW PROGRAMS
ANALYZES INDUSTRIAL REPORTS
MANAGES FILES
OPERATES RADIO
COORDINATES WITH OTHER OFFICES
WRITES REGULATIONS
PRIPARTS CORRESPONDENCE
11 aD,
AMDUCTS INTERROGATIONS
PREPARES SUMMARIES
TRANSLATES GERMAN
DEBRIEFING SOURCES
KEEPS HOOK S
DRIVES TRUCK
MAINTAINS AIR CONDITIONING
EVALUATES SIGNIFICANCE OF DATA
2. For some jobs, duties may be broken down even further if supervisor considers it advisable, e.g., combined key
and phone operation, in the case of, a radio 
operator.
·
DESCRIPTIVE
THIS DUTY
INCOMPETENT IN THE PERFORMANCE OF
IN THE MERFORMANCE OF
BAKELY AUFQUATE
DUTY
THIS
RATING
NUMBLR
".
4.
SPILIPIC Du tr NO.
PERFORMS THIS DUTY ACCEPTABLY
PLAFORMS THIS DUTY IN A COMPETENT MANNER
PERFORM5
IN
THIS DUTY
THAT HE 15 A DISTINCT ASSET ON HIS JOB
SUCH
A
PERFORMS THIS OUTY IN AN OUTSTANDING MANNER
FOUND IN VERY FEW INDIVIDUALS HOLDING SIMI
LAR JORS
7. EXCELS
KNOW IN THE PERFORMANCE OF
THIS DUTY
ANYONE 1
FINE MANNER
PATING SPECIFIC DUTY NO.
Supervises malatenance of desk records NUMBER Extracts pertinent information from
and project files.
APACIFIC
2
Dufy NO.
Reviews and coordinates memoranda
reports and statistics for the prepa-
ration of studies
..
RATING SPECIFIC Du fe 43.
HATING
NUMBER
6
RATING
Prepares cables and dispatches for the NUMBER
6
field
6
SPECIFIC DUTY NO. 3
Processes for dissemination reports
from field stations
RATING SPECIFIC Du fr NO. 0
NUMBER
RATING
5
Supervises maintenance of country desk
files
NUMBER
3. NARRATIVE OF SCRIPTION OF MANNER OF JON PERFORMANCE
Stress strengths and weakness, particularly those which affect development on present job.
This employee is a highly efficient worker who in accomplishing her job assignments has
She has the 
ability to think clearly and
performed in a very outstanding manner.
logically and at all timos exercises extreme good judgment. Her knowledge of His and
field procedures constitutes a great asset and she has the 
facility for picking up
She is willing to undertake any
louse ends and keeping an office smoothly ruining
.
assignment that facilitates getting the job done and is entirely capable of seeing
Her contribution to the job 
reflects 
conscientiousness,
that the job is properly done.
loyalty and devotion to duty far above the average.
SECTION D.
SUITABILITY FOR CURRENT JOD IN ORGANIZATION
in the job.
DIRECTIONS Toke into account here everything you know about the individua!....productivity, conduct
pertinent personal characteristics or habits, 
spiral defects or talents....and how he fits in with your 
team. Com-
per him with others doing similar work of about 
the same level.
NATING
NUMBER
2
0871611FLY UNSUITABLE
SHOULD BE SEPARATED
of GuaruL SITABout D NOT HACE ACCEPTED HIM IF
A BARELY ACCEPTANCE EMPLOYEE BELOW AVERAGE BIT
RANT HIS SEPANATION
I HAD KNOWN SPAT I KNOW NOA
WITH NO WEAKNESSES SUFFICIENTLY OUTSTANDING TO #AR-
AS MOST PEOPLE " VNON Iv THE ORGANIZATION
HAS SOME JUTSTANDING STRENGT
5. AN UNUSUALLY STRONG PINSON
6
..
OF THE SAME ITABILITY
5-
A FISE FUPLOTEE
IN TERMS OF
UTREMENTS OF
LLLED ONLY A FIN SUITABILITY FO
THE ORGANIZATION
*་ས་ IN THE ORGANIZATION
FüR
IS THIS VAL AETTE SUITED
EXPLAIN FULLY
iN 50 07-ER POSITION IN THE ORGANIZATION
IF Its.
SECRET
14-00000
:
SECRET
When Fitted Int
FITNESS REPORT (Part II) POTENTIAL
FOR THE ADMINISTRATIVE OFFICER:
INSTRUCTIONS
Consult current instructions for completing this report.
FOR THE SUPERVISOR: This report is a privileged communication to your superviser, and to appropriate career mengen
ment and personnel officials concerning the potential of the employer being rated. It is NOT to be shown to the
|rated employer. It is recommended that you read the entire report before completing any question. This report is
to be completed only after the employee has been under your supervision FOR AT LEAST 90 DAYS.
If less than 90 days,
hold and complete after the 90 days has elapsed, If this is the INITIAL REPORT on the employee, however, at MUST be
completed and forwarded to the OP no later than 30 days after the due date indicated in item & of Section "F" below.
SECTION E.
1. NAME
(Last)
2
ZEHRUNG, Charlotte.
(First)
S. OFFICE/DIVISION/BRANCH OF ASSIGNMENT/
GENERAL
(Middle)
2. DATE OF BIRTH
12 Jan 1929
3. BEX
6. OFFICIAL POSITION TITLE
.. SERVICE DESIGNATION
DDP/NH/IX/DC/Argenitions / MEVICO Reports Officer (sive dates)
7. GRADE
GS-11 4 Nov 1957
10. TYPE OF REPORT
(Chork ono)
SECTION F.
OP
INITIAL
ANNUAL
28 August 1956 - 27 August 1957
REASSIGNMENT SUPER00
REASSIGNMENT-EMPLOYED
CERTIFICATION
SPECIAL (Spocily)
DI
THAT THIS REPORT REPRESENTS MY BEST JUDGEMENT OF THE INDIVIDUAL BEING KATED
AND SIGNATURE OF SUPERVISOR C.
1.
FOR THE RATERI I CERTIFY
A.
THIS DATE
A. TYPED OR PRINTED
20 January 1958
John B. Brady
2.
FOR THE REVIEWING OFFICIAL I HAVE
A.
THIS DATE
21 January 1958
B
SUPERVISOR'S OFFICIAL TITLE
C/WH/III/Mexico
REVIENTLY THIS REPORT AND NOTED ANY DIFFERENCE OF OPINION IN ATTACHED MEMO.
AND SIGNATURE REVIEWING C. OFFICIAL TITLE OF REVIEWING OFFICIAL
#. TYPED OR PRINT
OFFICIAL
m.
R. N. Dahlgren
ESTIMATE OF POTENTIAL
C/WH/III
SECTION G.
1. POTENTIAL TO ASSUME GREATER RESPONSIBILITIES
DIRECTIONS: Considering others of his grade and type of assignment, Fate the employee's potential to assume greater
-responsibilities. Think in term of the kind of responsibility encountered at the various levels in his kind of
work.
6
. . ALREADY ADOVE THE LEVEL AT WHICH SATISFACTORY PERFORMANCE CAN at EXPECTED
JAN HEACHED THE BEESHEST LEVEL AT *ICH AT SEACTORY PERFORMANCE CAN HE EXPECTED
MAKING PROGACAN NOT NEED MORE TIME BEFORE HE CAN HE TRAINED TO ATSUME GREATER RESPONSIBILITIES "
4. HLADY FOR TRAINING IN ASSUMING GREATER RESPONSIBILITIES
1.
WILL PROBABLY ADJUST QUICKLY TO BE RESPONSIBLL OUTIES WITHOUT FURTHER TRAINING
AUME ALTY ASSUMING MORE RESPONSIBILITIES THAN EXPECTED AT HIS PRESENT LEVEL
5.
1.
RATING
NUMOLA
7
.
AN EXCEPTIONAL PERION #80
LEVEL RESPONSIBILITIES
THE
15 ONE OF
SUPERVISORY POTENTIAL
SHO
0 TIS PHK
PARLY
DE CONSIDERED FOR
ASSUMPTION OF MIGNER
2.
DIRECTIONS: Answer this question" as this person
the ability to be a supervisor? ☐ Y ☐ No If your
answer is YFS, Indiente below your opinion or guess of the level of supervisory phility this person will reach AFTER
SUITABLE TRAINING. Indicate your opinion by placing the number of the descriptive rating below which comes closest
to expressing your opinion in the appropriate column. If your rating is based on observing him supervise, note your
rating in the "actual" column, 11 bed on opinion of his potential. note the rating in the "petratial" colum
HAVE NO OPINION ON HIS SUPERVISORY POTENTIAL 4 THIS SITUATION
DEC LEVE
ง
DESCRIPTIVE
1
RATING
NUMBER
2
3
INDIVIDUAL BOULD UT A WEAK SUPERVISOR IN THIS KIND OF DIATION
HEL LEVE INDIVIDUAL BOULD BE AN AVERAGE SUPERVISOR IN THIN SIND OF SITUATION
BELIEVE INDIVIDUAL WOULD BE A STRONG SUPERVISOR IN THIS SITUATION
ACTUAL
POTENTIAL
3 643UP
china or professional spe
FREQUENT (Pirst line
DESCRIPTIVE SITUATION
DOIN. THE BASIC 100 (truck drivers, stenographera
etaliate of various kinds) entai Contact WITH IMMEDIarz Sub120INATE 15
supervisor
A GROU
SI, PAVITOES емо LINICI
ASIC 120 (Second time supervisors)
ON KAY 407 JE SUPERVISORY, IN 13 RESPONSIBLE FOR MAJOR PLANS, DRGAN176769
AND POLICY (Executive Lovel)
WHEN CONTACT 7278 TMHED STE 5100 DINATES 5 NOT FREQ
3.
INMEDIATE SLO34DINArta ACTIVE185 002 DIVERSE
AND NE
CANIPUL COORDINATION
.2.
andy INMEDIATE SUBORDINATES Shilube VENDERs Ut 14 PP22176
+
3
State (Spacity)
1
33
FORM NO. 45 (Part 11) or ros
REPLACES DITIONS
เค
་་་
SECRET
100%
Potential
14)
14-00000
4
SECRET
(ohen Filled Ins
INDICATE THE APPROXIMATE NUMBER OF MONTHS THE RATED F
7 months
COMMENTS CONCERNING POTENTIAL
OFFICE OF PERSONNEL
HAS BEEN UNDER YOUR SUPERVISION
JAN 24-209 PM 38
Her potential has a wide range. She has the ability to organise and direct a sizeablo
office of reports writers and to supervise the administrati apertions for a large
office. She has a distinct aptitude for operations and her potential in the field of
operational support work as well as in the direct handling of operations is a good one.
SECTION M.
FUTURE PLANS
1. TRAINING OR OTHER DEVELOPMENTAL EXPERIENCE PLANNED FOR THE INDIVIDUAL
None recommended at this time.
2. NOTE OTHER FACTORS. INCLUDING PERSONAL CIRCUMSTANCES. TO DE TAKEN INTO ACCOUNT IN INDIVIDUAL'S FUTURE ASSIGNMENTS
SECTION 1.
(DIRECTIONS: This section
DESCRIPTION OF INDIVIDUAL
is provided as an aid to describing the individual as you see him on the job, Interpret
the words literally. On the page below are a sories of statements that apply in some degree to most people. lo
the left of each statement in a box under the heading "category." Read each statement and insert in the box the
category number which fast rolls how much the statereat pplies to the person covered by this report.
x . HAVE NOT OBSERVED THIS HENCH CAN GIVE NO OPINION AS TO HOW THE DESCRIPTION APPLIED 10 THE
INDIVIDUAL
CATEGORY NUMBER
1.
2.
"
APPLIES TO THE INDIVIDUAL TO THE I FAST POSSIBLE DEGREE
APPLIES TO INGIVIDUAL TO A LIMITED OFCREE
APPLIES TO INDIVIDUAL TO AN AVERAGE DEGREE
+- APPLIES TO INDIVIDUAL TO AN ABOVE AVERAGE DEGREE
APPLIES TO INDIVIDUAL TO AN OUTSTANDING DEGREE
CATEGORY
STATEMENT
1. ADLE 1•
440 THE '1
PAINI G
VIR
2.
CAN MAKE
USCISIONS
WHIN A S
CATEGORY
11. HAS
STATEMENT
CATEGORY
STATEMENT
G
ACCOMPLISHMENT
FANDARDS OF
21 15
51015
EFFECTIVE IN
1 in
CISCUS
6557GIA163
QN 15
12.
SHOWY WRIGLEY
3.
13.
ACCEPTS
7165
3.
43
INITIATIVE
5
4.
10 ANALYTIC 14 115 THING
1220
129.
Jurciw25 DECIDIOS A:
PAULE
FHOUGHTFUL
"F
074195
14.
ADMITS HIS
S
24.
ELL UNGER PALSSUE
5
5. STRIVES CONSTANTLY
NO KNULIDORA AND 10:45
5
MFJ
13. RESPONDA BILL TO 56.
125.
GISPLATS JUGUEMINT
4
1
31544
5.
..
14 70
235ANCE
118. OPER HIS JOB WITHOUT
STRONG SUPPORT
15 SECURITI CONSCIOUS
5.
_5
157. COMES UP WITH SOLUTIONS
7. COM
41 0% 5 WITH PEOPLE
VERSATILE
LATEST
4.
5.
MAS MT
F61 SAT
417
41965
10.
CAN LOPF
"
> SERVANT
119.
41 Chena
20.
WITHIN
LIMAT1
SECRET
CRIFICION #5
NERGETIVE
TION : 410
TIME
440
S. N
14-00000
=
CONFIDENTIAL
(When filled in)
NOTE TO PCS RETURNEES
Personnel processing in from a PCS foreign field assignment through
Central Processing Branch are required to review the Employee Conduct
Handbook and the information for PCS returnees. This information is
contained in a notebook provided by the CPB receptionist.
MEMORANDUM OF
UNDERSTANDING
I hereby acknowledge that I have read and understand the contents
of Handbook 20-4, Employee Conduct, dated 9 July 1970 and the infor-
mation for returnees dated 1 February 1972.
CHARACITE 2 DUSTES VIDEZA
HAME
(Please Print)
Chart
Signature
5
Hound 1972
Date
CONFIDENT (AL
(When filled in)
Excluded from
automatic do qustrading
and declassification.
14-00000
TO:
SECRET
(then Filled in)
REPORT OF SERVICE ABROAD
Office of Personnel, Control Division, Statistical Reporting Branch
FILE
PUNCHED
BY
SERIAL NO.
LAST
1.
(Print)
007667
Bustosvidele
NAME
FIRST
7.24
MIDDLE
Charletle
z
INSTRUCTIONS
USE APPROPRIATE SPACE BELOW TO REPORT DATA FOR CITHER PCS OR TOY. INSERT APPROPRIATE CODE NUMBER IN "CODE" COLUMN
TO DESIGNATE WHETHER SUBMISSION IS OF BASIC DATA, CORRECTION, OR CANCELLATION (Ono only), REPORT DATES BY USING
THE NUMBER FOR THE MONTH, AND LAST TWO DIGITS ONLY FOR YEAR. REFER TO OF 1, NO. 38. REVISED,
PCS DATES OF SERVICE
ARRIVAL 0/$
DEPARTURE 0/9
TYPE OF DATA
0/
WORTH
DAV
YEAR
25-20 27-20 29-30
MONTH
21-32
DAY
་..
1 •
33.34 25.30
.
5.
PCS (Basic)
CORRECTION
CANCELLATION
Coos
37
USE
ONLY
20 30
082072
DEPARTURE O/S
TOY DATES OF SERVICE
ARRIVAL 018
TYPE OF DATA
07
USE
NORTH
29-26
DAY
YEAR
27-28 29.30
MORTH
31-32
DAV
YEAD
33.34 75-76
..
6
2 TDY (Basic)
CORRECTION
CANCELLATION
CODE
37
ONLY
30 30
TRAVEL VOUCHER
CABLE
OTHER (Specify)
DOCUMENT IDENTIFICATION NO,
REMARKS
OFFICE OF PERSONNEL USE ONLY - PUNCH ARFA
SOURCE DOCUMENT AND CERTIFICATION
DISPATCH
COUNTRY
CODE
40-42
Mexico
AREA(S)
CODE
40-42
OUTY STATUS ON TIME AND ATTENDANCE SEPORT
DOCUMENT DATE/PERIOD
IN 680.799
5/16/72
1000
4-71
PREPARED BY
Cco
C
2113/09, crea.
DATE
+
DIVISION
1451a s
EDITIONS
REPORT ANNOTATED 0%
DOCUMENT
ANGE DATA CERTIFIED CORRECT.
BASED ON SOURCE
DOCUMENT CITED
5/11/721
SIGNATURE
THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNEL
IN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDER
SECRET
(4-10)
14-00000
8
---
SECRET
OFF
FIELD REASSIGNMENT QUESTIONNAIRE
DO NOT COMPLETE
FOR HEADQUARTERS USE OBLY
NAME OF EMPLOYEE (ušo pesudo only if SA) DATE (from item S. D NAME OF SUPERVISN (frue)
Charlotto Z. Bustos-Videla 8 Sep 1971 John R. Horton
DATE RECEIVED AT HEADQUARTERS:
15 September 1971
DISPATCH NUMBERY DATE RECEIVED BY CANTER SERVICE!
HMMT 11,086,
8 Sep 1971
DATE (from item 5-2)
8 Sep 1971
TO BE COMPLETED BY EMPLOYEE
1. DATE OF BIRTH
2. SERVICE 3. YOUR CURRENT POSITION. TITLE
DESIGN
AND COADE
4. STATION OR BASE
B. CRYPT FOR
CURRENT COVER
12 Jan 29
A. DATE OF PCB ARRIVAL
IN FIELD
28 July 1967
Cuba/CI; GS-13
Mexico City
6. REQUESTED DATE OF 6c. EXPECTED DATE OF FIRST 66.
DEPARTURE
CHECK-IN AT HO
9 Sept. 1972
7. NUMBER AND AGES OF DEPENDENTS WHO WILL TRAVEL WITH YOU!
Nominal
LNGOLD
DESIRED DATE TO REPORT TO DUTY
AFTER LEAVE
16 October (3 weeks H/L)
(2 weeks A/L)
None
8. PERSONAL CIRCUMSTANCES THAT SHOULD BE CONSIDERED IN DETERMINING NEXT ASSIGNMENT:
My husband is currently a professor in New York City, and I would very
much appreciate an assignment in New York City so I may join him there.
I would be agreeable to changing somewhat my departure date from Mexico
if it would help in my accepting an opening in New York City. My reason
for requesting the two month extension is to insure my 5 years overseas
duty so as to qualify for the organization's retirement plan.)
. LIST YOUR MAJOR DUTIES OURING CURRENT TOUR ( special note on transmittel form).
(also attach personal cover questionnaire in accordance with CSI-F 240-8)
1.
2.
Analysis of personality and target data from raw and finished reports:
preparation of target studies, and finished intelligence dissems.
Operational reporting: cables, dispatches, projects, progress reports,
etc.
3.
Handling of outside transcribers.
(off and on). '
4.
5.
6.
Records control and purge of Station files.
Preparation of memos for other components of LNCUFF.
General Ops support IA typo work.
10. TRAINING DESIRED:
INDICATE WHAT TRAINING YOU BELIEVE YOU SHOULD HAVE DURING THE NEXT SEVERAL YEARS
1004
3.03
JUOLETE
PREVIOUS
202
SECRET
(4)
14-00000
11. PREFERENCE FOR NEXT
ARCILGMENT.
SECRET
TYPE of RUER YOU WOULD POTFED FOR 4527 2551GADSNT IF DIFFERENT FROM THAT INDICATED
IF YOU HAVE MORE THAN ONE PREFERENCE, IQVICATE YOUR CHOICE.
1ta. DESCRIDE DAIFFLY THE
IN ITEM NO. • ABOVE,
110. INDICATE IF YOU DESIRE TO EXTEND YOUR CURMENT TOUR BY CHECKING IN APPROPRIATE-BOX. ALSO INDICATE PREFERENCE
FOR NEXT REGULAR ASSIGNMENT BY INSERTING 1, 2, 3 (for 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.
"
MONTHS AT CURRENT STATION TO
9 September
(Date)
BE ASSIGNED TUTIONS FOR A TOUR OF DUTY, INDICATE IS CHOICE OF DIVISION, OR OFFICE.
2NG CHOICE MUR
☑ EXTEND TOUR _
2
'
2 0
1ST CHOICE.
1 ☑
DE ASSIGNED
WTork"
1ST CHOICE'
3 ☐ RETURN TO MY CURRENT STATION
3RD CHOICE —
ISTORIELD STATION, INDICATE CHOICE OF GEOGRAPHIC AREA OR SPECIALIZATION
2ND CHOICE,
3RD CHOICE.
TO BE COMPLETED BY FIELD STATION
12. IN CONSIDERATION OF THE EXPERIENCE AND PERFORMANCE OF THE FLOTTE AND HIS PREFERENCE FOR NEXT ASSIGNMENT,
INDICATE YOUR RECOMMENDATION FOR HIS NEAT ASSIGNMENT AND TRAISING:
Those of you who know her realize that I would hardly give up
SCALETTI, even after five years on the job, without a fight, did not
other reasons intervene. Her husband is working in New York now and
so her romaining here any longer than needed for her to qualify for her
retirement time, as she explains, is a needless hardship. (It would
holp us if you would confirm that time: is that the date needed for
her to remain in order to qualify?) Please do your best to arrange
TO BE COMPLETED BY APPROPRIATE HEADAPTERS OFFICE
--continued
13. IN CONSIDERATION OF THE EXPERIENCE AND PERFORMANCE OF THE EMPLOYEE, HIS PREFERENCE FOR NEXT ASSIGNMENT,
AND THE STAFFING REQUIDEMENTS OF YOUR COMPONENT. INDICATE YOUR COMPONENT'S PECOMMENDATION FOR HIS NEXT
ASSIGNMENT AND TRAINING,
One.
Subject will be assigned as chief of the CA Section, WH/Branch
She is being notified via HMMS 7580.
DATE 9Jun72
TITLE DC/WH/Pers
SIGNATURE
Jane Wurz/
FOR USE BY CAREER SER CE
14. APPROVED ASSIGNMENT:
13, EMPLOYES NOTIFIED BY DISPATEM NO.
TABLE NO.
CAREER SERVICE REPRESENTATIERE
رماندار است
IDIGTues)
SECRET
Oates,
DATED:
DATE
:
14-00000
12.
CONTINUED
an assignment in New York for her. She is such a valuable
person that anyone who has worked with her would be glad to have
her on the premises: so there is no need to try to "sell"
her: it's just the question of whether the timing would be
right, I should think.
14-00000
CONFIDENTIAL.
Then Filled'})
Complete in original. The data recorded on this form is essential in determining travel expenses allowable in con-
nection with leave at government expense, overseas duty, return to residence upon separation, and for providing
Current residence and dependency information required in the event of an employee emergency. This form will be
filed in the employee's official personnel folder.
SAME OF EMPLOYEE
1.
(Lost)
BUSTOS-VIDELA
(PHN)
Charlotte
RESIDENCE DATA
(Middle) SOCIAL SECURITY NUMBER
Z
069-24-3138
PLACE OF RESIDENCE WHEN INITIALLY EMPLOYED BY AGENCY
Washington, D.C.
PLACE IN CONTINENTAL U.S. DESIGNATED AS PERMANENT RESE
DENCE Dayton, Ohio
2
SINGLE
X MARRIED
1 LAST PLACE OF RESIDENCE IN CONTINENTAL U.S. (If appointed
sbrood
HOME LEAVE RESIDENCE
Washington, D.C.
SEPARATED
Dayton, Ohio
MARITAL STATUS (Check one)
DIVORCED
WIDOWED
IF MARRIED, PLACE OF MARRIAGE
Dayton, Ohio
IF DIVORCED, PLACE OF DIVORCE DECREE
NA
1.WIDOWED, PLACE SPOUSE DIED
MA
PREVIOUSLY MARRIED, INDICATE NAME(S) OF SPOUSE, REASON(S) FOR TERMINATION, AND DATE(S)
MA
ANNULLED
DATE OF MARRIAGE
March 18, 1961
DATE OF DECREE
NA
DATE SPOUSE DIED
2.
MEMBERS OF FAMILY
NAME OF SPOUSE
ADDRESS ( Street, City, State, Zip Code)
TELEPHONE NOMEXICO CIT
Cesar Dustos-Videla
Apartado Postal 6-940, Mexico 6,D.F.MEXICO 525-42-36
NAMES OF CHILDREN
ADDRESS
SEX
DATE OF BIRTH
HA
DAME OF YOUR PATHER (Or male guarstian)
Samuel D. Zehrung.
SAME OF YOUR MOTHER (Or female guardian)
Nazel Zehrung
12
AD09E53
425 Dayton Towers Dr, Dayton, Ohio
ACONESS
Jame
TELEPHONE NO.
CENTRAL PRI
515-202-25502
TELEPHONE NO.
Same
WHAT MEMBER(S) OF YOUR FAMILY. IF ANY, HAS BEEN TOLD OF YOUR AFFILIATION WITH THE ORGANIZATION IF CONTACT IS.82-
QUIRED IN AN-EMERGENCY..
PERSON TO BE NOTIFIED DI CASE OF EMERGENCY
(Last First Middle)
SAVE (Mr., Mrs., Miss)
Cesar Bustos-Videla
HOME ADDRESS (No., Street,City, State, Zip Code)
Bee above
RELATIONSHIP
husband
HOME TELEPHONE NUMBER
see above
BUSINESS ADDRESS (No Street,City, State, Zip Codej and SAME OF EMPLOYER. IF APPLICABLE BUSINESS TELEPHONE & EXTENSION
Universidad de las Americas, Puebla, KEXICO
IS THE INDIVIDUAL NAMED ABOVE BITTING OF YOUR AGENCY AFFILIATION” (If "%a" give name and address of organiza
irm be believes you work for.)
YES
X
NO
yes:
THIS INDIVIDUAL AUTHORIZED TO DECISIONS ON YOUR SEHALF IN THE EVENT YOU ARE INCAPABLE! (I *Na*
name and address of person. It any, who can make such declare in case of cincy.)
YES
JUN 22 11 00 AM 270.
NO
DOES THIS INDIVIDUAL KNOW THAT HE HAS BEEN DESIGNATED AS YOUR EMERGENCY ADDRESSEE? (If one or is "No*
ezgin why in item 6.)
VES
✗
47
The persons named in itam 3 above may also be notified in case of emergency. IF SUCH NOTIFICATION IS NOT DESIRABLE BE-
CAUSE OF HEALTH OR OTHER REASONS, PLEASE 50 STATE IN ITEM 6 ON THE REVERSE SIDE OF THIS FORM.
:
61 USE PREVIOUS
ECITIONS.
CONFISDED ON REVERSE SIDE
CURRENT RESIDENCE AND DEPENDENCY REPORT
CONFIDENTIAL
(4)

14-00000
3.
CONFIDENTIAL
(When Filled in)
VOLUNTARY ENTRIES
Experience in the handling of employee emergencies has shown that the absence of certain personal data often delays and compli
cates the settlement of estate and financial matters. The information requested in this section may prove very useful to your family
or attorney in the event of your disability or death and will be disclosed only when circumstances warrant.
INDICATE NAME AND ADDRESS OF ANY BANKING INSTITUTIONS WITH WHICH YOU HAVE ACCOUNTS AND THE NAMES IN WHICH THE AC-
COUNTS ARE CARRIED.
All financial information is on file with our lawyer
Mr. John DAHLGREN
DAHLGREN DARRAGH & CLOSE
1000 Conn. Avc., N.W., Washington D.C.
ARE YOU A MEMBER OF THE NORTHWEST FEDERAL CREDIT UNION?
IF YES, DO YOU HAVE A JOINT ACCOUNT?
YES
☐ NO
YES
NO
HAVE YOU COMPLETED A LAST WILL AND TESTAMENTT
☑ YES
NO. (Il "Yes" where le document located')
On file with lawyer listed above
"
HAVE YOU PREPLANNED AN ARRANGED QUARDIANSHIP OF YOUR CHILDREN IN CASE OF COMMON DISASTER TO BOTH PARENTS?
YES
NO. (If "Yes" give name(s) and address)
NA
HAVE YOU EXECUTED A POWER OF ATTORNEY?
YES
NO. (If "Yee, who possess the power of attomey?)
Believe the lawyer has this also
6.
SIGNED AT
ADDITIONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMS
DATE
22 June 197
SIGNATURE
CONFIDENTIAL
barkatu z plasto Kal
14-00000
E
CONFENTTAL
(When Filled In)
MEMORANDUM OF UNDERSTANDING
I hereby acknowledge that I have read and understand the contents
of Handbook 20-4, Employee Conduct, dated 7 October 1963, and the
information brochure for PCS returnees, dated May 1964.
Signature
BUSTOS delu, Charlotte
CONFIDENTIAL
(When Filled In)
22
× 1870
Date
14-00000
SECRET
FIELD REASSIGNMENT. QUESTIONNAIRE
DO NOT COMPLETE
FOR HEADQUARTERS USE ONLY
MAME OF EMPLOYEE (was proudo only 18 SA) DATE ( from item 5.1) NAME OF SUPERVISOR (true)
Charlotte Bustos-Videla
DATE RECEIVED AT HEADQUARTERS.
26 Jan. 70 James B. Noland.
DISPATCH NUMBER,
2 Feb, 1970
HMMT-10102
DATE RECEIVED BY CAREER SERVICE,
10APH
TO BE COMPLETED BY EMPLOYEE
1. DATE OF BIRTH
18. SERVICE | 3.
DESIGN
YOUR CURRENT POSITION, TITLE
AND GRADE
4. STATION OR BASE
.
DATE (from item'S-2)
26 Jan, 19,0
5. CRYPT FOR
CURRENT COVER
12 Jan 29
:
OA. DATE OF PCS ARRIVAL
IN FIELD
28 July 1967
Exec Assistant, GS-11 MEXICO CITY Station
6. REQUESTED DATE OF
DEPARTURE
16 Aug 1970
Tourist
Oc. EXPECTED DATE OF FIRST 60. DESIRED DATE TO REPORT TO DUTY
CHECK-IN AT NO
AFTER LEAVE
Will not go Hdqa 26 Oct 1970
unless requested
7. NUMBER AND AGES OF DEPENDENTS WHO WILL TRAVEL WITH YOU!
none
3. PERSONAL CIRCUMSTANCES THAT SHOULD BE CONSIDERED IN DETERMINING NEXT ASSIGNMENT I
Subject wishes to remain overseas for a minimum of two more years to
complete her 5 years overseas requirement.
9. LIST YOUR MAJOR DUTIES DURING CURRENT TOUR (see special note on transmittal form).
(also attach personal covor questionnaire in accordance with C51-F 240-8)
:
1.
2.
During most of Subject's tour in Mexico she has been the Cuban IA.
In this job she also handled some Cuban operational matters
including two outside contract employees.
During this period she also handled some sensitive projects for
the CCS.
3. During the last six months bubject has been Exec Asst to the
COS/DCCS concentrating on file and administrative recrganization
of the Station.
h. Subject has had supervisory responsibility over one to three
clerical/TUY staff for short periods.
10. FRAIG DESIMEDI
INDICATE WHAT TRAINING YOU BELIEVE YOU SHOULD HAVE DURING THE NEXT SEVERAL YEARS
None
ES
202
SECRET
141
14-00000
SECRET
11. PREFERENCE FOR NEXT ASSIGNMENT -
11.
DESCRIBE BRIEFLY THE
IN ITEM NO. ABOVE.
TYPE
OK, YOU WOULD PREFER FOR NEXT ASSIGNMENT IF DIFFERENT FROM THAT INDICATED
"F YOU HAVE MORE THAN ONE PREFERENCE, INDICATE YOUR CHOICE.
I enjoy both Administrative and Ops, IA work.
118. 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 (for let, 2nd, and 3rd choice) IN REMAINING DONES.
COMPLETE ALL ALTERNATE CHOICES AND OPTIONS IN ALL CASES EVEN THOUGH YOU ARE REQUESTING AN EXTENSION OF YOUR
TOUR.
3
i
EXTEND TOUR
12
MONTHS AT CURRENT STATION-TO Aug 1971
(DATE)
☐ BE ASSIGNED TO HOOTRS FOR A TOUR OF DUTY: INDICATE YOUR CHOICE OF DIVISION. STAFF OR OFFICE.
IST CHOICE.
2ND CHOICE
3RD CHOICE
STATION: INDICATE CHOICE OF GEOGRAPHIC AREA OR SPECIALIZATION
2ND CHOICE,
AD CHOICE
1.☐
BE ASSIGNED TO ANOTHER FIELD
EST CHOICE. Paris
2 ☐ RETURN TO MY CURRENT STATION for 2nd tour.
TO BE COMPLETED BY FIELD STATION
12. IN CONSIDERATION OF THE EXPERIENCE AND PERFORMANCE OF THE EMPLOYEE AND HIS PREFERENCE FOR NEXT ASSIGNMENT,
INDICATE YOUR RECOMMENDATION FOR HIS NEXT ASSIGNMENT AND TRAINING!
Would not stand in Subject's way, were she to be fortunate enough to
get a Paris assignment. However with her long Mexico background (both
Hdgs and field) and her multiple talents she has been invaluable in the
reorganization of this highly complicated Station under changed
circumstances, will continue to be so during the next several years
and to lose her would be like losing one's right arm. Therefore we
strongly endorse either a second tour or an extension.
13.
TO BE COMPLETED BY APPROPRIATE HEADQUARTERS OFFICE
IN CONSIDERATION OF THE EXPERIENCE AND PERFORMANCE OF THE EMPLOrtz HIS PREFERENCE FOR NEXT ASSIGNMENT.
AND THE STAFFING REQUIREMENTS OF YOUR COMPONENT. INDICATE YOUR COMPONENT'S RECOMMENDATION FOR HIS NEXT
ASSIGNMENT AND TRAINING.
WI Division recommends that subject return to Mexico City for a second tour.
DATE 11 Mar 70 C/Rd/Pars
14. APPROVED
ASSIGNMENT.
New tour in Mexico City,
SIGNATURE Henry L. Berthold
FOR USE BY CAREER SERVICE
TS, EMPLOYEE NOTIFIED OF DISPATCH NO, GATED.
CABLE 0.
DATEDI
20
Can i *EPRESTATATIVE
161806guret
SECRET
DATE,
14-00000
CONFIDENTIAL
(When Filled In)
Complete in original. The data recorded on this form is essential in determining travel expenses allowable in con-
nection with leave at government expense, overseas duty, return to residence upon separation, and for providing
Current residence and derendency information required in the event of an employee emergency. This form will be
files in the employee's official personnel folder.
NAME UP EMPLOYEE (LOA!)
1.
BUSTOS. VIDELA
(First)
RESIDENCE DATA
PLACE OF RESIDENCE WHEN INITIALLY EMPLOYED BY AGENCY
WASHINGTON DC
(Middle) 9OCIAL SECURITY NUMBER
2
649-24-5/38
LAST PLACE OF RESIDENCE IN CONTINENTAL U.S. (If appointed
abrood
DIRECTOR OYICED
approved
PLACE IN CONTINENTAL U.S. DESIGNATED AS PERMANENT RESH
DENCE
WASHINGTON
DC.
2.
SINGLE
☑
MARRIED
SEPARATED
N.A
HOME LEAVE RESIDENCE A
Crever AND
MARITAL STATUS (Check one)
DIVORCED
0410
Afton,
IF MARRIED, PLACE OF MARRIAGE
DAYTON. CHIO
IF DIVORCED, PLACE OF DIVORCE DECREE
NA
NA
IF WIDOWED, PLACE SPOUSE DIED
WIDOWED
oor & June 7
ANNULLED
DATE OF MARRIAGE
march 18, 1961
DATE OF DECAKE
DATE SPOUSE DIED
IF PREVIOUSLY MARRIED, INDICATE NAME(S) OF SPOUSE, REASON(S) FOR TERMINATION, AND DATE(S)
NA.
1.
MEMBERS OF FAMILY
NAME OF SPOUSE
CESAR
Busros - VIDELA
NAMES OF CHILDREN
ADDRESS (No Street,City, State, Zip Code)
LAS AMERAS UNIV., MEXICO CITY, HEVC
ADDRESS
TELEPHONE NO.
SEX
DATE OF BIRTH
HAMP GP YOUR PATHER for mate guardian)
SAMUEL
ZAMONG
NAME OF YOUR MOTHER (or female guardion)
HALEL J. ZEHRUNG-
ADDRESS 1. Das USER ST
425 DAMEN SWAS ROAD
DATA coko.
TELEPHONE NO.
ADDRESS
Same
TELEPHONE NO.
"
WHAT MEMBER(S) OF YOUR FAMILY IF ANY, HA3-BEEN TOLD OF YOUR AFFILIATION WITH THE ORGANIZATION IP CONTACT IS HP.
QUIRED IN AN EMERGENCY.
am tables all ing family I am res 16 July 67.
PERSON TO BE NOTIFIED IN CASE OF EMERGENCY
4.
NAME (Mr., Mrs., Mine)
(Last-First-Middle)
miz.
FLAUMER
.
Mary
HOME ADDREss the Street,City, State, Zip Code)
Zhzabeth
576 LAKE TOKEST DRIVE ΚΑΙ VILLAGE CHIC
(MAS "DALE)
44140
BUSINESS ADORESS (No., Street, City, State, Zip Code) AND NAME OF EMPLOYER, IF APPLICABLE
RELATIONSHIP
5157613
- - g
HOME TELEPHONE NUMBER
216. 871-068 7
BUSINESS TELEPHONE & EXTENSION
IS THE INDIVIDUAL NAMED ABOVE WITTING OF YOUR AGENCY APPILIATION? (II "No" give name and addreas of organiza-
tion be believes you work fur.)
only with
d
to cure forgot.
IS THIS INDIVIDUAL AUTHORIZED TO MAKE DECISIONS ON YOUR BEHALF IN THE EVENT YOU ARE INCAPABLE! (If "No"
elve name and is of person, I my, who call make such doristane bì case of emergency.)
Lawyer
11. Esite
←
با میانی ماتا کم کم یکے
Play
проталки
BOES THIS INDIVIDUAL KNOW THAT HE HAS BEEN DESIGNATED AS YOUR EMERGENCY ADDRESSEE' (II anewer to "No"
spin why in Heim 0.)
Yes
NO
Á
YES
NC
YFS
i No
The persons named in item 3 above may also be notified in case of emergency. IF SUCH NOTIFICATION IS NOT DESIRABLE BĘ.
CAUSE OF HEALTH OR OTHER REASONS, PLEASE SO STATE IN ITEM 5 ON THE REVERSE SIDE OF THIS FORM.
FLUM
QSE PREVIOUS
3.37
EDITIONS.
CONTINUED ON REVERSE SIDE
CURRENT RESIDENCE AND DEPENDENCY REPORT
CONFIDENTIAL
14)
14-00000
".
CONFIDENTIAL
(When Filled In)-
VOLUNTARY ENTRIES
Experience in the handling of employed emergencies has shown that the absence of certain personal data often delays and compli
cates the settlement of estate and financial matters. The information requested in this section may prove very useful to your family
or attorney in the event of your disability or death and will be disclosed only when circumstances warrant.
--
INDICATE NAME AND ADDRESS OF ANY BANKING INSTITUTIONS WITH WHICH YOU HAVE ACCOUNTS AND THE NAMES IN WHICH THE AC-
COUNTS ARE CARRIED.
The naternal Bank of Washington, Diceyond Cursus Brauche, Washington
joint account with husband
Columbia Tural Savings & Roan Assoc, 5201.ise aut.n.w.0.0.
joint
account with iusband.
مان
:
ARE YOU A MEMBER OF THE NORTHWEST FEDERAL CREDIT UNION?
IF YES, DO YOU HAVE A JOINT ACCOUNT?
♥69
NO
VES
baht.
1000
yun barra
Surmave..
HAVE YOU COMPLETED A LAST WILL AND TESTAMENT? ☑ YES
langer: Ms Join & Lahlgren
NO. ( "Yes" whore le document located?)
Close
HAVE YOU PREPLANNED AN ARRANGED GUARDIANSHIP OF YOUR CHILDREN IN CASE OF COMMON DISASTER TO BOTH PARENTS1
YES [2] NO. (II "Yes" give name(s) and address)
HAVE YOU EXECUTED A POWER OF ATTORNEYT
for accagting alles. The nation st Bank
YES
NO. ("Yes", wh presses the power of attomey?)
Washingtry
ADDITIONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMS
SIGHED AY
CAVE
SIGNATURE
hine 28 1967 | (nu I fish tai a
CONFIDENTIAL
14-00000
_ GRET
ELECTION, DECLINATION, OR WAIVER
OF LIFE INSURANCE COVERAGE
FEDERAL EMPLOYEES GROUP LIFE INSURANCE PROGRAM
TO COMPLETE THIS FORM-
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.
IMPORTANT
AGENCY INSTRUCTIONS
ON BACK OF ORIGINAL
1
2
NAME (last)
(first)
(middle)
Bustos-Videla
Charlotte
EMPLOYING DEPARTMENT OR AGENCY
Louise
007667
DATE OF BIRTH (month, day, year)
January 12, 1929
LOCATION (City, State, ZIP Code)
SOCIAL SECURITY NUMBER
069
24 3138
FILL IN THE IDENTIFYING INFORMATION BELOW (please print or type):
MARK AN "X" IN ONE OF THE BOXES BELOW (do NOT mark more than one):
Mark here
if you
WANT BOTH
X
optional and
regular
ELECTION OF OPTIONAL (IN ADDITION TO REGULAR) INSURANCE
elect the $10,000 additional optional insurance and authorize the required deductions
from my salary, compensation, or annuity to pay the full cost of the optional insurance.
This optional insurance is in addition to my regular insurance.
insurance
Mark here
if you
DO NOT WANT
OPTIONAL but
do want
regular
insurance
Mark here
if you
WANT NEITHER
regular nor
optional
insurance
(B)
(C)
DECLINATION OF OPTIONAL (BUT NOT REGULAR) INSURANCE
I decline the $10 000 additional optional insurance. I understand that I cannot elect op
tional 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 evidence
of insurability. I understand also that my regular insurance is not affected by this declina-
tion of additional optional insurance.
WAIVER OF LIFE INSURANCE COVERAGE
I desire not to be insured and I walve coverage under the Federal Employees Group Life
Insurance Program. I understand that I cannot cancel this waiver and obtain regulár in-
surance until at least 1-year after the effective date of this waiver and unless at the time
1 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.
SIGN AND DATE. IF YOU MARKED BOX "A" OR "C".
COMPLETE THE "STATISTICAL STUB." THEN RETURN
THE ENTIRE FORM TO YOUR EMPLOYING OFFICE.
SIGNATURE (do not print)
Oliarister Z - Rust-Vin
DATE
13 February 1968
FOR EMPLOYING OFFICE USE ONLY
(official receiving date stamp)
ORIGINAL COPY-Retain in Official Pi
SECRET
der
Sea Table of Effective Dates on back of Original
STANDARD FORM N. 175-T
JANUAR 1968
(For use only Apr 14, 1968)
176-101
14-00000
TO:
SECRET
(Than Filled In)
REPORT OF SERVICE ABROAD
Office of Personnel, Transactions and Records Branch, Status Section
NAME
SERIAL NO.
LAST
FIRST
1.0
(Print)
7.24
007667
BUSTOS VIDELA
CHARLOTTE
INSTRUCTIONS
MIDDLE
2
USE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TOV, 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. 60. REVISED.
COUNTRY
CODE
40.48
PCS DATES OF SERVICE
ARRIVAL 0/0
DEPARTURE 0/9
TYPE OF DATA
MONTH
25-20
DAY
27.20 20.30
YEAR
MONTH
31-32
DAY
YEAR
33-34 36-26
CODE
.
072867
1 PCS (Basic)
CONNECTION
CANCELLATION
37
0/P
USE
ONLY
30 29
MEXICO
l
TDY DATES OF SERVICE
ARRIVAL 0/8
DEPARTURE 0/8
TYPE OF DATA
MONTH
25-26
DAY
YEAR
27-28 29.30
MONTH
31-32
DAY
YEAR
CODE
O/P
USE
ONLY
AREA(G)
•
TOY (Basic)
33-34 35-38 •
37
CORRECTION
20 39
CODE
40.42
•
• CANCELLATION
TRAVEL VOUCHER
CABLE
OTHER (Spocily)
:
DOCUMENT IDENTIFICATION NU.
FORM 764
REMARKS
OFFICE OF PERSONNEL USE ONLY - PUNCH AREA
SOURCE DOCUMENT AND CERTIFICATION
DISPATCH
X OUTY STATUS OR TIME AND ATTENDANCE REPORT
DOCUMENT DATE/PERIOD
29 JULY 1967 --
ARRIVAL DATE REPORTED UNDER "OTHER PRMARKS" ON DUTY STATUS REPORT.
ABOVE DATA CERTIFIED CORRECT. BASED UPON SOURCE
PREPARED BY
EVOOT ANNOTATED
CONTROL GOCUMENT
CAL
CT52.
DATE
SIGNATURE
☑
•
DIVISION
16 APR 1968
DOCUMENT CITED
7. Lanary
THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNEL
IN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDER
FROM 1451a
3-07
SSITION
SECRET
GOLF?!
14-10)
14-00000
SECTION 1
EJAR SER NO
6 40
SECRET
44 fal
QUALIFICATIONS SUPPLEMENT TO PERSONAL HISTORY STATEMENT
OFFICIAL USE ONLY funt
READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING INFE OR PRINT AVOID USING LIGHT COLORED INKS
BIOGRAPHIC AND POSITION DATA
3 SEX DATE OF BIRTH
2 NAME Lost First Middle
597067
BUSTOSVIDELA C
7 POSITION TITLE
.OPS OFFICER
• OFFICE OF ASSIGNMENT
WH
01/12/29
LOCATION Country (108)
-S SCHEDULE, GRADE/STEP
GS--23-06
MEXICO CITY, MEXICO
SECTION
AREA
46 OVERSEAS SERVICE
MEXICO CITY
STATION
AGENCY. OVERSEAS SERVICE
1st tour
2nd tour
OVERSEAS CATA
DATE:
60 JU
INITIALS: S
EDUCATION
MAIOR FIELD
SECTION
DEGREE
NACH
ECONOMICS, GENERAL
F0R4
167 444)
Mhy 201
TYPE TOUR
FROM
10
27. Junt 1967
N JUNE 1970
1970
COLLEGE
SYRACUSE UNIV NY
YEAR
50
35
"
SECRET
(451)
14-00000
DATE
SECTION D
SECRET
Won't lied in'
MARITAL STATUS
PRESENT STATUS Engle Married Widowed orced. Annulled Some SPECIN
2 NAME OF SPOUSE
'LoT'
3 DATE OF BIRTH
Feb
3. OCCUPATION
BASICS VIDELA
Cisar
4 PLACE OF BIRTH 16.
27. 1922
SAN
JUAN
6 PRESENT EMPLOYER
ARGENTINA
PROFESSOR
7. CITIZENSHI
USA (naturalized)
SECTION X
NAME
LLN, VERSIDAD
• FORMER CITIZENSHIP,S' COUNTRYTIES)
Argentine
DE LAS
DEPENDENT CHILDREN AND DEPENDENTS OTHER THAN SPOUSE
DATE AND PLACE OF BIRD
RELATIONSHIP
CITIZENSHIP
Ma-den
Cholula,
AMERICAS, MEXICU
DATE US CITIZENSHIP ACQUIRED
1956
PERMANENT ADDRESS
SECTION XI
PROFESSIONAL SOCIETIES AND OTHER ORGANIZATIONS
NAME AND CHAPTER
ADDRESS ber, Sweet City State, Counity!
DATE OF MEMBERSHIP
82001
10
22 Juni 1970
SIGNATURE OF EMPLOYEE
Charlie & Bustos Thaila
SECRET
.7.
に

14-00000
CERTIFICATION OF
LANGUAGE PROFICIENCY
1 EMPLOYEE NO. 2.
NAME (LAST-FIRST-MIDDLE)
3. TYPE CHANGE
A-ACC
CODE
4 LANGUAGE PATA PR104
LAN. COUE
TO TEST
R
S
UT YEAR
BUSTOS VIDELA, CHARLOTTE
C CHANGE
BEDELETE
LANGUAGE DATA AFTER TEAT
LAN CODE R W
6 DATE TESTED
7 CATE OF BIRTH
8. GRADE
orrice
OR DIVISION
P S U I/T YEAR
10/17/72
01/12/29
13
WH
NOTICE TO PERSON TESTED
10. ON THE DATE SHOWN IN ITEM 6 ABOVE, YOU WERE TESTED IN SPANISH- (NEW WORLD)
BLIS
AND YOUR TEST SCORES ARE AS FOLLOWS:
(NAME OF LANGUAGE)
READING
WRITING
N
+
PRONUNCIATION: SPEAKING
UNDERSTANDING
I+
H
TEST
RATINGS
11. REMARKS
"4" indeh
CL BY 017470
EX-2 IMPDET
Speaking grade.
Q = ZERO 1
S BLIGHT H = HIGH
E ELEMENTARY N # NATIVE
12. SIGNATURE
R18
INTERMEDIATE
WISMI
FORM
OBSOLETE PREVIOUS
11-64
1273
EDITIONS
13. LD NUMBER
20723
CONFIDENTIAL
(10.45) SEGRET
SNOYUTS FROM
GROUP +
AND DECLASS
1 . OPIQAB
1 JAZMUST CONTAIN 20-DIGITS
20
4. DATE OF BIRTH
MO
DA
YR
5. DATE CODED
MO
DA
YA
ITCMS 2 THAU 5) WILL BE FILLED IN
THIS
FORM IS THEN ATTACHED TO FORM 1962, MASTER QUALIFICA-
TIONS CODING RECORD.
LANGUAGE CODING DATA - FORM 444c
THE DATA ABOVE
WHEN CODING AN APPLICANT FOR THE FIRST TIME,
1. 10
3
2. EMPLOYEE NO. 3. HAVE
3-LETTERD
4 LANGUAGE DATA CODK
BASE CODE
R
P
S
YR
15. DATE SUBMITTED
MO
DA
YR
6. LATE OF BIRTH
MU
DA
YR
€
1. 10
2 EMPLOYEE NO
NAME
3-LETTERS
<5 $67667 Bus.
15, LANGUAGE DATA AFTER TEST
HASE CODE
WHEN FORM 44C DENOTES NO LANGUAGE
COMPETENCE, ENTER THE FOLLOWING IN
ITEM 4: "NO++LANGUAGE" (12-016176)
LANGUAGE PROFICIENCY TEST DATA
BL18 NiHiHug
1. 10 12. EMP/APPL NO 13
PLAME
3-LETTERS
。 4
YR
CODE
C-A-D
с
☐ LANGUAGE DATA DE
BASC CODE
°
BL18
7. DATE OF TEST
MO
DA
YA
72/14/17172
QUALIFICATIONS RECORD CHANGE
ENTER UNDER "TYPE"
A - ADDITION TO RECORD
C
D
CODE #1
TYPE
BASE
2
YR
77H7745
DATA FOR ITEM 2 THRU 7 IS
EXTRACTED FROM FORM 1273.
LANGUAGE PROFICIENCY AND
AWARDS DATA.
CHANGE TO EXISTING RECORD
DELETION OF DATA FROM EXISTING RECORD.
BASE
CODE # 2
2
YR
10
IDAM
10.44
°
•
•
1962a
SECRET
GROUP !
14-32)
s
14-00000
SECRET
(WHEN FILLED IN)
CERTIFICATION OF LANGUAGE PROFICIENCY
1 EMPLOYEE NO. 2.
NAME (LAST-FIRST-MIDDLE)
BUSTOG-VIDHIA, CHARLOTTE 2.
$7667
LANGUAGE DATA AFTER TEST
OCATE TESTED
cort
4. LANGUAGE DATA PRIOR TO TEST
LAN. CODE R W P S UI/T YEAR
13. TYPE CHANGE
A=400
CFCHANGE
0-DELETE
DATE OF BIRTH 8 GRADE 19. OFFICE OR DIVISION
LAN CODE R W P S U 1/T YEAR
NOTICE
10. ON THE DATE SHOWN IN ITEM 6 ABOVE, YOU WERE TESTED IN SPANISH (NEW WORLD)
AND YOUR TEST SCORES ARE AS FOLLOWS:
06/22/67
TO
01/12/29
13
WH
PERSON
TESTED
BL18
(NAME OF LANGUAGE)
'
READING
WRITING
PRONUNCIATION
SPEAKING
UNDERSTANDING
$
TEST
RATINGS
I
CODED
H
I
I.
11. REMARKS
FOR
QUALIFICATIONS
DATE 1
25 AUG
FORM
.1273
OBSOLETE PREVIOUS
EDITIONS
2 - ZERO 1 = INTERMEDIATE
SBLIGHT H * HIGH
E ELEMENTARY N = NATIVE
12. SIGNATURE
13. LD NUMBER
kia
14168
1 - OP/QAB
GROUP 1
EXCLUDED FROM AUTOMATIC DOWNGRADING
AND DECLASSIFICATION
112-FIV
(10-45)
SECRET
11LM 4. NU LANTUMUL
1. 10
2. EMPLOYEE NO. 3. NAME
3-LETTERS
<5 #57667° BULS
O. LANGUAGE DATA AFTER TEST
BASE CODE
"BL18
P
LANGUAGE PROFICIENCY TEST DATA
CODE
C-A-D
ре
15. LANGUAGE DATA BEFORE TEST
BASE CODE
•BL18
7. DATE OF TCST
iiHii467°16
12. EMP/APPL NA
1. ID
0 4
°
NAME
3-LETTERS
CA
18
16/22/67
QUALIFICATIONS RECORD CHANGE
ENTER UNDER "TYPE" -
DATA FOR ITEM 2, THRU 7
EXTRACTED FROM PEAM 127.
LANGUAGE PROFICIENCY AND
AWARDS DATA.
2
OCT 1967
TYPE
A
- ADDITION TO RECORD
C
D
CHANGE TO EXISTING RECORD
DELETION OF DATA FROM EXISTING RECORD
CODE # 1
BASE
2
YR
BASE
CODE #
2
10
7334
14
1962a
YR
SECRET
GROUP 1
14.236
14-00000
1. PERSONNEL STRAL NO (1-6)
SECRET
(When Filled in)
LANGUAGE PROFICIENCY AND AWARDS DATA
MIODAR
4 OFFICE OR DIVISION
SP
SLAMME
7.10 NO
thith
6 LANO CODE (25 17)
780
3 NAME (7-24) LAST
FIRST
Charlotte
7. DATE OF TEST 46-31
8 ANNIVERSARY DATE
9 QRADE
10 DATE
12
1980
11 REASON FOR TAKING TEST
3 APPLY FOR AWARD
12.
READING (34)
WISTING (35)
TEST SCORES
PRONUNCIATION (36)
ESTABLISH SKILL LEVEL
SPEAKING (37)
У
UNDERSTANDINO (28)
ཝཱ
13. ELIGIBRITY (30)
14.
23A
ACHIEVEMENT (N)
ELEMENTARY
INTERMEDIATE
TYPE OF AWARD
READING (R) SPEAKING (5)
M
. MAINTENANCE
HOM
19
02
COMPREHENSIVE TO
BASED ON TRAINING THAT WAS
DIRECTED (D) OR VOLUNTARY (V
NA
A
E-I
C
ሃ
15. INELIGIBLE (REASON)
REMARKS
16. I CERTIFY THIS EMPLOYEE FOR A PROFICIENCY AWARD OF $) (0.00 (40-43)
SIGNATURE
BATE
17 I CERTIFY THAT FUNDS ARE AVAILABLE
OBLIGATION REF. NO.
SIGNATURE
FORM
560
1273
OBSOLETE PREVIOUS
EDITIONS
SECRET
CHARGE ALLOTMENT NO.
(1345)
MRD COPY
14-00000
°
SECRET
When Fillet Too
THIS DATE
PERIODIC SUPPLEMENT
PERSORAL MISTORY STATEMENT
INSTRUCTIONS
AUG
10 September 1957
This form provides the seams wheraly out official personal records will be best current. Even though it duplicates
information you have furnished previously, it all bees for new to complete to the sugh XL in shell
entirety.
You need complete Sertione / through All only
the organisation or if you believe the few requires more complete
change since you entered on duty with
than you have previously reported.
SECTION 1
GENERAL
1. FULL NAME (Lest-Piratado)
ZEHRUNG, Charlotte L.
1
2. CURRENT ADDRESS (No., Street, City, Zone, Statej
3817 Davis Place, 5. M., Washington
.. HOME TELEPHONE NUMBER
Em 2-1618
1.
3. PERMANENT ADDRESS (No.. Street, City, Zone, State)
5536 South Lixie Highway, Dayton 9, Ohio
9. STATE, TERRITORY, POSSESSION OR Counter 14 WHICH YOU NOW CLAIM NESIDENCE
Ohio
!
PERSON TO BE NOTIFIED IN CASE OF EMERGENCY
2. PELATIÒN SHIP
Father
SECTION
1. NAME (Lost-Piratoriddle) PREFFRANCY PESTUING IN U.S.
REURUNG, Dammel Dasion
3. HOME ADURESS (No, Street, City, State, Country).
5536 South Dixie Kasey, Dayton 9, Ohio
4. BUSINESS ADDRESS (Y., Street, City, Lone, State, Country), INDICATE NAME OF FIRM OR EMPLOYER, IF APPLICABLE
San Has Gardens
5536 South: Dixio Higher, Dayton 25 Ohio.
D. HOME TELEPHONE NUMBER
MO 3-3511.
t BUSINESS TELEPHONE NUMBER
10 3-3511
". BUSINESS TELLPHONE EXTENSION
None
" BUCH NOTIFICATION
5. IN CASE OF EMERGENCY, OTHER CLOSE #TIVE (Spouse, Mother, Father) MAY ALSO SE NOTIFIED.
13 NOT DESIRABLE BECAUSE OF HEALTH OR OTHER REASONS, PLEASE SO STATE.
SECTION 111
MARITAL STATUS
1. Check (n) 34.
2
MNICHIED
FURNISHall, PLACE AND REASON #10 GA SIGNATIONS, DIVORCES OF ANN GUMENTA
°
☐ ☐☐
ANMUU
separate shaet
for former wife of
SPOUSE If you have been sarried 201 ten once, including annulments, 430
husband geing date befoe fut all previous marriapon. 17 marriage is contemplated, provide same data for finach.
2. NAME
(Flex)
(Middle)
(Mardon)
$. DATE OF MARKTAGE
"LACE OF RIAGE (City, State, Counits;
20 OF SPOUST ONE WARNFAG: 199 Street, City, State, Compity)
3. LIVING
DATE
OF REATM
716
10. CURRENT
*ESS GIVE
13.
BATE " 2:2TH
13.
90
13- CEZA (Unity;
13 OC PAPLITH
2. CAUSE OF DEATH
of desmasect)
112.
PLACE
# (City, State, Country )
ོརྟོ*།! ་་ སྦེ་༔ *
1000111ike.
416 61
1 PLACE OF INTRY
16. CATE, ACQUI
(Last)
1:1
QUALIFICATIONS
DATE: 11
233
1358
JUN 1952
11.
of spouse
10 deceased of
PRESENT EMPLOYER (Also pose)
aleyad, jest two
Street, City, State Counter:
SECTION 111 COED to Past 2
SECRET
14-00000
SECTION
7.
DATES OF MILITARY SERVICE OF SPOUST (From
72. BRANCH OF SERVICE
SECRET
(Nem Filled in)
111 CONTINUED FROM PAGE
and too 3 MOUTH AND 754
74 DETAILS OF OTHER GOVERNMENT SERVICE. U.B. OR FOREIGN
COUNTRY
# 1 TH HICH -ILITOR
SECTION IV
"
RELATIVES BY BLOOD, MARRIAGE OR ADOPTION LIVING ABROAD OF WHO ARE NOT U.S. CITIZENS
FULL NAME (Lost-Virat-Middlej
:
RELATIONSHIP
J. 465
4. ADDRESS OR COUNTRY IN WHICH PELATIVE RESIDES
". CITIZENSHIP (Country)
1. FULL NAME (Lost-Pret-Middle)
QUENCY OF CONTACT
4. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES
S. CITIZENSHIP (Country)
6. FREQUENCY OF CONTACT
FULL NAME (Lost-Pirot-Middlej
ADDRESS OR COUNTRY IN WHICH WELATIVE RESIDES
CITIZENSHIP (Country)
8. FREQUENCY OF CONTACT
1.
FULL NAME (L-l-Middle)
4.
ADDRESS OR COUNTRY IN WHICH PELATIVE RESIDES
3. CITIZENSHIP (Country)
7. DATE OF LAST CONTACT
2. RELATIONSHIP
3. AGE.
7. DATE OF LAST CONTACT
2.
RELATIONSHIP
1. DATE OF LAST CONTACT
#ELATIONSHIP
". FREQUENCY OF CONTACT
7. DATE OF LAST CONTACT
5. SPECIAL REMARKS. " AMY, CONCERN195 THESE RELATIVES
SECTION V
ARE YOU ENTIRELY DEPENDENT 04 YOLE SALAR('
FINANCIAL STATUS
ve
NO
a. AGE
3. AGE
CONGRATIONS OR BUSINESSES OR IN OB
IF YOU HAVE
☐YYS ☐ NO
E. SO YOU HAVE ANY CHANCIAL INT, OR OFFICIAL CONNECTION WITH, 405
5TH U.S. CORPORATIONS ON BUSINESSES WAVING SUBSTANTIAL FOREIGN INTERES
ANSWERED "YES. GAME COMPLETE DETAILS ON A SEPARATE SHEET AND ATTACH IN & SEALED ENVELOPE.
20 YOU RECEIVE AN ANQUETY FROM THE UNITED STATES OR DISTRICT OF COLUMBIA GOVERNMENT UNDER ANY RETIREMENT ACT
PENSION. ON COMPENSATION FOR MILIT967 GR NAVAL SERVICES
4. IF YOU HAVE ANSWERED
☐
715
TO QUISTIGH 3 ABOVE. GIVE CONFLETS LETAILS,
5. #17HOUT REFERENCE TO roue SALARY, STATE OTHER SOURCES IN Attre 507 INDICATED BY PRECEDING ITEMS.
SECTION V CONTINUED TO PAGE
SECRET
2
14-00000
SECRET
(when illed in:
SECTION V CONTINUED FROM PAGE 2
$0.69 INSTITUTIONS WITH quitar w ACCOUNT7
HAMS
Co
1071914
Citizens Federal Savings & Loan Asan.
Rigga National Bank
565 (City
State, Country)
Dayton, Ohio
Washington, D. C.
7. HAVE YOU EVER DIEN IN, ON PERS9SQWED TO,
NANKRUPTCYP
YES 1× NO
8. IF YOU HAVE ANSWERED "YES" TO QUESTICO 7 ABOVE. GIVE PARTICULARS, INCLUDING COURT AND DATE(S)
• SECTION VI
1. COUNTRY OF CURRENT CITLI
US
CITIZENSHIP
12, CITIZENSHIP ACQUIRED BY CHICK { "i ONE 1
☐
UTHER (Specify)
3. HAVE YOU TAKEN STEPS TO CHA
**
4. GIVE PARTICULANS
PRESENT CITIZENSHIPT ☐
"%
☑-
8. IF YOU HAVE APPLIED FITIZENSAS, INDICATE PRESENT STATO F THER APPLICATION (FIRE paport, *tc.)
SECTION VIL
EDUCATION
1. 64958 (5) 5T LEVEL OF EDUCATION ATTAINTO
L
than HIGH SCHOOL
MICH SCHOOL GRADUATS
PADL. AUSW24, 47 C
3881 SKARGATE
CULISO6
4.
NO DICOFT
***
LEADING 1. NIGHIN DELORE
2 COLLIGE DR L.NIVERSITY きたない
Subit (t
SATE ATTENDED
SAME AND LOCATION OF
OR UNIVIS317
DEGREE
REC D
SEM/OTH .
Gatt
SECTO
10
COMPLETED
(Specify)
SASTAL AND SPECIAL BUSES
DATES ATTENDED
NAME OF SCHOO
STUDY OR SPECIAL1741964
TOTAL,
HOUS
4.
MILITARY TRAINING (Full
20 sportatioed schoals with 4 12 F
Intelligence. Co-sunication
DATES ATTENDED
SAME OF $44032
STUDY OR SPECIALIZATION
TOTAL
223
nt Act
SECRET
14-00000
2
3
"
SECRET
Cahon Filled In;
SECTION X CONTINUED FROM PAGE 4
7. LIST ANY SIGNIFICANT PUBLISHED MATERIALS OF WHICH YOU ART THE AUTHOR (Do not subert copies unless requested);
INDICATE TITLE, PUBLICATION DATE, AND TYPE OF BRITING (Non-fiction, scientific articles, general interest sub-
jecia, novels, short stories, etc.)
a. INDICATE ANY DEVICES WHICH YOU HAVE INVENTED AND STATE WHETHER OR NOT THEY ARE PATENTED
9. LIST ANY PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE
10. LIST ANY PROFESSIONAL, ACADEMIC OR MONCRARY ASSOCIATIONS OR SOCIETIES IN WHICH YOU ARE NOW OR WERE FORMERLY A
MEMBER. LIST ACADEMIC HONORS YOU HAVE RECEIVED.
$.
SECTION XI ORGANIZATION WORK EXPERIENCE - SINCE LAST COMPLETION OF A PERSONNEL QUALIFICATIONS QUESTIONNAIRE
INCLUSIVE DATES (From. and To-)
27 Aug 51 - 27 Apr 52
4. NO. OF EMPLOYEES UNDER YOUR DERECT
SUPERVISION
4. DESCRIPTION OF DUTIES
°
2. GRADE 3
OFFICE/DIVISION/BRANCH OF ASSIGNMENT
DDP/WH/II (Hqs)
3. OFFICIAL POSITION TITLE 1
Secretary (Steno).
1. INCLUSIVE DATES (Prom and To-)
27 Apr 52 - 27 Sept 53.
4. NO. OF EMPLOYEES UNDER YOUR DIRECT
SUPERVISION
4. DESCRIPTION OF DUTIES
2. GRADE 3. OFFICE/DIVISION/BRANCH OF ASSIGNMENT
5.
2 DDP/WH/II-(Hqs )--
OFFICIAL POSITION TELES
Intell Officer (Rpts)
All duties of Reports Officer
INCLUSIVE DATES (From. and Tuy
27 Sept 53 - 10 Apr 55
8. 49.
EMPLOYEES UNDER YOUR DIPECT
SUPERVISION
one to two
15. LL3CRIPTION OF DUTIES
2. GRADE J. OFFICE/DIVISION/BRANCH OF ASSIGNMENT
5.
2
DDP/WH/II (Has)
OFFICIAL POSITION TETLE
Reports Officer
Duties of Chief reports officer af
INCLUSIVE, DATES (From- and To.)
2.
10 Apr 55 - June 1957
4. NO. OF EMPLOYEES UNDER YOUR DIRECT
SUPERVISION
one -
two
4. DESCRIPTION OF DUTIES,
INCLUSIVE DATES T Pronk
June 1957
-
present
To+)
4. NO. OF (Lories UNDER YOUR DIRECT
SUPERVISI09
DESCRIPTION OF DUTIES
/!SION/BRANCH OF ASSIGNMENT
11.
3.
DDP/H/II (Hoa).
OFFICIAL POSITION FITLE
Chief Reports Officer_
GRACE
11
04/01ISION/BRANCH OF ASSIGAMENT
DOP/WH/ITI (Hqs)
OFFICIAL POSITION TITLE
Reports Officer
SECRET
{" additional peger if required;
८
14-00000
:
SECTION XII
".
ARE UNMARRIED.
AND ARE NOT SELF.
SECRET
(Then Filled in)
CHILDREN AND OTHER DEPENDENTS
HUNDER OF CHILDREN (Including stepchildro:
and adopted children)
UNDER 21 YEARS OF AGE.
SUPPORTING.
DESICE OF PERSONNEL
NUMBER OF OTHER DEFINDENTS (Including space.
parents. stepparents, stater, etc.)
UND DEPEND ON YOU FOR AT LEAST 50% OF
THEIR SUPPORT, GR. CHILDRENDERY
OF AGE__ARK_NG 1. ALLE, SUPPORTA
3. PROVIDE THE FOLLOWING INFORMATION FOR ALL CHILDREN AND DEPENDENTS
NAME
RELATIONSHIP
YEAR OF BIRTH
"
SEX
CITIZENSHIP
STARS
P.AZ 3-42 PM 57
ADDRESS
MAIL-ROOM
ADDITIONAL COMMENT AND/OR CONTINUATION OF PRECEDING ITEMS
DATE COMPLETED
Charters
SECRET
14-00000
PERSONNEL SERIAL NO. 11.61
3. NAME 17.241
-
ཀ — * }
SECRET
(When Filled In)
LANGUAGE PROFICIENCY AND AWARDS DATA
4. COMPONENT
5. GRADE
LD NO.
་་:t
6. DATE OF BIRTH
7. LANGUAGE
0 Cock (25.27)
9 DATE OF TEST
1001
10. ANNIVERSARY DATE (20.33)
11. TEST PURPOSE
12.
READING 134)
WRITING (35)
TEST SCORES
PRONUNCIATION (36)
13 ELIGIBILITY (39)
GPEARING 137)
UNDERSTANDING (38)
AWARD
AWARAPLE
=
MOT
AWARDABLE
PHILL
14. I CERTIFY THIS EMPLOYEE FOR AWARD
DIGNATURE
DATE
15.
TYPE OF AWARD
A - M
8.1.N
€
R.W.B
D-V
::
16. AMOUNT OF AWARD
$ 100.00
17. [CERTIFY THAT FUNDS ARE AVAILABLE
OBLIGATION REF. NO.
GIGNATURE
18. FEDERAL TAX DEDUCTION
20. CHARGE ALLOTMENT NO.
19. STATE/DC TAX DEDUCTION
$
22, EMPLOYEE PAYROLL NO.
21. NET AMOUNT OF AWARD
$
23. FORWARD CHECK TO
24. ALLOTMENT OF ASSIGNMENT
FORM
4.58
1273
USE PREVIOUS EDITIONS
Ex
20. CHECK NO.
SECRET
SECRET
(When Filled in)
DATE
DATE
(10-43) MRD COPY
i
PERSONNEL SERIAL NO. (1.6)
LANGUAGE PROFICIENCY AND AWARDS DATA
---
17.241
4. COMPONENT
5. CRACK
Charlotte
11
7. LANGUAGE
Stanich
11 TEST PURPOSE
AWARD
KILL
8. Long (25-27)
9. CATE OF TEST
2. LD NO.
G. DATE OF BIRTH
-720
10. ANNIVERSARY DATE (20-33)
12.
H
READING (34) WRITING (35)
F
TEST GCORES
PRONUNCIATION (36)
13. ELIGIBILITY (30)
SPEAKING (37)
UNDERSTANDING (99)
AWARDABLR
HOT
AWARDAPLE
14. I CERTIFY THIS EMPLOYEE FOR AWARD
BIGNATURE
DATE
15.
TYPE OF AWARD
A. M
B
c
R.W.B
D-V
::
16. AMOUNT OF AWARD
17. THAT FUNDS ARE AVAILABLE
OBLIGATION ALF. NO.
GIGNATURE
18. FEDERAL TAX DEDUCTION
$
20. CHARGE ALLOTMENT NO.
19. STATE/DC TAX DEDUCTION
$
72. EMPLOYEE PAYROLL NO.
21. NET AMOUNT OF AWARD
$
23. FORWARD CHECK TO
24. LLOTMENT OF ASSIONMENT
1273
4.52
LA PRAVIDI: EDITIONS
25 CHINO.
SECRET
DATE
DATE
10- MRD COPY
14-00000
:
(1-6)
107667
1.
NAME (Lot-Pirot-Middle)
ZEHRUNG, Charlotte Louise
3. LANGUAGE
(31-33)
Spanish
720
(7-241
"
SECRET
When Filled in)
LANGUAGE DATA RECORD
PART 1-GENERAL
TODAY'S DATE
734-301
NORTH
DAY
April
2
1957
2.
CATE OF DIRTH
W. TH
January
(25-30)
Dav
YEAR
12
1929
TEAD
I HAVE NO PROFICIENCY
IN ANY FOREIGN LANGUAGE
SECTION A,
1.
3.
4.
PART 11-LANGUAGE ELEMENTS
Reading (40)
I CAN READ TEXTS OF ANY DIFFICULTY, OF A GENINAL NATURE OR IN FITEGO I AM AMS. FAR TH, USING THE DICTIONARY
ONLY RARELY,
I CAN READ TEXTS OF MO51 GRADES OF DIFFICULTY, OF A GENERAL NATIUE OP 36 #181 AM FAMILIAR WITH USING TM'
DICTIONARY OCCASIONALLY.
I CAN READ TEXTS OF AVERAGE DIFFICULTY (newspapers. referance motorinio, etc.)USING THE DICTIONARY
PREQUENTLY,
I CAN READ SIMPLE TEXTS, SUCH AS STREET SIGNS, NEWSPAPER HEADLINES, ETC., USING THE DICTIONARY FREQUENTLY,
5. I HAVE NO READING AUILITY IN THE LANGUAGE.
SECTION B.
1.
Writing (41)
1541 6MMATICAL
1 CAN WRITE PERSONAL LETTERS AND SIMILAD USTERIAL WITH COMPLETE SUCCESS #HOUT USING THE DICTIONARY.
WRITE PACTUAL NARRATIVE 、1:,{a" i,,「;,at# **༈!,, ན} 4. A, ONANIE CLANTIC, B
NATIVE STYLE, USING THE DICTIONARY ONLY MAIL.
1 CAN
IN
2.
1 TAH RITH PENSIONAL LETTERS AND SIMILAR STOPLE MATERIAL. ITH COMPLATE SUCCESS, USING THE DICTIONARY ONLY
RANTLY. I CAN WRITE FACTUAL NARRATIIS ANG EXPOSITORY MATERIAL WITH REASONABLE CLARITY, WITH FEN GRAMMATICAL
f945, BUT IN A STYLL WHICH MAY NOT At astive, USING THE DICTIONARY OCCASIONALLY,
4.
1 CAN WRITE PERSONAL LETTERS AND SIMILAD SIMPLE MATERIAL. WITH REASONABLE SUCCESS IN CONVEYING MY MEANING.
BUT WITH OCCASIONAL MINOR GRAMMATICAL ERROSS AND IN OBVIOUSLY FOREIGN. AGY AND STYLE, USING THE DICTIONARY
OCCASIONALLY.
1 CAN GRITE PERSONAL LETTERS AND SIMILAR TIMPLE HATERIAL, WITH REASONABLE SUCCESS IN CONVEYING MY MEANING,
BUT WITH MANY CHASMATICAL EFFUNT ANT 5th Year FOREIGN AWKWARD STYLING THE DICTIONARY FREQUENTLY.
5. I CANNOT BRITE IN THE LANGUAGE:
SECTION C.
" MAY PRONUNCIATION IS NATIVE.
Pronunciation (42)
7
2.
WHILE NATIVES CAN DETECT AN ACCENT IN MY PRONUNCIATION THEY HAVE NG DIFFICULTY UNDERSTANDING ME.
MY PRONUNCIATION IS OBVIOUSLY FOREIGN. 067 0917 RARELY CAUSES DIFFICULTY FOP NATIVES TO UNDERSTAND.
4.
MY PRONUNCIATION IS OCCASIONALLY DIFICUL FOR NATIVES TO UNDERSTAND.
5.
HAVE NO SKILL IN PRONUNCIATION.
132 NO
444C
1910 27
CONTIME UN REVERSE SIDE
SECRET
13-437
:

14-00000
SECTION O.
I SPEAK FLUENTLY AND ACCURATELY
1.
CONTINUATION OF PART 11-LANGUAGE ELEMENTS
Speaking (43)
IN ALL PRACTICAL AND SOCIAL SITUATIONS₁ I CONVERSE FREELY AND IDIOMATICALLY
IN ALL FIELDS WITH WHICH I AM FAMILIAR,
2.
4.
IN NEARLY ALL PRACTICAL AND SOCIAL SITUATIONS
I SPEAK FLUENTLY AND ACCURATELY
I CAN CONVERSE IN MOST FIELDS
WITH WHICH I AM FAMILIAR AND I EMPLOY SOME POPULAR SAYINGS, LITERARY QUOTATIONS, AND COMMON PROVERDS.
I GET ALONG QUITE WELL IN SITUATIONS OF DAILY LIFE AND TRAVEL AND CAN CONDUCT ROUTINE BUSINESS IN PARTICULAR FIELDS.
1 MANAGE TO GET ALONG IN THE MOST COMMON SITUATIONS OF DAILY LIFE AND TRAVEL.
S.
I HAVE NO ABILITY TO USE THE LANGUAGE IN ANY OF THE ABOVE RESPECTS.
SECTION E.
Understanding (44)
1.
I UNDERSTAND NON-TECHNICAL CONVERSATION ON ALL SUBJECTS, BOTH FACE TO FACE AND ON THE TELEPHONED I UNDERSTAND
NEARLY EVERYTHING I HEAR ON THE RADIO AND AT THE MOVIES, PLAYS, AND LECTURES.
2.
UNDERSTAND NON-TECHNICAL CONVERSATION ON NEARLY ALL SUBJECTS, BOTH FACE-TO-FACE AND ON THE TELEPHONE: 1
UNDERSTAND MOST OF WHAT I HEAR ON THE RADIO AND AT THE MOVIES, PLAYS, AND LECTURES, INCLUDING MOST JOKES AND
PUNS.
UNDERSTAND NEARLY ALL CONVERSATION ON TOPICS OF DAILY LIFE AND TRAVEL, BOTH FACE-TO-FACE AND ON THE TELE
PHONE I UNDERSTAND MUCH OF WHAT I HEAR ON THE RADIO, AND AT THE MOVIES, PLAYS, AND LECTURES.
4.
5.
I UNDERSTAND THE SIMPLEST CONVERSATION, BOTH FACE-TO-FACE AND ON THE TELEPHONE I UNDERSTAND SOME OF WHAT
I HEAR ON THE RADIO AND AT THE MOVIES, PLAYS, AND LECTURES.
AM NOT ABLE TO UNDERSTAND THE SPOKEN LANGUAGE.
BEFORE CONTINUING - CHECK PART 11 TO ENSURE THAT YOU HAVE CIRCLED ONE NUMBER PER SECTION.
PART 111-EXPERIENCE AS TRANSLATOR OR INTERPRETER (45)
I HAVE HAD EXPERIENCE AS A TRANSLATOR.
2,
I HAVE HAD EXPERIENCE A> AN INTERPRETER.
3.
BOTH OF THE ABOVE STATEMENTS APPLY.
③ NONE OF THE ADUVE STATEMENTS APPLY.
PART IV-CERTIFICATION
1 CERTIFY THAT THE INFORMATION GIVEN ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
THIS CERTIFICATION CONSTITUTES MY APPLICATION FOR A MAINTENANCE ABARD PROVIDED I AM ELIGIBLE UNDER THE TERMS OF
REGULATION NO. 25-115, PAR, 10(4). UNDERS THAT I MUST PASS ACTIVE LANGUAGE PROFICIENCY TEST SECURE I
DECOME ELIGIBLE FOR AN AWARD. AND THAT IRRESPECTIVE OF THE DATE OF TESTING. ANNUAL MAINTENANCE AWARDS WILL BE
CUMULATIVE AS OF THE ANNIVERSARY DATE OF COMPLETING THIS FORM.
CAFE SIGNED
SIGNATURE
2 April 1957
Carlotu
(463
(
1
.A
14-00000
TO:
FROM:
SUBJECT:
SECRET
Security Information
HEADLINE: 13 Sept. 1252
Name:
ZEHRUNG, Charlotte L.
Last,
First
Middle
قناة الساعد فية
All C. I. A. Personnel
QUATTENTIONS
DATE 10-8-52
Personnel Director
PERSONNEL QUALIFICATION QUESTIONNAIRE
1. The Agency is currently revising the system for machine coding
employee qualifications, thereby permitting more complete and accurate
data on all personnel. The new system will aid in implementing Agency
policies on promotion from within by facilitating the selection of personnel
with desired education and experience for vacancies which may occur. It
is also expected that the new system will provide readily accessible statistics
for planning and management purposes.
2. The attached questionnaire is designed to cover adequately those
factors in which the Agency is interested. Although the information is, in
a large measure, already reflected in previous forms submitted by you, it
is felt that your time within the organization may enable you to emphasize
those qualifications pertinent to its needs. The questionnaire also serves
to bring your education and qualifications record up to date.
3.
Your cooperation is requested in completing the questionnaire as
thoroughly and accurately as possible and returning it to your Administrative
Officer within the time allotted.
FORM NO.
MAY 1952
37-132
:
George & Melom
g
George
E. Melcon
Personnel Director
SECRET
Security Information
16-122
14-00000
་
SECRET
Security Information
PERSONNEL QUALIFICATION QUESTIONNAIRE
1. Serial No.
2. NAME: (last)
(first)
(middle)
3. Office
ZEHRING
Charlotte
Luisa
FI
,
(no entry)
7667
4. Date of Birth
12 Jan. 1929
7. Citizenship:
SEC. I.
U.S.
Other
6. CIA Entry Date:
August 1951
5. Sex: male (1) Martial Status
Nr. Dependents __
Birth (2) Marriage (3)
Other(specify)
✗ female (2)
8. Acquired By: (1)
EDUCATION
(4)
Year U.S. citizenship acquired, if not by birth
1. Extent: (circle one)
1. Less than high school
2. High school graduate
3. Trade, Business or
Commercial school
graduate
Naturalization
4. Two years college, or less 8. Masters degree
5. Over two years, no degree
⑥ Bachelor degree
2. College or University Study:
Name and location of
7. Post-graduate study
(minimum 8 sem. hrs.)
9. Doctor's degree
Dates att'd
College or University Major Minor From To
Yra Compl
Day Night
Degree Recd
Title
Sem
Date Hrs
Syracuse University
Econ. Span. 9/46
1/50
h
B. A.
1/50 115
San Carlos niversity Span.
7/65
3/48
5
3. Trade, Commercial, and Specialized Training:
School
Attendance Dates
From To Tot.mo's
Study or Specialization
Miami Jacoba Rusins89
5/50 12/50
7
tyoing and shorthand
"College
4. Military or Intelligence Training (full time duty as a student in specialized
schools such as intelligence, communications, ordnance disposal, command &
staff, etc.)
Attendance Dates
School
From
To Tot.mo's Study or Specialization
SECRET
Security Information
-
14-00000
i
P
1.
SECRET
Security Information.
SEC. II. WORK EXPERIENCE.
CIA Experience: State the specific nature of duties performed with CIA and
CIG, starting with your present position. Take position titles from your of-
ficial personnel papers, if you have personal copies. Please do not request
your Official Personnel Folder. Include geographic area and subject matter
dealt with, if applicable. Position Title is your classification title such as
Geographer, Intelligence Officer, etc. Duty Title indicates your organization
position such as - Section Chief, Branch Chief, Administrative Assistant, etc.
and is to be filled in only if different to the Position Title. Approximate dates
(month and year) are sufficient. Use a continuation sheet, if necessary, to
adequately describe your duties.
From 1/2 To
Tot. mos.
Grade 7 Salary 3/20.00
Office PI/WH/23211
Position
-
Intelligence Officer
Reports Officer
Title:
Duty
Title:
From 12/1 To1/-2
Tot.mos.
Grade 5 Salary
63410.00
Description of Duties: I have the reasonability
of disseminating and routing all reports received:
from oo Station, take appropriate action on
reports received from other apencion forwardial
this information to the field or unpl ing requested
Hata. I inform the flald of additional info it
Headquarters on fallziduala a d organizati na as
requested or na decred recensary. I also maintain
Duty Station, it overseas: two CE notebooks.
Description of Duties:
Same as above with a Station. I had loos
individual responsibility,
Office FI/MH/Brazil
Position
Title: _ Intalliganca Offices
Duty
Title: Reports Officer
1
From 11/51 To
Tol, mos. 1
Grade 5 Salary 33410.00
Office FI/H/II
Position
Title: Secretary (sorraphy)
Duty
Title:
Duty Station, if overseas;
Description of Duties:
As a casual I breed dispatches, memoranda,
and dissemination for mach 11. I took
a limited amount of shorthand.
Duty Station, if overseas:
From 3/11 To
Tot, mos.
Description of Duties:
I nasembled disseminated resorts.
Grade 5. Salary
33420.00
Office BC
Position
Title:
Secretary (Sterceraphy)
Duty
Title:
Duty Station, if overseas:
Two montia in tlo spol attending clasest seer op filing system for ussidy
SECRET
Security Information
Inlex canis.
14-00000
SEC.
2.
II.
SECRET
Security Information
WORK EXPERIENCE (CONT'D.)
Exact Title of your position
Other than CIA: (Describe work experience for the last 15 years in sufficient
detail to permit specific coding of your qualifications. Include military work
experience. List last position first.)
From 1/1 To 2/21 Tot. mo's /
Classification Grade (if in Federal
Service) 3. Salary $2650.00
Number and Class of Employees
Supervised: none
Employer Do artment of Interior
Kind of Business or organization.
(i.e., paper products mfr, public
utility)
From 5/50 To 3/51 Tot. mo's 11
Classification Grade (if in Fedéral
Service)
Salary 1.
Number and Class of Employees
Supervised: 2 - 6 clarky
Employer
"
Kind of Business or organization
(i. è., paper products mfr, public
utility)
and 1 Choppe
From 2/50 Tor/22 Tot. mo's
Classification Grade (if in Federal
Service) Salary $200/mo.
Number and Class of Employees
Supervised:
4
Employer National Peanut Courcib
Kind of Business or organization
(.e., paper products mír, public
utility) trade association
---
From 6/17 To 2/19 Tot.mo's 5.3
Classification Grade(if-in Federal
Service)
Salary
Number and Class of Employees
Supervised:
Statistical riftsman
Description of Duties:
I did statistical drafting, cartography,
Parking of 1
Duty Station if overseas:
Exact Title of your position
..
Description of Duties: An as assistant to the
executives I was respo albia for purchasing stock
for the gift shoppe and l-strictly clerks and
greenhouse emplovenu, I had 11 responsibility
of the books a d cash, 1 reports on tha
busions and acted as sales clerk for the shoppe
Duty Station if overseas: discaping bua
Exact Title of your position
Assistant Bookkeeper
Description of Duties:
I made monthly financial reports, had the
responsibility of the books, did typing and
other peneral office work.
Duty Station if overseas:
Exact Title of your position
Description of Duties: I worked one month
In the office of the Chemical shoratory and
two months in the factory.
Employer Frigidaica Co., Con, lotora,
Kind of Business or organization
(i. e., paper products mfr, public
utility)
From
To
Tot. mo's
Classification Grade(if in Federal
Service)
Salary
Number and Class of Employees
Supervised:
Employer
Kind of Business or organization
(i. e., paper products mfr, public
utility)
Duty Station if overseas:
Exact Title of your position
Description of Duties:
Duty Station if overseas:
SECRET
Security Information
--41དྷཱ ། 1e, e! 14H, ?p
14-00000
SECRET
Security Information
SEC. II. WORK EXPERIENCE (CONT'D).
3. Special Work Experience: Check any of the following organizations by which
you may have been employed.
U.S. Secret Service
01
24
Air Force A-2
4.
02
Civil Police
25
03
Military Police
26
Foreign Economic Admin.
Counter Intelligence Corps
04
U.S. Border Patrol
27
Immigration & Naturalization
05
U.S. Narcotics Squad
28
Strategic Services Unit
06
FBI
29
Foreign Service, State Dept.
07
Criminal Investigation Div.
30
Central Intelligence Group
21
Office of Naval Intelligence
31
Armed Forces Security Agency
22
Office of War Information
32
Coordinator of Information
23
Army G-2
33
Office of Facts & Figures
20
Office of Strategic Services
34
Board of Economic Warfare
-
SEC. III. FOREIGN LANGUAGES
35 Federal Communications Comm.
-
List below the foreign languages in which you have some competence. Be sure to
include uncommon modern languages. Check (X) your competence and how acquired.
LANGUAGE
Spanish
Fronch
Portugis
COMPETENCE
Equivalent to
Native Fluency *
Fluent but obviously
Foreign *
Adequate for
Research **
Adequate for
Limited
Knowledge
Travel
HOW ACQUIRED
Native of
Country
Prolonged
Residence
Contact
Study (Inc. CIA training)
(Parents, etc.)
Academic
li you have checked 'Fluent' for a language that has significant difference in spoken
and written form (e.g., Arabic), explain your competence herein
**Specialized Language Competence: Describe ability to do specialized language work
involving vocabularies and terminology in the scientific, engineering, telecommuni-
cations, and military fields. List the language with the type of speciality.
SECRET
Security Information
14-00000
SEC. IV. AREA KNOWLEDGE.
SECRET
Security Information
1. List below any foreign countries or regions of which you have knowledge
gained as a result of residence, travel or study. Study can mean either
academic study, or study of a foreign country resulting from an intelligence,
military, commercial or professional work assignment.
Dates of
Residence, Study
Etc.
Country or Region
Manner in Which Knowledge
Was Aquired (check (X) one)
Residence Travel
Study
South America
Guatemala
Mexico
11 com econ and mox.
7/13 to 8/18
7/46
✗
2.
Specialized Knowledge of Area
List specalized knowledge of foreign country such as knowledge of terrain,
coasts and harbors, utilities, railroads, industries, political parties, etc.,
gained as a result of study or work assignment. Include name of employer
or organization.
Country
Type of Knowledge
How and When Gained
SEC. V. TYPING AND STENOGRAPHIC SKILLS (PRESENT UTILIZATION)
Per Cent of
Skill
Time Used
Not Used
WPM (Approximate
Proficiency)
Typing
1. drafts
Shorthand 1. none
2.
2.
60
70
Prefer Assignment
Using Skill Oftener
1. Yes 2. No
1. Yes
2. %
Shorthand System: 1. Z Manual 2. Machine 3. Speedwriting.
SEC. VI. LICENSES, HOBBIES, SPECIAL QUALIFICATIONS
1. Licenses: List any licenses or certi- 2. Hobbies: List any hobbies such
fication such as teachers, pilot, marine,
etc.
as sailing, skiing, writing, or
other special qualifications.
painting, skiing
SEC. VII. PROFESSIONAL AND ACADEMIC HONORS
List any professional or academic associations or honorary societies in which
you hold membership.
SECRET
Security Information
5
14-00000
SEC. VIII. PUBLICATIONS
SECRET
Security Information
List below the type of writing (non-fiction: professional or scientific articles,
general interest subjects, current events, etc; fiction: novels, short stories, etc.)
of any published materials of which you were author or co-author.
SEC. IX. INVENTIONS
Describe any devices you have invented as to type of work for which intended
and whether patented.
Device
Patented
(1) Yes
Yes
(2) No
(2) No
(1)
Yes
·(2)
No
SEC. X. CIA TESTS
Describe below the type of tests which you have taken in CIA:
Type of Test
typing, shorthand, moneral intelligence exam
exam for reports officer
SEC. XI. PHYSICAL HANDICAPS
List any physical handicaps you may have.
Date Taken
8/1951
2/12:2
SEC. XII. OVERSEAS ASSIGNMENT
Are you willing to accept periodic tour of duty overseas?
(1) 2 year Tour
(2) 4 year Tour (3) Net interested
SEC. XIII. WORK ASSIGNMENT
In view of your total experience and education, for what assignment in CIA do
you think you are best qualified?
I feel I am best qualified for a mporta
position.
SECRET
Security Information
6
14-00000
Yes
SEC. XIV. MILITARY STATUS
1.
2.
Present Draft Status
SECRET
Security Information
Have you registered under the Selective Service Act of 1948?
If yes, indicate your present draft classification
Present Reserve or National Guard Status
-
Do you now have Reserve or National Guard Status Yes
If yes, complete the following.
National Guard
Active Reserve Status (member of organized unit)
Inactive Reserve Status
1.
2.
Air National Guard
3.
4.
Service
Grade
Location
aughte
No.
Reserve Unit with which currently affiliated
Service Mobilization Assignment, if any
Location of Service Records, if known
-
No.
SEC. XV. CIA TRAINING
List the training courses or subjects you have taken while in the CIA.
Course or Subject
Orientation CONFE
(from) Dates (to)
2-11 Jun 1972
Hours
9-12 am
SEC. XVI.
REMARKS
Use this space to indicate any other qualifications you may have which you do
not describe above,
DATE
18 September 1912
SIGNATURE
Zbrang
SECRET
Security Information
7
14-00000
STANDARD FORM 57-NOY 1947
US CIVIL SERVICE COMMISSION
LICATION FOR FEDERAL EMPLOY T
INSTRUCTIONS In onfer to prevent delar a consuleration of your appli.
catiul power every question on this form clearly and completely Type
write or print in INK. In apesising for a specify Vnited States Cird Service
etamination, read the examination mouement carefully and fellow all
directum If you are applying for a WRITTEN amination, follow the
|_ NAME OF EXAMINATION OR KIND OF PUISITION APPLIED FÜR
instuctions on the almieri cent arganding disposition of the application
If you are apsting for an UNWFITTEN examination, mas this application
to the head in the anni, piment, Be sure to mad to the same office
any other boxes required be the announcement. Non the obce with which
your site this application of any change in Wur address
DO NOT WRITE IN THIS BLOCK
For Use of Civil Service Commission Only
ARNOUNCEMENT
APPLICATION NO
2 OPTIONS" (of mentioned in examination announcement)
3 PLACE OF EMPLOYMENT APPLIED FOR (City and State) 2. DATE OF THIS APPLICATAW
Washington, D. C.
WATERHA
☐ APTOR.
☐ NON APPOR
NOTATIONS
SUBMITTED
RETURNED
APP. REVELW.
5 NR
μες
MISS
aret name)
Charlotte
TARRIST
L.
(Mardon, if any)
Zehrung
(Last)
(A) STREET AND NUMBER OR R. D. NUMBER
1401 -
16th St., N. W.
(3) CITY OR POST OFFICE (including postal sone) AND STATE
Washington, D. C.
LEGAL OR KOTING RESIDENK (State)
Ohio
DATE OF BIRTH (month, day, year)
1-12-29
14 OFFICE PHONE | (B) HOME PHONE
RE 1820
X 732
10 NO. 5450
..
MARRIED
☑ SINGLE
11 PLACE OF BIRTH (city and State: if born outside U 3, name city and country)
MALE
FEMALE
Dayton, Ohio
113 A HEIGHT WITHOUT SHOLS
PECT 8 INCHES
WEIGHT
125 POUNDS
14. (A) HAVE YOU EVER PEEN EMPLOYED BY THE FEDERAL GOVERNMENTI ☐ YES ☑NO
(B) IF SO, GIVE LAST GRADE AND DATE OF LAST CHANGE IN GRADE
'
APPRMED
ENTERED REGISTER.
EARNED PRITER AUGM
OPTION
GRADE
RATING
EMY RATING
ㅁㅁㅁㅁㅁ
PLYNTS
(TENTJ
13
POINTS
WIFE
દરે
wow
CESAL
26743
TREATED
INITIALS AND
DATE
15. (A) WHAT IS THE LOWEST ENTRANCE SALARY YOU WILL ACCEPTI 3…………………………
PER YEAR
You will not ha conantared for any position with a lower entrance
salary.
☐,
(D) CHECK IF YOU WILL ACCEPT SHORT-TERM APPOINTMENT IF OFFERED, FOR.
☐ 1 TO 3 MONTHS
3 TO MONTHS
☐ 6 TO 12 MONTHS
NOTE. Acceptance or refusal of a temporary short-term appointment
will not affect your opportunity to obtain a probational appointment
(C) YOU ARE WILLING TO SPECIFY
[
☐☐ FREQUENTLY
CONSTANTLY
LOVE
15 PXP It portat for you to furnish all information requested
1-low in authent detais to enable the Civil Service Commission and the
appeting off of as to give you full crest in determitting your
dation Use sepse think the patio with
prescut potion and we explaining dearly the principal tasks which
on performed in each post, sunting for all petals of ment
perteme ned more the area tinent to the work
for which you are applying mar te smarted in one more of the blenks.
if your duties changed materially while working for the same employer, use
a separate link to desente rich wit 10 hay unclade any pertinent
(D) CHECK IF YOU WILL ACCEPT APPOINTMENT IF OFFERED-
☐ IN WASHINGTON, D. C. ☐ ANYWHERE IN THE UNITED STATES
☐ outside THE UNITED STATES
© IF YOU WILL ACCEPT APPOINTMENT IN CERTAIN LOCATIONS ONLY, GIVE ACCEPTABLE
LOCATIONS
reliatoa, etes, welding of organizations activity which you have performed,
either with or withwat compensation, showing the number of ho
and wecks per you in which you were engaged in such srey Mary
experience should be described in the spaces below in 'ta pay
(a) If you were ever empl wat in any post on under a naerent hom
that shown the St iha ap pheaton, give der Desop n of your
work” for each poution, the name used,
(b) If you have neve been comployed or are now cananeyed, indicate
that fact in the space provided beli "Present Potion"
F
PRESENT POSITION
IF YOUR ENTENE nities
TO PRESENT TIME
Statistical Draftsman
verson, if Pederal.
FROM 4-51
ACE OF LOS)
HAVE AND A
Washington, D. C.
name department, but son of establishment, and division)
Board of Geographical Names,
NUMBER AND KIND
Interior
HAME AND TI
CLASIFICATION G
Fodral Services
3
DEINMEDIATE SUPERVISION
Mrs. Mildred Noorman
SALARY AN
STARTING 2630
PRESENT. $
MARYT.
KIND OF B
NATION ("d", w
whale tency.
anufacture of locks, etc),
175411 CANS EXPLOTMENT
none
"DESERIPTION OF TO
statistical drafting.
typing
marking diacritics
(CONTINUED ON NEXT PAGE)
-

14-00000
16 CONTÍNUED
DATES OF EMPLOYMENT (month, 764)
FROM
5/50
"
3/51
PLACE OF BROYMENT (city and State
Darton, Chio
"ExACE TITLE OF YOLA FUSITION
Bookkeeper-Clork
HAME AND ADDRESS OF EMPLOYER (Rim organisation, or person, if Federal,
name department, bureau or establishment, and diziewn)
San Rae Gardens, R. H. 11 Dayton 9, Ohio
NUMBER AND KIND OF EMPLOYEES SUPERVISED BY YOU
2 6 clerks
DESCRIPTION OF YOUR BORS
Bookkeeper
Clerk
CLASSIFICATION GRA
(if in Federal service);
NAME AND TITLE MUDATE SUPERVISO
Mr. Ray F. McKechnie
S
STAFTING 1.00
FINAL 1,10
Ahr
KIND OF BUSANATION (od wholesale with insurance agency.
manufacture ed locks, aro)
Nursery and Gift Shoppe
REASON FOR LEA
New Job
Made reports on stock and ordered wholesalo
Made resorts for the executives on the business, finances, etc..
FROM
DATES OF EMC (month, year
2/50.
ΤΟ
5/50
EXACT TITLE OF YOUR POSITION
CLASSIFICATION GALLE
Of in Federal)
Aat. Bookkeeper.
SALARY OR LESS
STARTING S
FINAL
$200
PER
PERMO
NAME AND TITLE OF IMMEDIATE SUPERVIAW
PLACE OF EMPLOYMENTty and States.
Washington, D. C...
NAME AND ADORNs of ikona (hero, organisation, or person: if Federal,
name department, berean as establishment, and division)
National Peanut Council
1111 Dupont Circle Bldg. Hashington,
NUMBER AND KIND OF SWAROYLES SUPERVIDAG 10
none
DESCRIPTION OF YOUR
Bookkeeping
Filine
General office work
Financial reports
Mr. William F. Seals, Prey,
KIND OF PUSGANIZATION (wholeoats wilk, insurance agency.
manufacture of locks, etc)
:
Trade Association
REASON FOR LEAVING
New Job
GATES OF EMPL
Fred
16/17
200
8/47
E OF YOUR H
ART
STATING
PLACE OF EMPLOYnd State)
Dayton, Ohio.
NAME AND ACTR agation of person, iPoderal
name department, butas de estababicant and dression)
Fricitaire, Flant 2
HUMBER AND
none
Dayton 9, 0
HAME AND TITLE OFTE S
Mr. Herbert Hauldorman Personel
FIRD
tail w
manufacture of less. }
Manuf. of Frigidaires
return to college
CSCRIPTION OF A bon
Secretary. In Qerica Lab
Forked. in fastory..
PER
FER
ا سورجيد
14-00000
DATES OF EMPLOPMENT 13th, year)
EXACT TIRED MYTABITION
FTPLAS
10
PLACE OF EMPLOYEE (vity and State)
Wifin
CLASSIFICATION GRADE
Balservice)
SALARY OR EATING
STARTING S
FINAL
FEA
PER
NAME AND TITLE OF IMMEDIAT SUPERVISOR
RAME AND AVESS OF EMPLOYER (Arm, organisation, of permen, of Fandorak
name department, bureau of establishment, and division)
KIND OF BUSINESS OR ORGANIZATION (• . wholesale silk, insurance agency.
manufacture of locks, ota.)
NUMBER AND KIND OF EMPLOYEES SUPERVISED BY YOU
DESCRIPTION OF YOUR BURK
REASON FOR LEAVING
If more space is required, use a continuation sheet (Standant Form No. 58) or a sheet of paper the same sise as this page. Write on each sheet your name,
address, date of birth, and examination title. Attach to inaude of this arvavina
17. MILITARY TRAINING in the space below, describe any training MIN
the Armed Services (not already hated under Item 16) that would ext
appointing officers in placing you most effectively. Indicate actual amount
DATE'S
LOCATION
of training scarves, such as hours per week. Detailed information regent.
ing any special service schools you attended is especially important. (Estra
pages may be used to pve full descriptions.)
DESCRIPTION OF TRAINING
FROM
to
18 EDUCATION (Circle highest grade completed):
1 2 3 4 5 6 7 8 9 10
MARK (1) THE APPROPRIATE DON TO INDICATE SATISFACTORY COMPLETION OF
…2;LV*%ཎྷ ཡ༥
MICH WO
11
12
☑
MAJON
(C) NAME AND LOCATION OF COLLEGE OR UNIVERSITY
Syracuse Univ, Syracuse, N
San Carles Univ, Guatemala City Span
Mani Jacobs Business CollegeStore.
(0)
Gabon
Econories
Spanish
(4) GILE NAME AND LOCATION OF LAST HIGH SCHOOL ATTENDED
78) ȘI BITCTS STUDIED IN HIGH SCHOOL WHICH APPLY TO POSITION DESIRED
CATES ATTENDED
AND
SPECIALTY
7200
10
TEARS COMPLETED
GAY
DEUBLES CARD
NIGHT
TITLE
(\ATT
CRETAR
Y Econ.
9-46
1-50.
BA.
1-50.
7-49.
8-42..
115.
...5
5-50 12-50
3. no 4mo
LIST YOUP CHIEF GRADUATE COLLEGE SUBJECTS
122
30
23.
(2) OTHER AT
THROUÂN IN
SLON AS VOCATIONAL BUSINESS, STUD COURSES GIVEA
ARMED FORCES INSTITUTE (show name and honation
of school) a TRAINING PUBLIC OR PRIVATE EMPLOYMENT
SURC
DATES ATTENDED
YEAS
FAIN
TO
1217
31445
READING
EANING
UNDERST NO
22
19 TISCATERING AND ALĘPCA OF
#CREEN LANA VÁN
1145004
Spanish
French
Tax
☑
X
17
2) IF YOU RATHERED IN ANY PORNO CON
*** KATE (DARS AND
h,༩༥r+aསྶཏྠཾ
TIME SEAT THESE AND
ste & muntary servo, Cusiners,
Guatemala 3/4-2/48 Education
Mexica 7:16
_ Traval
21257ADIO NAVAFOLAITETAAN MAZIONES DEN? YOU
CARLET RITA 1440×9 % stiuta comero
ma tena? LATRA, SUTENTIFIC LA POLIESPORAL CLINCH
Calculator
GALA SON A LICENSED OR CERTIFIED MEMBER OF ANY TRADE OR PRO
apist clean, radio operator, Lea hor, (anyor, CPA, off
GATE KING OF LICENSE AND STATE.
OR CERTIFICATE (+ČAR)
TAPIO TOSSA ON CEATIO
23RDELTEWHERE IN FOR APPLICATION SUCH AS
RATIOS (do not submit copies unite toate)
S
QASY WY AND RELATIKAS EXPERIENCE
(SC248 SUCHT, STC.
1743440 FELLA76070
13-41213-1
13
14-00000
24 FENG List three per living in the United States of any of the United States who are 1/27 related to you and who have definite knowledge of
yının qalibu ations and fitness for the praction, for which you are appr Local names of supervienes hated under Item 16 (EXPERIEN(R)
NESS OR HOME ASS
FULL HAME
1.
Mr. John Lewis
Miss Theadosía Moran
2
Mr. Harry Schwartz
(Oire complete tyrrent address, including street and number).
Oakwood High School, Dayton 9, 0.
Cazanoria R. D. 2, N. Y.
Univ. of Byracuse, Syracuse, N. Y.
INDICATE "YES" OR "NO" ANSWER BY PLACING “E” IN PROPER COLUMN 185 ag
29 MAY INQUIRY DE MADE OF YOUR PRESENT EMPLOYER REGARDING YOUR
CHAPACTED QUALIFICATION3 STCS
་
29. APP YOU A CITIZEN OF OR DO YOU OWE ALLEGIANCE TO THE UNITED ☑:
STATEST..
27 ARE YOU NOW OR HAVE YOU, VERBEEN A MEMBER OF THE COMMUNIST
PARTY USA OR ANY COMMUNIST ORGANIZATION
28 ARE YOU NOW, OR HAVE YOU EVER BEEN A MEMBER OF A FASCIST ORGAN
ITATION
20 ARE YOU HOW ON HAVE YOU EVEN & MEMBER OF ANY ORGANIZATION
ASSOCIATION MOVEMENT GROUP ON COMBINATION OF PERSONS WHICH AD
VOCATES THE OTHERTHROW OF OUR CONSTITUTIONAL FORM OF GOVERNMENT,
OR OF AN ORGANIZATION, ASSOCIATION MOVEMENT, GROUP OR COMBINATION
GF PERSONS WHICH HAS ADOPTED A PRICE OF ADVOCATING OR APPROVING
THE COMMISSION OF AS IS OF FORCE OR FALENCE TO DENY OTHER PERSONG
THEIR RIGHT SUNGER THE CONSTITUTION OF THE UNITED STATESORO SEE
JING TO ALTER THE FORM OF GOVERNMENT OF THE UNITED STATES BY UNCON
STITUTIONAL VENGE
If your answer to question 27, 28, or 29 above is "yes," state
in liam the names of all such organizations, associations.
movemaste, groups, or combination of persons and dates of
membership Give complats" details of your activities
therein and make Any explanation you desire regarding
your membership or notivifine therein
30 DINGE YOUR 10TH BIRTHDAY, HAVE YOU EVER BEEN ARRESTED, INDUCTED
OF LOMMEND INTO COURT ADA-PENDANT IN A CRIMINAL PROCEEDING
OR CONTED, FINED OR IMPRISONED OR MACED ON PROBATION OR HAVE
YOUR BEEN ORDERED TO DEPOSIT BAH, OH COLLATERAL FOR THE VIGLA.
LIGN OF ANY LAN POLICE REGULATION OR ORDINANCE (EXCLUDING MINOR
TRAFFIC VIOLATIONS FOR WHICH A FINS OR FORFEITURE OF 125 CR LESS WAS
MALL
If your answer in "Yoo." list all auch cases under frem 19
halow, Give in each case (1) the date, (2) the nature of the
offense of violation, (3) the name and location of the court,
(4) the penalty imposal, if any, or other disposition of the
CAGA Il appointed, your angergrents will be (when
SAVE
routati DESIGN FOR MON
CONT OR UNSATISFACTORY SKØLGE FROM ANY POSITIONI
If your swer is "Yes," give in Itom 39 the name and
Gridface of amployer, data, and renown in bach case
37 HAVE 10U EAR BLEM NAUTED BATHEUSCHIL MANCE COMMISSION
FROZE ZAMINATIONS OR ACCEPTING CIVIL SERVICE APISHINTMENT
If your hever is "Yes" "'re Jaice of and reasons for
auch dabaimant in Irein 19
22 HAVE YOU ANY PHYSICAL HANDICAP DISEASE, OR OTHER DISABILITY
WHICH CHOND BE CONSIDERED IN ASSIGNING YOU TO MONKI..
If your answer "Yes." A completo do in Items 345
that consideration can be given to your physical fitness for
the job.
1 TO YOU PECIVE AN ANNUITY UNITED STATES OR UPSTRICT
OF COLUMBIA GOMET ER ANY RETIREMENT ACT ON ANY FIND
OR OTHER COMPENSATION FOR MILITARE CE NAVAL SERV
If your answer is "Y" complete details in Item 37"
x
א
%
SPACE POREDANA TUTIONS (indute numbers
x
%
BUSINESS CA OCCUPATION
Principal
Teacher
Professor
• INDICATE "YES" OR "NO" ANSWER BY PLACING "" IN PROPER COLUMN
ARE YOU AN OFFICIAL OR EMPLOYEE OF ANY STATE, TERRITORY, COUNTY
MUNICIPALITY?
If your answer is "Yes," five detaile in Stern 39
36 GTS THE UNITED STATES GOVERNMENT EMPLOY IN A CIVILIAN CAPACITY
ANY RELATIVE OF YOURS (RY BLOOD OR MARRIAGE) WITH WHOM YOU LIVE
S HAVE LIVED WITHIN THE PAST ZA MONTHS
If your answer is "Yes," show in Item 39 for EACH such
relative (1) full name; (7) present address; (3) relationship:
(4) Department or Agency by which employed, and (3) kind
appointment
VES NO
SPECIAL INSTRUCTIONS FOR CLAIMING VETERAN PREFERENCE
x
x
A. If you are claiming preference at PRACETIME VETERAN who has
Leen awarded a campaign barige se servire ribbon, or as a DISABLED VET.
MAN, or as the WIFE OF A DISABLED VETERAN, of the WIDOW OF
A WAR OR CAMPAIGN VEIKHAM, attach Veteran Preference Claim,
CSC Fm 14, together with paperin therein.
B. If you are WAR-TIME VETERAN not claiming disability preference.
you should NOT submit your discharge with this application, Preference with
tentatively credited to you or if appointed, you will be requiced to submit
to the appointing offer rive to entry on duty, official evidence of separa.
tion from active service in the armed forces of the United States in time of war.
LS но
x
27 A) WERE YOU EVER IN THE UNITED STATES MILITARY OR NAVAL SERVICE
LURUNG TIME OF WART
(b) IS THE WORD 'HONORABLE" ON THE WORD "SATISFACTORY USED
IN YOUR DISCHARGE OR SIPARATION PAPERS TO SHOW THE TYPE OF YOUR
HARGE OR SEPARATIONS
(C) WAS SERVICE PERFORMED ON AN ACTIVE FULL-TIME BASIS. WITH FULL
MILITARY PAY AND ALLOWANCE
כי
DATE OF ENTRY OR ENTRIES INTO SERVICE DATE OF DEPARATION OR SEPARATIONS
CPANCH OF SERVICE (Army, Navy, SERIAL (1/ none, sive drado or
Marine Corps, Coast Guard, 10.) rating at time of separation).
IF YOURED IN THE UNITED STATES MILITARY OR NAVAL PMVICE
ANGIOME ONES
PANTAT ACASAGRAN
ON AND RECEIVE A CAMPAIGN BADGE OR RID
ARE YOU A DISANITO VETERAN).....
If so, and you have not listed your disability in answer to
Item 13, plain in Item 35 below
ARE YOU A VETERANS WIDOW AND HAS NOT REMARRISON
49) ARE FOU THE WIFE OF A VETERAN WIND WAS A VILL CONNECTED
DUTY ON DIRIGALSEYS HIM KONCU
SE INTUENTI
YES BED
✗
THIS SPACE FOR USE OF APPOINTING OFFICER ONLY
The information contained in the answers to Question 37 alive has been verk.
hed by comparison with the discharge rertificate un
19.....
ARPA'Y'
anawers apply)
Title.
i
i
:
2
If inare space is required, the paper the same saa at iba pogany name, address, date of birth, and examination title. Attach to insie
efus
Before signing this appleation check back over it to make sure that you have answered ALL questions correctly,
Press
SIGNATURE OF APPLICANT
1 CERTIFY that the statements made by me in this application pre true, complete, and correct to the best of my knowledge
and belief, and are made in goni faith.
False statement on this application
is punishable by Law (U. a Cote..
Title 18, Section 80)
Стиль тих завлика
*
* A* INK te i
mala, and
discount name
If forazio,
0 64.3'
10-SIN t
以
14-00000
As of 5 July, 1951, Subject's
Washington
address is
3817 Davis place, N.W.
Phone - Ordway
1618
**
14-00000
PERSONAL HISTORY STATEMENT
Instructions: 1. Answer all questions completely. If question is not applicable write "NA.". Write
"unknown" only if you do not know the answer and cannot obtain the answer from
personal records. Use the blank pages at the end of this form for extra details on
any question or questions for which you do not have sufficient room.
2. Type, print, or write carefully; illegible or incomplete forms will not receive consid-
eratiom
HAVE YOU READ AND DO YOU UNDERSTAND THE INSTRUCTIONS?
Bec. 1. PERSONAL BACKGROUND
Mits
AKK
(n)
A FULL NAME Charlotte. Louise.. Zehrung
120352
Jostinis
PRESENT ADDRESS
PERMANENT ADDRESS
(Mille)
yes
(Yes or No)
Telephone:
Ext.
(Date)
Home
Office RE 1820.
4691
NO:.5450
C. USA......
(Country)
1401-16th St., E... W. Washington, D
(St. and Number)
(City)
(Stale)
San. Rae Gardena, Dayton 9, Ohio RR 11 USA.....
(St. and Number)
B. NICKNAME
--
Sherri
NAMES?
(City)
(State)
(Country)
WHAT OTHER NAMES HAVE YOU USED? none
_ UNDER WHAT CIRCUMSTANCES HAVE YOU EVER USED THESE
aborted to use it at school...
HOW LONG!
5 yrs IF A LEGAL CHANGE, GIVE PARTICULARS.
C. DATE OF BIRTH 1/12/29 PLACE OF BIRTH,
D. PRESENTOUZENEMP
USA.
¡Country)
(By what authority)
Dayton Ohio.
(City)
(State)
USA.
(Country)
BY BIRTH? yos BY MARRIAGE? no
BY NATURALIZATION CERTIFICATE NO...no-
ISSUED
BY
(Date)
(Court)
38-1
AT
(State)
(Country)
HAVE YOU HAD A PREVIOUS NATIONALITY? ……………
Yes or No)
(Country)
HELD BETWEEN WHAT DATES? TO
ANY OTHER NATIONALITY?.
GIVE PARTICULARS
_
(Country)
HAVE YOU TAKEN STEPS TO CHANGE PRESENT CITIZENSHIP: no .. GIVE PARTICULARS:
(1)
+
14-523-
14-00000
SEC.
:
(2)
E. IF BORN OUTSIDE U. S. WHEN DID YOU FIRST ARRIVE IN THIS COUNTRY:
PORT OF ENTRY?
LAST U. S. VISA
ON PASSPORT OF WHAT COUNTRY?.
(Number)
2. PHYSICAL DESCRIPTION
Type:
Place of laque)
(Date of Inte)
22
F
5' 8"
125
AGE
SEX
HEIGHT
WEIGHT
blue
brown
EYES
HAIR
COMPLEXION
med.
SCARS none
_
slender
BUILD
OTHER DISTINGUISHING FEATURES
SEC. 3. MARITAL STATUS
x
A. SINGLE
MARRIED
DIVORCED
STATE DATE, PLACE, AND REASON FOR ALL SEPARATIONS, DIVORCES OR ANNULMENTS
WIDOWED
B. WIFE OR HUSBAND (IF YOU HAVE BEEN MARRIED MORE THAN ONCE-INCLUDING ANNUL-
MENTS USE A SEPARATE SHEET FOR FORMER WIFE OR HUSBAND GIVING DATA REQUIRED
BELOW FOR ALL, PREVIOUS MARRIAGES)
"
NAME OF SPOUSE
(First)
(Middle)
(Makan)
(Last)
PLACE AND DATE OF MARRIAGE.
HIS (OR HER) ADDRESS BEFORE MARRIAGE
SL and Number)
(City)
(State)
(Country)
LIVING OR DECEASED
DATE OF DECEASE
CAUSE
PRESENT, OR LAST, ADDRESS
(St. Nutaber)
(1945)
(State)
(Country)
DATE OF BIRTH
PLACE OF BIRTH
(City)
(State)
(Country)
IF BORN OUTSIDE U. S. INDICATE DATE AND PLACE OF ENTRY
CITIZENSHIP
WHEN ACQUIRED?
WHERE?
(City) State)
(Country)
OCCUPATION
LAST EMPLOYER
EMPLOYER'S OR BUSINESS ADDRESS
181, and Humuler}
(City)
(State)
(Country)
MILITARY SERVICE FROM
TO
BRANCH OF SERVICE
(Date)
(Date)
COUNTRY
DETAILS OF OTHER GOVT. SERVICE, U. S OR FOREIGN
1021-1
14-00000
SEC. 4. CHILDREN OR DEPENDENTS (Include partial dependents):
1. NAME
M
CITIZENSHIP
RELATIONSHIP
none
AGE
ADDRESS
(St. and Number)
(City)
(State)
(Country)
RELATIONSHIP
AGE
2. NAME
CITIZENSHIP
ADDRESS
8. NAME
(St. and Number)
RELATIONSHIP
(City)
(State)
(Country)
AGE
CITIZENSHIP
ADDRESS
(St. and Number)
(City)
(State)
(Country)
SEC. 5. FATHER (Give the same information for stepfather and/or guardian on a separate sheet)
SEC.
FULL NAME
Samuel
(Not)
LIVING OR DECEASED
Danford
(Middle)
living DATE OF DECEASE
PRESENT, OR LAST, ADDRESS
Zehrung.
(Last)
CAUSE
San Rae Gardens, Dayton 9, Ohio
(St. and Number)
DATE OF BIRTH 1/23/1892 PLACE OF BIRTH
(City)
2....
(State)
Roseville, Ohio
(City)
IF BORN OUTSIDE U S. INDICATE DATE AND PLACE OF ENTRY
birth
Landscape Architect.
WHERE?
(State)
USA
(Country)
USA
(Country)
(City) (State) (Country)
own employer over 20 yrs.
-
USA
CITIZENSHIP
OCCUPATION
EMPLOYER'S OR OWN BUSINESS ADDRESS
WHEN ACQUIRED? .....
LAST EMPLOYER
San Rae Gardens, Dayton 9, Ohio USA
(St. and Number)
(City)
(State)
(Country)
b
MILITARY SERVICE FROM
TO
BRANCH OF SERVICE
(Date)
(Date)
COUNTRY ..
DETAILS OF OTHER GOVT. SERVICE, U. S. OR FOREIGN
E TU
6. MOTHER (Give the same information for stepmother on a separate sheet)
FULL NAME_
Hazel
(First)
Charlotte Jackson Zehrung
(Matte)
LIVING OR DECEASED lying DATE OF DECEase
(Last)
CAUSE
State
USA.....
Country
PRESENT, OR LAST, ADDRESS -Son, Faq Gardens Layton Ohio
BIRTH 19/17/1896 PLACE OF BIRTH Montague, Michigan USA
DATE OF BIRTH
CITIZENSHIP USA
WHEN ACQUIRED? birth WHERE?
IF BORN OUTSIDE U. S. INDICATE DATE AND PLACE OF ENTRY
(3)
(City} Mater (Country)
19-4535-:
14-00000
housewife
OCCUPATION
(4)
LAST EMPLOYER Detroit Fourd of Educ†127
EMPLOYER'S OR OWN BUSINESS ADDRESS
18t and Number)
(City)
(State)
(Country)
MILITARY SERVICE FROM
-
---
то
COUNTRY
BRANCH OF SERVICE
DETAILS OF OTHER GOVT. SERVICE, U. 8. OR FOREIGN
1. FULL NAME
Nancy
(First)
PRESENT ADDRESS
SEC. 7. BROTHERS AND SISTERS (Including half-, step-, and adopted brothers and sisters) :
Zehrung..
(Middle)
(Last)
AGE 21
Verity Hall, Middletown Hospital, Middletown, Ohio USA
(St and Number)
Dorothy
2. FULL NAME
(First)
(City
'Jon
(Michelle)
(Blate)
(Country)
Zehrung
PRESENT ADDRESS
San Rue Gardens, Dayton 9, Ohio USA
(Citizenship)--USA
17
AGE
(Last)
USA...
(St. and Number)
(City)
(State)
(Country)
({'itisonship)
3. FULL NAME
Mary
Elizabeth
Zehrung
AGE
...
(First)
(Middle)
(Last)
PRESENT ADDRESS
San Rae Gardens, Dayton 9, Ohio. USA
USA..
(81. and Number)
(City)
(State)
(Country)
(Citizenship)
4. FULL NAME
AGE
(First)
(Middle)
(Last)
PRESENT ADDRESS
(St. and Number)
(City)
(ماهان)
(Country)
5. FULL NAME
(Flint)
(Middle)
(fatizenship)
AGE
(Last)
PRESENT ADDRESS ..
(81. od Number)
(fly)
(State)
(Country)
(Citizenship)
*
SEC. 8. FATHER-IN-LAW
FULL NAME.
(First)
•Middle)
DATE OF DECEASE
LIVING OR DECEASED
PRESENT, OR LAST, ADDRESS
DATE OF BIRTH
(that)
CAUSE
(St. and Number)
(City)
(State)
(Country)
PLACE OF BIRTH
IF BORN OUTSIDE U. S. INDICATE DATE AND PLACE OF ENTRY
CITIZENSHIP
OCCUPATION
WHEN ACQUIRED? -
WHERE?
(City) (State)
"l'ountry)
:
LAST EMPLOYER
20
QU'E
14-00000
SEC. 9. MOTHER-IN-LAW
FULL NAME
(mm)
(Michile)
LIVING OR DECEASED
DATE OF DECEASE
PRESENT, OR LAST, ADDRESS
DATE OF BIRTH
(Last)
CAUSE
(and Number)
(City)
(State)
(Country)
ELLE PLACE OF BIRTH
IF BORN OUTSIDE U. 8. INDICATE DATE AND PLACE OF ENTRY
CITIZENSHIP
OCCUPATION
_ WHEN ACQUIRED?.
LAST EMPLOYER
WHERE?
(City) (Stale) (Country)
12
SEC. 10. RELATIVES BY BLOOD, MARRIAGE OR ADOPTION, WHO EITHER LIVE ABROAD
OR WHO ARE NOT CITIZENS OF THE UNITED STATES:
1. NAME Col. Paul Zehrung.
CITIZENSHIP
USA
RELATIONSHIP
cousin
ADDRESS HI USA FE, APO 633
(St. and Numb-or)
(City)
(State)
2. NAME distant relatives in Sweden RELATIONSHIP.
Grandparents on Mother's side camo from Sweden
ADDRESS
AGE
38
Post Mastor
(Country)
N.Y N.Y.
AGE
CITIZENSHIP
3. NAME
CITIZENSHIP
(St. and Number) Wasi
RELATIONSHIP
(state)
(Country)
AGE ...
ADDRESS
18, std Number)
(City)
(Sitate)
(Country)
SEC. 11. RELATIVES BY BLOOD OR MARRIAGE IN THE MILITARY OR CIVIL SERVICE OF
THE U.S. OR OF A FOREIGN GOVERNMENT:
1. NAME
Col. Paul Zehrung
RELATIONSHIP
ocusin
38
AGE
(S1 and Number)
(Chy)
(State)
CITIZENSHIP USA. _ ADDRESS EI USA FE, APO 633 Post Master,
N.Y.
TYPE AND LOCATION OF SERVICE (IF KNOWN) Director of Maintenance HI USA FE
Major Jack Macklin
2. NAME
CITIZENSHIP
USA
cousin
31
RELATIONSHIP.
AGE
ADDRESS.
Washington, D. C. USA
(St. and Number)
(City)
(State)
(Country)
TYPE AND LOCATION OF SERVICE (IF KNOWN) Pentagon, Mashington, D...C...
Mrs. Elsie Dickent
3. NAME
CITIZENSHIP
USA
RELATIONSHIP
Aunt
AGE55
314 N 29th St. Billings, Hont.
ADDRESS.
USA
1St and Number)
TYPE AND LOCATION OF SERVICE (IF KNOWN)
(y)
Social work
Stats)
(Country)
-
Dept. of Interior
(5)
-located in Kontana
• la
}
14-00000
SEC.
12. POSITION DATA
(6)
A. KIND OF POSITION APPLIED FOR Administrative position with Latin.....
America, Economist, Statistician, or temporarily as a
_ Stenographer....
B. WHAT IS THE LOWEST ANNUAL ENTRANCE SALARY YOU WILL ACCEPT? $
(You Will Not Be Considered For Any Position With A Lower Entrance Salary.) .
C. IF YOU ARE WILLING TO TRAVEL, SPECIFY: OCCASIONALLY
3,100
FREQUENTLY
CONSTANTLY
D. CHECK IF YOU WILL ACCEPT APPOINTMENT, IF OFFERED: IN WASHINGTON, D. C.
ANYWHERE IN THE UNITED STATES
OUTSIDE THE UNITED STATES
x
x
E. IF YOU WILL ACCEPT APPOINTMENT IN CERTAIN LOCATIONS ONLY, SPECIFY LOCATIONS:
SEC. 13. EDUCATION
ELEMENTARY SCHOOL West Carroll EssWest Carrollton, O. USA
(City)
(State)
(Country)
DATES ATTENDED
1933 - 1944
HIGH SCHOOL
Oakwood High School ADDRESS.
GRADUATE? 389
Dayton 9, Ohio
USA
(City)
(State)
(Country)
DATES, ATTENDED
1944 - 1946
GRADUATE? Yes.
COLLEGE
Syracuse University ADDRESS Syracuse,
(('lly)
New York
(State)
USA
(Country)
MAJOR AND SPECIALTY
Economica & SpaniaEARS COMPLETED.
4
1946
-
1950
BA
DEGREE
!
Spanish
DATES ATTENDED..
COLLEGE
Universidad de Sun C Guatemala City, Guatemala C.A.
MAJOR AND SPECIALTY
(Gow)
5 credits
(City)
(State)
_ YEARS COMPLETED
DATES ATTENDED
summer 1948
DEGREE... none given
CHIEF UNDERGRADUATE COLLEGE SUBJECTS
economics
statistics
Spanish grammar literaturo.
CHIEF GRADUATE COLLEGE SUBJECTS.
-
:

14-00000
I
2
SEC. 14. ACTIVÉ U. S. OR FOREIGN MILITARY SERVICE
(Country)
(Last Station)
REMARKS:
(Service)
(Berial Number)
A
none
(Rank)
(Dates of Bervice)
(Type of Discharge)
SELECTIVE SERVICE BOARD NUMBER ADDRESS.
IF DEFERRED GIVE REASON
INDICATE MEMBERSHIP IN MILITARY RESERVE ORGANIZATIONS
SEC. 15. CHRONOLOGICAL HISTORY OF EMPLOYMENT FOR PAST 15 YEARS.
ACCOUNT
FOR ALL PERIODS. INCLUDE CASUAL EMPLOYMENT. INCLUDE ALSO PERIODS
OF UNEMPLOYMENT. GIVE ADDRESSES AND STATE WHAT YOU DID DURING
PERIODS OF UNEMPLOYMENT. LIST LAST POSITION FIRST. (List all civilian em-
ployment by a foreign government, regardless of dates.)
FROM 4/51
TO
CLASSIFICATION GRADE
(IF IN FEDERAL SERVICE)
EMPLOYING FIRM OR AGENCY. Board of Geographic Namoa
Interior Bldg.
ADDRESS
C & 18th Sta:, 1, W, Washington, D. C.
(St. and Number}
KIND OF BUSINESS..
TITLE OF JOB
YOUR DUTIES
3
USA
(Ct)
(State)
(Country)
Mrs. Mildred Koorman
_ NAME OF SUPERVISOR.
Statistical Dreftamall
SALARY $2,050
drawing discrition, drafting, typing
PER VP,
FROM
4/51
ΤΟ
REASONS FOR LEAVING botter position more in my interests
5/50
CLASSIFICATION GRADE
(IF IN FEDERAL SERVICE)
ADDRESS
(St. and Number)
KIND OF BUSINESS nursery
TITLE OF JOB
clerk
EMPLOYING FIRM OR AGENCY
Box 240 Dayton 9, R. R. 11 Ohio
San kee Gardons, Inc.
USA
(City)
(State)
(Country)
Ray McKechnie
NAME OF SUPERVISOR
1.10
hr.
SALARY
PER
YOUR DUTIES hookkeeping, pin, ole king, making financial
reports, ordering wholesalo, making floral arrangements
1
REASONS FOR LEAVING to take a job ore in line with my training
(7)
14-42566-1
14-00000
2/50
FROM
(8)
5/50
ΤΟ
CLASSIFICATION GRADE
(IF IN FEDERAL SERVICE)
EMPLOYING FIRM OR AGENCY National Peanut Council.
1111 Dipont Circle Building, Washington, D. C. USA
ADDRESS
KIND OF BUSINESS
(St. and Humer)
(City)
Trade SOC.
TITLE OF JOB
Asst. Bookkeeper
(State)
(Concary)
NAME OF SUPERVISOR Mr. William F. Seals
BALARY
200
mo.
YER_..
YOUR DUTIES bookkeeping, filing, goneral office work, financial
"
reports
REASONS FOR LEAVING ... return home to help my father in his business
FROM
6/47
ΤΟ
8/47
EMPLOYING FIRM OR AGENCY
Plant
CLASSIFICATION GRADE
(IF IN FEDERAL SERVICE)
Frigideira, Ocneral Hotora.
Dayton 9; Ohio USA
# 2
(City)
(SL And Nuvolari
ADDRESS
KIND OF BUSINESS
TITLE OF JOB
YOUR DUTIES
manuf
(State)
(Canary)
NAME OF SUPERVISOR MR, Herbert Halderman
SALARY ...
PER
office work in the chemical laboratories
work in the factory proper
REASONS FOR LEAVING
return to college
4-40
6-40
FROM
TO...
CLASSIFICATION GRADE
(IF IN FEDERAL SERVICE)
EMPLOYING FIRM OR AGENCY
Grants 5/10 Store
ADDRESS
Syracuse, New York
USA
(St. and Ha
(City)
(rinte)
(zristry)
KIND OF BUSINESS....
35029
NAME OF SUPERVISOR.
TITLE OF JOB clark
PER_
YOUR DUTIES waited on customery into lo deventment
SALARY $
:
REASONS FOR LEAVING part-time temporary position for Hester
11
14-00000
SEC.
16. HAVE YOU EVER BEEN DISCHARGED OR ASKED TO RESIGN FROM ANY POSI-
TION? HAVE YOU LEFT A POSITION UNDER CIRCUMSTANCES WHICH YOU
DESIRE TO EXPLAIN? GIVE DETAILS:
NO
SEC. 17. GENERAL QUALIFICATIONS
A. FOREIGN LANGUAGES (STATE DEGREE OR PROFICIENCY AS "SLIGHT," "FAIR," OR
"FLUENT")
LANGUAGE
Spanish
LANGUAGE French..
· LANGUAGE
SPEAK fluont
SPEAK slight.
SPEAK __
fluent
fluent
READ
WRITE
READ fair WRITE
fair
READ
WRITE .
B. LIST ALL SPORTS AND HOBBIES WHICH INTEREST YOU: INDICATE DEGREE OF PROFI-
CIENCY IN EACH:
-
Art-drawing, painting, crafts, studied at school good
Swimming, good; Reading; Knitting, good;
tennis, fair
Basketball, fair;
C. HAVE YOU ANY QUALIFICATIONS, AS A RESULT OF TRAINING OR EXPERIENCE, WHICH
MIGHT FIT YOU FOR A PARTICULAR POSITION?
I have spent a summer in Guatemals, living with a Guatemalan
family, learning the life and ways of a Spanish family and ofty.
I have quite a complete knowledge of the florist business from
helping my father over a period of about 3 years.
D. LIST ANY SPECIAL SKILLS YOU POSSESS AND MACHINES AND EQUIPMENT YOU CAN USE,
SUCH AS OPERATION OF SHORT-WAVE RADIO, MULTILITH, COMPTOMETER, KEY PUNCH,
TURRET LATHE, SCIENTIFIC OR PROFESSIONAL DEVICES:
calculator
APPROXIMATE NUMBER OF WORDS PER MINUTE IN TYPING __ 60.
(5)
SHORTHAND.
70
32-52513-1
14-00000
(10)
E. ARE YOU NOW OR HAVE YOU EVER BEEN A LICENSED OR CERTIFIED MEMBER OF ANY
TRADE OR PROFESSION, BUCH AH PILOT, ELECTRICIAN, RADIO OPERATOR, TEACHER,
LAWYER, CPA, ETC.
NO
IF YES, INDICATE KIND OF LICENSE AND STATE
FIRST LIC. OR CERTIFICATE (YR)
LATEST LIC. OR CERTIFICATE (YR)
F. GIVE ANY SPECIAL QUALIFICATIONS NOT COVERED ELSEWHERE IN YOUR APPLICATION
BUCH AS:
(1) YOUR MORE IMPORTANT PUBLICATIONS (DO NOT SUBMIT COPIES UNLESS REQUESTED)
(2) YOUR PATENTS OR INVENTIONS
(3) PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE.
(4) HONORS AND FELLOWSHIPS RECEIVED
3-1 did a lot of extempt and declamation work in public speaking
contests in high school. I am a member of the National Forensic
League.
4-I received a partial scholarship from Chapel at Syracuse
University.
G. HAVE YOU A PHYSICAL HANDICAP, DISEASE, OR OTHER DISABILITY WHICH SHOULD BE
CONSIDERED IN ASSIGNING YOU TO WORK? IF ANSWER IS "YES," EXPLAIN:
HO.
HL DO YOU RECEIVE AN ANNUITY FROM THE UNITED STATES OR DISTRICT OF COLUMBIA
GOVERNMENT UNDER ANY RETIREMENT ACT OR ANY PENSION OR OTHER COMPENSATION
FOR MILITARY OR NAVAL SERVICE? IF ANSWER IS "YES," GIVE COMPLETE DETAILS:
HQ
1602955-1
:
14-00000
SEC.
18. GIVE FIVE CHARACTER REFERENCES-IN THE U. S.-WHO KNOW YOU INTI-
MATELY (Give residence and business addresses where possible.)
1.
Mr. John Lewis
Street and Number
BUS. ADD
RES. ADD.
City
State
Oakwood High School, Dayton, Ohio
NA
2. Mr... Herbert Holderman BUS. ADD Frigidaire, Plant 2, Dayton 9.Ohio
11 Winding Way, Dayton 9, Ohio
RES. ADD
Mr. Albert F. Kuhl, M.DBUS. ADD Harries Bldg. Dayton Ohio
NA
RES. ADD
Mr. George Pohlmeyer BUS. ADD.
NA
RES. ADD
96 Winding Way, Dayton, Ohio
Kiss Katherine Smith
5.
BUS. ADD
NA
RES. ADD 59 Wiltshire Dayton 9, Ohio.
SEC. 19. NAMES OF FIVE PERSONS WHO KNOW YOU SOCIALLY IN THE UNITED STATES-
NOT REFERENCES, RELATIVES, SUPERVISORS, OR EMPLOYERS-(Give residence
and business addresses where possible.)
City
State
RES. ADD R. R. 2 Cazanovia NY
Street and Number
1. Miss Theadosia Koran BUS. ADD.
HA
Mrs. Ed Eastin
2.
3.
Miss Batty Hollis.
4. Hr. Harry Schwartz
Mr.ter Bohm
5.
BUS. ADD San Rae Gardens Dayton 9, Ohio
RES. ADR _Pease Ave., West Carrollton, Ohio
BUS. ADD. Arlington Arex, Arlington, Va.
RES. ADD. 1401-16th St., N. W. Washington DC
BUS. ADD v, of Syracuse, Syracuse, R.Y.
RES. ADD
A
BUS APD Winter's National bank, Dayton, 0.
259 Greenmont blvd. Dayton 9,
RES. ADD
SEC. 20. GIVE THREE NEIGHBORS AT YOUR LAST NORMAL RESIDENCE IN THE U. S.—
(Give residence and business addresses where possible.)
1. Mr. Ray F. McKechnie
school ₤2.
Hiss Shella Dewey
Neighbors
City
State
San Rao Gardens, Dayton 9, Ohio
same
Street and Number
BUS. APD.
RES. ADD.
BUS. ADD..
NA
RES. ADD.
Box 303 Spuncer, M. Y.
HA.
RES. ADD..
811 Abbott.st. Highland Park
3. Mise Marilyn Morris BUS. ADD
11
SEC.
21. FINANCIAL BACKGROUND
A. ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY: yes IF NOT, STATE SOURCES
OF OTHER INCOME
B. NAMES AND ADDRESSES OF BANKS WITH WHICH YOU HAVE ACCOUNTS
West Carrollton Bank-West Carrollton Ohio
Wasington Loan and T Co.,
13-872331
Washington, D. C.
14-00000
(12)
C. HAVE YOU EVER BEEN IN, OR PETITIONED FOR, BANKRUPTCY?
GIVE PARTICULARS, INCLUDING COURT:
D. GIVE THREE CREDIT REFERENCES—IN THE U. S.
no
1. NAME Heredian Hill Hotel ADDRESS 2601-16th St NW Washington DC
Mrs. Blick
(t, and Number)
(City)
State)
ADDRESS 1401-16th St, NW Washington DC
Syracuse NY.
2. NAME
3. NAME
1. and Number)
(City)
Delta Gamma Sorority
ADDRESS
901 Walnut Ave.
(St and Number)
.....
(City)
........
(State)
(State)
FROM 4-1-51
TO.
FROM 5-50
TO 4-51
FROM 2-50
ΤΟ
5-50
9-48
2-50
FROM
TO
SEC. 22. RESIDENCES FOR THE PAST 15 YEARS
Present
1401-16th St., N.W. Washington. F.G. USA
(St. and number)
(City)
(Htate)
(Country)
Son Rae Gardena, Dayton 2, Ohio USA
(St. and number)
(City)
(Blato)
(Country)
2601-16th St,, NW Washington, D.C. USA
(t. and number)
(City)
(State)
(Country)
901 Walnut Ave., Byracuse, H. Y. USA
(St. and number)
(City)
(State)
(Country)
9-46
9-48
FROM
ΤΟ
(it and num)
two cottages of Syracuse Univ, Syracuse
USA
(City)
(Male)
(Country)
7-48
8-48
FROM
ΤΟ
9 C.P. # 30 Guatemala City, Guatemala
(St. and mum
(City)
(Riate)
(Country)
FROM
time before this San Rae Gardens, Dayton 9, Ohiɔ
USA
(St. and number)
(City)
(State)
(Country)
FROM
ΤΟ
(E. and Number:
(City)
(Hinte)
(Country)
A. FROM
7-46
ΤΟ
FROM 7-48.
TO 8-48
SEC. 23. RESIDENCE OR TRAVEL OUTSIDE OF THE UNITED STATES
Mexico City Mexico tourist
(City open)
(Country)
Guatemala City Quotemala.
FROM
ΤΟ .....
(int)
FROM.
FROM
ΤΟ
tity or Dar
(( uit/)
(Country)
(Country)
... TO
SEC.
+Country)
__
(Purpose)
student.
(P3)
(Purpose)
ܚܐܙ ha (
24. CLUBS, SOCIETIES, AND OTHER ORGANIZATIONS
LIST NAMES AND ADDRESSES OF ALL CLUBS, SOCIETIES, PROFESSIONAL SOCIETIES, EM-
PLOYEE GROUPS, ORGANIZATIONS OF ANY KIND (INCLUDE MEMBERSHIP IN, OR SUPPORT
OF, ANY ORGANIZATION HAVING HEADQUARTERS OR BRANCH IN A FOREIGN COUNTRY) TO
WHICH YOU BELONG OR HAVE BELONGED:
901 Walnut Ave., Syracuse, II. Y. USA
(C)
(State)
(Country)
1950 to present inactive
1.
Delta Gamma -
Name and Chapter)
Pho
(SL and Number)
1947-50 active
-
DATES OF MEMBERSHIP:
Spanish Club
(St. and Nemier)
(City)
1947 3
9
Syracuse Univ., Syracuse, N. Y. USA
(blate)
Woanity)
2.
3.
(Name and Chapter)
DATES OF MEMBERSHIP:
Economics Club
.
(Name and Chapter)
DATES OF MEMBERSHIP:
Syracuse Univ., Byracuse, N. Y. USA
(St. and Number)
(Ct)
(State)
1948 9 - 50
g
-
9. Brownies Grado School -
Dayton 0, Chio
West Currollton, Olo
USA
USA
Westminsterian Church
+Country)
14-00000
10.
11.
Girl Scouts High Stool - Best Colton, Ohio
-
Hemmador. &
-
1943-4
Westminster Presbyter
USA
Church
-
Dayton 9,v..
UDA
12.
Alumni Association of Syracuse Univ, Syracuse, N. Y. USA
1950-
International Relations Club - Syracuse Univ, Syracuse H.Y. USA
Name and Chapter)
(St. and Number)
DATES OF MEMBERSHIP: 1946-7-8-9
&
2nd & 1st Cabinet
-
Chapel
(Name and Chapter)
1St. and Number)
1948-9
(CUF)
(State)
(Country)
Syracuse Univ., Syracuse, N.Y. USA
(Cu)
(State)
(Country)
&
DATES OF MEMBERSHIP:
National Forensic League - Oakwood High School, Dayton 9, 0. USA
(Name and Chapter)
DATES OF MEMBERSHIP:
(BL and Number)
1945-6
(CRF)
(State)
(Country)
active
Sigma Theta Phi
-
Dayton 9, Ohio
USA
high school sorority
9.
(Name and Chapter)
(St. and Number)
(City)
(State)
(Country)
DATES OF MEMBERSHIP:
__1945-6
SEC. 25. MISCELLANEOUS
A. DO YOU ADVOCATE OR HAVE YOU EVER ADVOCATED; OR ARE YOU NOW OR HAVE YOU
EVER BEEN A MEMBER OF, OR HAVE YOU SUPPORTED, ANY POLITICAL PARTY OR ORGANI-
ZATION WHICH ADVOCATES THE OVERTHROW OF OUR CONSTITUTIONAL FORM OF GOV.
ERNMENT IN THE UNITED STATES?
IF YES," EXPLAIN:
NO
B. DO YOU USE, OR HAVE YOU USED, INTOXICANTS?
EXTENT!
YES
IF SO, TO WHAT
an occasional drink at dinners und parties
C. HAVE YOU EVER BEEN ARRESTED, INDICTED OR CONVICTED FOR ANY VIOLATION OF
LAW OTHER THAN A MINOR TRAFFIC VIOLATION? IF SO, STATE NAME OF COURT, CITY,
STATE, COUNTRY, NATURE OF OFFENSE AND DISPOSITION OF CASE:
NO
D. HAVE YOU EVER BEEN COURT-MARTIALED WHILE A MEMBER OF THE ARMED FORCES?
IF ANSWER IS "YES," GIVE DETAILS BELOW:
E. LIST BELOW THE NAMES OF GOVERNMENT DEPARTMENTS, AGENCIES OR OFFICES TO
WHICH YOU HAVE APPLIED FOR EMPLOYMENT SINCE 1940:
NPA&DFA; Atomic Energy Commission:
Council.of.
-Beonomic Advisors; round of Geographic Names...
(13)
1+ 43054-1
14-00000
(14)
F. IF, TO YOUR KNOWLEDGE. ANY OF THE ABOVE HAS CONDUCTED AN INVESTIGATION OF
YOU, INDICATE BELOW THE NAME OF THAT AGENCY AND THE APPROXIMATE DATE OF
THE INVESTIGATION:
Board of Geographic Names
4-1-51
SEC. 26. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY:
.
NAME
_ Samuel D. Zehrung
ADDRESS
(St. and Number)
...
RELATIONSHIP _ father_
USA
(State)
(Country)
San Rae Gardens R. R. 11 Dayton 9, Ohio
(City)
SEC. 27. YOU ARE INFORMED THAT THE CORRECTNESS OF ALL STATEMENTS MADE
HEREIN WILL BE INVESTIGATED.
ARE THERE ANY UNFAVORABLE INCIDENTS IN YOUR LIFE NOT MENTIONED ABOVE WHICH
MAY BE DISCOVERED IN SUBSEQUENT INVESTIGATION, WHETHER YOU WERE DIRECTLY
INVOLVED OR NOT, WHICH MIGHT REQUIRE EXPLANATION? IF SO, DESCRIBE. IF NOT,
ANSWER "NO,”
NO
:
SPARE W
',
SEC. 28. I CERTIFY THAT THE FOREGOING ANSWERS ARE TRUE AND CORRECT TO THE
BEST OF MY KNOWLEDGE AND BELIEF, AND I AGREE THAT ANY MISSTATEMENT
OR OMISSION AS TO A MATERIAL FACT WILL CONSTITUTE GROUNDS FOR IM-
MEDIATE DISMISSAL OR REJECTION OF MY APPLICATION.
SIGNED AT .
Washington DC
Fity and Statef
Bitty L Hallies
Witnessi
DATE: Meng 201001
Senature of
NUMBER ACCORDING TO THE NUM-
SIGN YOUR NAME AT THE END OF
USE THE FOLLOWING PAGES FOR EXTRA DETAILS.
BER OF THE QUESTION TO WHICH THEY RELATE,
THE ADDED MATERIAL. IF ADDITIONAL SPACE IS REQUIRED USE EXTRA PAGES THE
SAME SIZE AS THESE AND SIGN EACH SUCH PAGE.
"
14-00000
152
Soo. 11
-
Mr.
Ji. Zohrung, Sr. Unclo
USA
i
61
1210 Wilson Dr., Dayton, Ohio USA
Rechanical Engineer Wright Air Field,
Dayton, Ohio
14-00000
FOT
Orto
CONFIDENTIAL
SECURITY APPROVAL
Chief, Covert Fersonnel Division
from: Chief, Security Division
SUBJECT: ZEHRUNG, Charlotte Louise
2.
1.
Fili
мея
Date: 16 Oct. 195
Your Reference: 12419
Case Number: 56840
This is to advise you of security action in the subject case as indicated
below:
Security approval is granted the subject person for access to classified
information.
Provisional clearance for full duty with CIA is granted under the provisions
of Paragraph D of Regulation 10-9 which provides for a temporary appoint-
ment pending completion of full security investigation.
The Director of Central Intelligence has granted a provisional clearance
for full duty with CIA under the provisions of Paragraph H of Regulation
10-9.
Unless the subject person enters on duty within 60 days from the above
date, this approval becomes invalid.
3.
Subject is to be polygraphed as part of the EOD procedures.
M.L.
250er
100
Porint
10/18
Ar. not
10/18
C. V. BROADLEKA
Ps st
****
39-301
CONTAL
(4)

14-00000
707-73
CONFIDENTIAL
INTEROFFICE MEMORANDUM
TO:
Chief, Covert Personnel Division
FROM: Chief, Security Division
SUBJECT: ZEHRUNG, Charlotte Louise
Date: August 1951
3.
56840
1. Reference is made to your request for security clearance of the subject
person who is being considered for employment in the following position:
2.
This is to advise you of the following security action:
a. ☐ Provisional security clearance is granted to permit subject's
employment on a temporary basis in the following area or in the following
capacity: D Street Pool
This clearance in prented upon the condition that subject: 1. not
have access to classified material; 2. not have access to secure areas;
3. not be issued a badge or credential; -4. not represent himself as a
CIA employee; and 5. not be assigned to any unclassified duties other
than indicated above.
b.
Name-checks have been completed on this percon. Arrangements
should now be made by your office for an interview in this Division. Upon
completion of this interview further consideration will be given to the re-
quested Limited clearance for access to information classified no higher than
Secret. If subject has not entered on duty under a previously granted p-
visional clearance the interview should be arranged after entrance on duty.
c.
Subject in security approved for temporary appointment to a posi
tion requiring access to information classified no higher than Decret.
Officials of the employing office should be advised of this secu-
rity limitation and should be instructed to supply future expervisors with
advice as to the limitation so as to insure continued compliance.
Security Betion to effect full approval is continuing and your
office will receive advice of full clearance upon completion of this
action. Upon receipt of full security clearance, the present limitation
will be rescinded and supervisors should be advised accordingly.
Dr. Notified
CV. Bradley
ст
FOSH 80.
J1931
20-196
CONFIDENTIAL
:
14-00000
DEPARTMENT
OF
INTERIOR
E
14-00000
1-203
UNITED STATES
MEMON OF PERSC..
RIMENT OF THE INTERIOR
IRI SVILION AND MANAGEMENT
WASHINGTON D.C.
Date of Action
02 2008 of 8000 8000
800
000000
000 000
Res
Kios Charlotte L. febrOS
Sen Rus Gardens, fl.il. 11
Dayton 9, Chio
Journe
...
Permanent
CLAVICE OF
OR LEGAL AUTHORITY
CB Certificate No.
H-2500 dated 1/16/51.
C.B. Reg. 2.115
Acteurishion
-
Effective Date: April 2, 1951
Position
Grade and Salary
Bureau
Branch
Headquarters
Departmental
From
or Field
Q. I.
• Martha K. Hold
INDUFI BITS APFOLDSET
Work
To
Statistical Drafteran
08-3, 82650.00 per annus
(08-1553-30504)
offies of the becretary
Division of Geography
Machington, Do Go
Empartmental
Mis appointment is cufeet to a trial peried of one year.
Subject to investigation.
Dala sppsintment you will be covered by the Nation
Snatal Serity by
hogilar
to
1/12/29
Yes...
root evidence
Ohio
Brace
T₂
“VETERĀRTS PREFERENCE
No
LAST STATUS CHANGE
O
APPOINTMENT
live
NATURE OF POEÏÏÍÒN“ *¯*
V. Identics! _
More Warthe E.Reid
V&1638-3¬£4
Mathilda
Chief, instrative brach
(SGD) THOMAS TELLIER
Pal
Seed
feer
P
Offles of use Secretasy
Appropriation Tule: rting And, Interior, Hard 64
JUSTIFICATION
Bouro¿àia Ny. W01.
Contato essential reasons for the action recommended;
As he be selected for expoteza a eat
Service Cor76
25.
op Givi ! Speita paper, in certificate, and fors 75
Tap premye loyalty check are etched,
Attelse.
Social Security Now 069-24-3138
BUREAU NOTIFICATION COPY
SOMET
LA ACT AS
2/2/31
AMORATIVE
AUTRICAL FOR ACTION1
New agendas Glicers
9.
ALLGRATASPROVAL
14-00000
DTANDARD FORM so is ATT)
UNITED STATED
CIVIL SERVICE COMMISSION
OCTOBER 1946
UNITED STATES
ARTMENT OF THE INTERIOR
OFFICE OF THE SECRETARY
00
COO
000 000
NOTIFICATION OF PERSONNEL ACTION
1. NAME (MA.-MIDS-MRS. FIRST-MIDDLE INITIAL-LAST)
Mes Obavlatba La Babrung
A. DATE OF BIRTH
3. JOURNAL OR ACTION Na
4. DATE
1/22/09
This is to notify you of the following action affecting your employment:
5 NATURE OF ACTION (USE STANDARD TERMINOLOGY)
(To escept Arcepted Appl.
Reparation with Central Intelligens
FROM
Statistical Draftsman
(08-1853-3-503)
63-8, 82650.00 por amm
Office of the Secretary
Division of Goography
Research Branch
Washington, Do Go
6. EFFECTIVE DATE
7. CIVIL SERVICE OR OTHER LEGAL AUTHORITY
8/26/51
Agener
16. POSITION TITLE
3. SERVICE, GRADE,
SALARY
10. ORGANIZATIONAL
DESIGNATIONS
11. HEADQUARTERS
ΤΟ
FIELD
13. REMARKS
DEPARTMENTAL
12. FIELD OR DEPT'L
Any leave remaining to your credit will be transferred.
Separated without remploymenė rights.
15 VETERAN S PREFERENCE
NONS PT
IS POINT
201
15300
EX RATE
FIELD
DEPARTMENTAL
16. POSITION CLASSIFICATION ACTION
VICE. A
19. APPROPRIATION
248391.003 Working
FROM "Pan, Interior, Office of the
TO
20 SUBJECT TOC
RETIREMENT ACT
(YES -NG)
21. DATE OF OATH
LACCESSIONS ONLY)
22, LEGAL PESIDENCE
4. PERSONNEL FOLDER COPY
mis (plain)
1 SE, M 743364
14-00000
ve to the
APPOINTMENT CLERK
at the
PHS OUTPATIENT CLINIC
4th and
Streets SW.
EL 8100 Est. 1728
(Gods 1/6)
FIRST
1.
Charlotte
NATICH TITLE
2
329718
L. Zehrung
Statistical Draftaman.
8.
3. DATE OF BIRTH
1/29/29
AT THE SERVICE CHECKLO BLLOW.
PHOTOTLUCROGRAM
_ HAS AN APPOINTUTSET ON
A. M.
AT.
P M.
11/040)
OB-GYN
12
BACKLIZY
16.
NUTRITION
MFCICAL
EXAMINATION
9
☐ PHYS MED.
☐☐☐
MENTAL
17.
HEALTH
10
SURGICAL
16 ULSTAL
15.
DERMATOLOGY
$5.
ELAST.
LADORATORY
MEDICAL
OTHER
13. ☐ (Spify)
21. CLINIC ALGO
STANDAR
FEM
FP. M. CHAPA KI
" ☐ PEDIATRIC
21. NAME A
13-09-
MA
MEDICAL APPOINTMENT AND REPORT
2
14-00000
STANDARD FORM 61 (REVISED APRILL 1907)
PROMULGATED BY TIVE FEE COMMISSION
CHAPTER AS FEDERAL PERSONNEL MANUAL
:
APPOINTMENT AFFIDAVITS
IMPORTANT.--Before swearing to these appointment affidavits, you should read and understand the
attached information for appointee
Office of Secretory Washington DC
(Place of employment)
Interior
(Department or agency)
Geograp
Dyrenu or division)
do solemnly swear (or affirm) that-
1. Свальбы завоевавыстаў
A. OATH OF OFFICE
I will support and defend the Constitution of the United States against all enemies, foreign and
domestic; that I will bear true faith and allegiance to the same; that I take this obligation freely
without any mental reservation or purpose of evasion; that I will well and faithfully discharge the
duties of the office on which I am about to enter, SO HELP ME GOD.
B. AFFIDAVIT AS TO SUBVERSIVE ACTIVITY AND AFFILIATION
I am not a Communist or Fascist. I do not advocate nor am I a member of: any organization
that advocates the overthrow of the Government of the United States by force or violence or other
unconstitutional means or secking by force or violence to deny other persons their rights under the
Constitution of the United States. I do further swear (or affirm) I will not so advocate, nor will
I become a member of such organization during the period that I am an employee of the Federal
Government.
C. AFFIDAVIT AS TO STRIKING AGAINST THE FEDERAL GOVERNMENT
I am not engaged in any strike against the Government of the United States and that I will not
so engage while an employee of the Government of the United States; that I am not a member of
an organization of Government employees that asserts the right to strike against the Government
of the United States, and that I will not, while a Government employee, become a member of such
an organization.
D. AFFIDAVIT AS TO PURCHASE AND SALE OF OFFICE
I have not paid, or offered or promised to pay, any money or other thing of value to any person,
firm or corporation for the use of influence to procure my appointment.
E. AFFIDAVIT AS TO DECLARATION OF APPOINTEE
February
The answers contained in my Application for Federal Employment, Forin No. 52 .......
dated
1950, filed with the above-named department or agency,
which I have reviewed, are true and correct as of this date with the exceptions noted in the Declara-
tion of Appointee on the reverse of this form. (If no exceptions, write "None" on the Declaration
of Appointee.)
Charter Zarung
(Signature puntec)
Subscribed and sworn before me this
(City)
2 day of
arie
261943
a Washington
act of June 26,
[SEAL]
pie
D.C.
(State)
gn state of offer)
A. D. 19 51
"Echel S. Covell
Clark, Division of Teography
NOTE.-If the orth is taken before a Notary Public the date of expiration of his commission should
be shown,
10-03140-1
14-00000
MECLARATION OF APPOINTEE
This form is to be completed before entrance on duty. Question 3 is to be answered in all cases, otherwise
answer only those questions which require an answer different from that given to the corresponding
questions on your application form. If no answers are different, write "NONE" in Item 10, below. Any
false statement in this declaration will be grounds for cancellation of application or dismissal after appointment.
Impersonation is a criminal offense and will be prosecuted accordingly.
1. PRISENT ADDRESS (afreet and number, city and State)
16th St
1401
1/12/29
2 (A) DATE OF BIRTH
Washington D.C.
(B) PLACE OF BIRTH (city of town and State of country)
Dayton
Co. U.SA
(R) PILATIONSHIP
(C) STREET AND NUMBER, CITY AND STATE
in
(D) TELEPHONE NO.
1. (A) IN CASE OF EMERGENCY PLEASE NOTIFY
Samuel D. Zehrung
THE PAST 24 MONTHS? ☐ YES ☐ NO
Father Can Ree Gardens. RRI WA 5851
Sextors
& DOES THE UNITED STATES GOVERNMENT EMPLOY. IN A CIVILIAN CAPACITY, ANY RELATIVE OF YOURS (EITHER BY BLOUD OR MARRIAGE) WITH WHOM YOU LIVE OR HAVE LIVED WITHIN
If so, for each such relative All in the blanks below. If additional space is necessary, complete under Item 10.
NAME
POST OFFICE ADDRESS
(Qive street number, if any)
1.
&
2.
1.
2
INDICATE "YES" OR "NO" ANSWER BY PLACING "X"
IN PROPER COLUMN
YES NO TEMA
MO.
B. ARE YOU A CITIZEN OF OR DO YOU OWE ALLEGIANCE TO THE UNITED STATE
8 ARE YOU AN OFFICIAL, OR EMPLOYEE OF ANY STATE, TERRITORY, COUNTY, GR
MUNICIPALITY?
If your answer is "You", give details in Item 10.
1. DO YOU AFCTIVE ANY ANNUITY FROM THE UNITED STATES OR DISTRICT OP
COLUMBIA COVERNMENT UNDER ANY PER
ACT OR ANY PENIAGA
OTHER COMMEN„A? „¿• UHLFAHNYA quae ; e
If you was is" You", Aive in Itam to reason for retirement,
thatge, opsional Tisability, or by reason of voluntary
involuntary reparation after 3, carte, amount of
rotirement pay, and under what rotuement act, and reting.
if retured from military or naval service.
B. HAVE CHARGED FACED TO RESIGN, FOR MISCONDUCT
OR UNSATISFACTORY SERVICE FROM ANY POSITION.....
If your answer is "Yes', Aive in Itam 10 the name and address
of employer, date, and reason in each case.
9. SINGE YOUR 16TH BIRTHDAY, HAVE YOU EVER BEEN ARRESTED INDICTED, OR
SUMMONED INTO COLD AS A DEFENDANT IN A CHIMINAL PRE
62
CONVICTED FINED OR IMPRISONED OR PLACE DONERATION OIL HAL
EVER BEEN OROPPED TO LLOSIT HAIL OR CALATERAL FOR THE VASTIGA
OF ANY LAN PO REGULATION CRORONABLE (EXCLUDING MINOR TRAFFIC
VIOLATIONS FOR WHICH AIRE OR FORFEITURE OF 123RLESS WAS IMPOSEOUT
If your answer is "You". hot all auch cars under Itam 10.
tine in each cate (1) The data, (7) the nature of the offence
or violation; (3) the name and location of the court, (^) the
penalty imposed, if any, or other disposition of the cacO
It appointed your fingerprints will be taken
x
1.
2
(1) POSITION (:) TEMPORARY OR NOT
DUPARTMENT OR AGENCY IN WHICH
MAR-
RELATION.
AIED
SHIP
EMPLOYED
SINGLE
(Check one)
10. SPACE FOR DETAILED ANSWERS TO OTHER QUESTIONS
WRITE IN LEFT COLUMN NUMBERS OF ITEMS TO WHICH DETAILKO ANSWERS APPLY
INSTRUCTIONS TO APPOINTING OFFICER
The appointing officer before whom the foregoing certificate is made shall
determine to his own antisfaction that the appointment would be in force
with the Civil Service Act, appealle Civil Service Rides and iegulations and
nets of Crogress pertaining to appointment,
The form should be the hard for holding of office pension, uitstality in con
bestion with any record of recent discharge or rest, and party many the the
fatiowir..
Qldentity of appointed-The apponitee's signature and endasitting are
to be competed with the application for other pertinges
The
phy prente inay be checked at the medical state 1 he
appote y also be questioned on his personal history for agreement with s
Previous tatements.
(2)
if dranite age limite have been established for the powvane, i should
teard that applicant to not outande the dare reforement
Until such determination is made, the app
not be edusur.mo.ed.
(1) Citurmushin-The appointing officer is responsible for observing the
tizens pins of (1) the Civil Service Rubs and (4) ippreparation acts,
Form of consputes an ardavit for both purpose and is aptable proot of
Citizenship states in the has ace of contty evidence. In doubt case the
artment should not be conamated until tearance has been se ured tom
the certifying othee of the Civil Service Commun
(4) Mambore of Paech -Sertion 9 of the Civil Service Art provides that
wbreezer there are already two or more members of a famit, serving under
pol or permanent apparent in the competitive scitce, no wher
end of such family is eligible for predation d or permanent agwantaret u
the competitive serv
Tappet of persons earth to veteran
sati.com are not subject to thōs requirement, The tankers-franady provinca
Burn apply to traps rary arouitments. Do Ohrit,ases may be deterred to
thenate ofice of the Civil Service Comes for decision,
16-10-1
14-00000
$-209
UNITED STATES
TMENT OF THE INTERIOR
OVISION OF PERSO
PERVISION AND ALANAGEMENT
WASHINGTON, D. C.
Re:
Miss Charlesto L. Zehrung
Date of Action
Journel
San Rae Gardens, R.R. 11
Dayton 9, Chio
Effective Date:
Position
Grade and Solary
From
Bureau
Branch
Headquarters
Departmental
or Field
O. I.
-
Martha S. Roid
INDEFINITS APPOINTMENT
Connection
To
Statistical Draftsman
GS-3. $2650.00 per annum
(GS-1533-3-504)
office of the Secretary
Division of Goography
Research Branch
Washington, D. C.
Permanent
CIVIL SERVICE C
ONE LEGAL AUTHORITY
CS Certificate No.
H-2580 dated 1/16/51.
C.S. Reg. 2.115
Arcvopriation.
Regular
Level Residence
Ohio
Date of Birth
1/12/39
Sex
Race
F
W
Yet
No ✗
VETERAN'S PREFERENCE
LAST STATUS CHANGE
from
OR APPOINTMENT
To
Effective
Departmental
This appointment is mibject to a trial period of one year..
Subject to investigation.
Undar this sppointment you will be covered by the National
Social Security,
OTS OF PLANE
FEB 15 1951
(SGD) THOMAS H. TELLIER
Signed xxxx
V
Ratina
NATURE OF POSITION
Vice ✗ Add. Identical_
Name Martha E.Reid
GS-1633-3-504
How
Reallegation
Other (Sing
SUPEREMONIT
No-
"SATE THIS ACTION INITIA
2/21/51
ADMINISTRATIVE
AUTHORITY FOR ACTION
އ
Recommending incens
xan
Bl
"
Approodlation Tide
195.001 Working Fund, Interior, Beard on
Geographie Nan, Sundry, 1951.
Camerons for the ection recowe, deal
JUSTIFICATION
Miss Bohrung has been celested for appolatzent from Civil
Service Certificate 11-2580
Her Civil Service papers, medical certificate, and Fora 05
for pre-appointment loyalty ohook are attachod,
At tech.
146
3/15/1
Pre appt. Rogally cont
DEPARTMENTAL ACTION COPY
Bill
pesAtl
-
__
S
ALLOCATION: APPROVAL
6.5-1533-3-50th
14-00000
STANDARD FORMS
Proranate
August 4, 1967, da
Cheil hervloe Codimitation
(Olmptor 12, F. F. M.)
REQUEST FC
'ORT OF LOYALTY DATA ON AI
LANTS AND APPOINTEES
T TO BE USED ONLY FOR APPLICANTS AND APPOINTEES
THE RECORD CHECKS AND INQUIRIES ARE CONDUCTED
BY CIVIL SERVICE COMMISSION
(PART 1-LAFCUTIVE ORDER DEJS)
CASE SERIAL NO.
(0°st use only)
TO:
The following information is furnished for identifiention purposes on the person named below. Kindly furnish a report on any
loyally information contained in your bice (The Enterprits of this person me attached)
1. FULL NAME (initials and
sirements of hill pane
are not table).
Z ALIASES AND NICKNAMES
Sherri
(STPM)
Zohrung
(Uiven name)
Charlotto
(All idle of other native)
Louise
3. DATE OF THIS REQUEST
2/14/51
& SPECIAL NUMBERS KNOWN TO REQUESTING AGENCY (HI number se FBI Amber, prabor, Army or Navy serial number, sowman's certanto of
dentification, alien registration number, Bocal bouurity number, etc. edify which)
Social Security No. 067-24-3138
& PLACE OF BIRTH
B. 3LX
Dayton, Ohio
☐ MALE
6. DATE OF BIRTH
7. TITLE OF POSITION
Jan. 12, 1929
Statistical Draftsman SENS
(Division of Geography)
9. MARITAL STATUS
FEMALE
☐ SINGLE
☐ HASPID
11. DATE OF APPOINTMENT
12. TYPE
APPL
13. IF MARRIED, GIVE SPOUSE'S FULL NAME, AND DATE AND PLACE OF BIRTH
None
te
EXCEPTED
[******ite Civil Service or other best maturity
☐
'Ib
12. ORGANIZATIONS WITH WHICH AFFILIATED, OTHER THAN RELIGIOUS OR POLITICAL ORGANIZATIONS OR THOSE WHICH SHOW RELIGIOUS OR FOLITICAL
AFFILIATIONS
Delta Gamma Sorority
14. DAILS AND PLACES OF RESIDENCE FOR THE LAST 10 YEARS
From
To
Street
Bao kas Gardens
901
ainut Ave.
Zan 74 Gurdene
901 in Ame
R. R. 11
30 Novena Callo Ioniento
501 laut Ave.
City
Dayton
Syracuse
Dayton
Kyracuse
Guatemala City.
Syracuse
State
Ohio
NY.-
Ohio
L. Y.
Guntonala C.A.
k. Y.
Tag Cardons
11. DATES, NAMES AND ADOK OF EMPLOYERS FOR THE LAST 10 YEARS
Unemployed prior to
Epiplayer
9/17
_ Friitaire Plant $2
ה:..
ustacuse
Mashington
PROTE","
Sayton,
Bytom, ontó
Address
Phyton 9, Ohio
WAR
Unemployed
WAR
5/0
Grants bipe tors (part-tino) Syrnamie,™*. 7.
6/9
Unemployed
6/49
949
2/50
Dan Ras Sardona, R. R. 11
Unemployed
Dayton, hio
2/50"
5/50
National Peanut Council
111
te-
5/50
proa.
Peyton, ho
Can no Gardens
136, THIS ANY HAS LOYALTY INFORMATOS FURNISHED BY THE AGENCIES PROPIATED AHOR
AGENCE WHICH ARE THE LOYALTY
hone
DATE OF REPORT
32. THIS SPACE RESERVED FOR RI TURN REPORT
10 AutXCY WERE 20 DEROGATORY IN
FORMATION IS DEA ELOPED
HI MARKS
19. NAME AND MAGNETRANG VALHOY
Paraense Picer
Te2/20152
Office of the merotary
Repartort of the interior
ܕ ., ܕܦܐ tlesiain
SLE HAVLIGE FOR REPORT ON CASES WHIAS DEANATORY TO ANILD
1-13-463-1
14-00000
__
UNITED STATES C
DIRECTOR
SERVICE COMMISSION
FOURTH U. S. CIVIL SERVICE REGION
TEMPORARY BUILDING 
"R"
3RD & JEFFERSON DRIVE, S. .
WASHINGTON CH. D. C.
PREAPPOINTMENT LOYALTY CHECK
OFFICE OF MASKY
ni, jx
MAR 15 1951
PRELIMINARY REPORT OF CLEARANCE ON INITIAL CHECKS
Personnel Officer
Office of the Sec'y
CASE SERIA
4-61-50/38 SUIS
2. DATE OF 65
3/14,51
3. PROPOSED
AFFL
Dept. of the Interior
Mach. 25, D.C.
L
10. NAME (Laat, first, middle)
PERSONAL
AND
CONFIDENTIAL
4. COMPETITIVE
15. EXCEPTED
7. DATE OF TH
ZUUMING, Charlotte Louice (Aka, Sharri)
A. PROPOSED POSITION, ORGANIZATIONAL DESIGNATION, AND PLACE OF EMPLOYMENT
1/12/29
Statistical Draîtumuna kort, of tht. off. of secty, DO
Preappointment loyalty check has been made on the above applicant for a 'sensitive' posi-
tion, pursuant to Chapter 12 of the Federal Personnel Manual. This check revealed no deroga-
tory information regarding this person's loyalty.
No further papers are required if the proposed action is the appointment of a person
employed by another agency and you have determined from the losing agency that the appointed
or incumbent check has been completed.
For any other type of appointment action, please submit to this office within thres
working days after the appointee enters on duty (1) application, (2) fil- covering any in-
vestigation or inquiry conducted by your agency on a preappointment basis, and (3) Standard
Form 87 (fingerprint chart) unless fingerprint search has already been mede as shown by item
9A below.
GA. FINGERPRINT SEARCH HAS BEEN COMPLETED AS PART OF THE PREAPPOINTMENT LOYALTY CHECK.
8.
XX
FINGERPRINTS WERE NOT SUBMITTED AS PART ON THE PREAPPOINTMENT LOYALTY CHECK.
C. FINGERPRINTS WERE UNCLASSIFIABLE. YOU MAY EITHER WAKE THE APPOINTMENT AT ONCE AND 523419 REPRINTS
WITH. THE OTHER REQUIRED PAPERS, OR (2) WITHHOLD APPOINTMENT SPEPRINTS SEPARATELY FOR COMPLET
110% OF FINGERPRINT SEARCH BEFORE YOU DECIDE WHETHER TO APPOINT,
UNCLASSIFIABLE FINGEAPAINTS
ARE ATTACHED.
WILL OF FORWARDED ON DECEIPT FROM OUR CENTRAL OFFICE.
Please use the copy of this notice for your transmittal or reply. Space has been prov
vided on the back for your convenience. A reply is required, even though it my fist be neces
sary to transmit forms in this case.
By Mauiciqve
REGIONAL DIRECTOR
186

14-00000
TO:
DIRECTOR.
U. S. CIVIL SERVICE REGION
1. Forme attached as requested. Proposed personnel action effected
April 16, 1951
2. Forms not submitted because proposed personnel action dropped from consideration.
3. Forme not submitted because this is an appointment without break in service of a person who was
employed by another agency and it has been determined from the Official Personnel Folder ar³ thë
losing agency that the appointee or incumbent check has been completed.
4. Reprints on Standard Form 87 attached. Decision regarding appointment will not be made.
results of the FBI fingerprint search have been received.
REMARKS:
Forme 57 and 87 attached.
CATE
April 9, 1951
- 05
until the
SIGNATURE OF APPOINTING OFFICER
OFFICIAL TITLE
(J.) F. T. SLITH
Personnel Offieer,
OfClea of the Iscretary.
Dept. of Interior.
3:
i
(Check one) (Check one)
14-00000
OPTIONAL FORM NO. 5
DEEWEE 1947
CIVE STRVICE COMMISSION
(SUPERSEDES CDC FORM 1981)
L
Return this
form to ->
INQUIRY AS TO AVAILABILITY
Miss Charlotte L. Zehrung
San Rae Gardens,
Dayton 9, Ohio
RR11
Pience correct address if different from above;
AGENCY AND ADDRESS (Street, cies, and tha
Miss Mathilda' C. Benser
Chief, Administrative Branch
Division of Googresby
Dept. of the Interior:
Washington 25, D.E.
7
DATE
Jan. 30, 1951
POSITION
Statistical
Draftsman, 53-3
LOCATION
Washington, D. C.
TYPE OF APPOINTMENT.
PRODATIONAL
TEMPORARY FOR
CERTIFICATE
H-2580
SALARY---
.
$2650 p..
Indefinite
This office is considering you among others for the employment described. Please fill out the "Availability Statement"
below, indicating whether you would accept this position if offered, and return the entire sheet to this office. Appointment
would be subject to the Civil Service requirements described on the back of this letter. Whether you are available or not,
3
please reply within …………………….. …………………… days in order that one of those who are available may be selected as promptly as pos
sible to fill the vacancy.
Failure to reply to this inquiry will result in the removal of your name from the register of elligibles until such time as
you request restoration and furnish the information asked for in the statement below.
THIS IS A LETTER OF INQUIRY AND NOT AN OFFER OF EMPLOYMENT. If reflected, you will be notified
and given further instructions.
Other information:
Sincerely nurg,
Mathilda C. Heuser
AVAILABILITY STATEMENT
Chief, min. Branch
✓ I am available and wish to be considered for the position described above. I can report for dirty within 10.
days after notification. I am now employed by San
.... at
☐ I do not wish to be considered for the position described above. I am giving my reassons on the other side of
this form.
I request that my name be removed from the active list of eligibles until I report that I am misuliable for appointment.
☐ Consider me available for other appointments, subject to the following conditions:
The position must pay at least $2,625...per (year, meat day, or hour),
I am willing to work: ☑ In Washington, D. C.; ☐ Anywhere in the U. S.; ☐ Outside the U. S.
I will eccept appointment in the following locations only:
I will accept short-term appointment for: ☐ 1 to 3 months: ☐ 3 to 6 months: iso il months,
Feb-2-1951
(Late)
Charlate
statu+)
14-00000
STANDARD FORM 78
JULY 1949
FEDERAL PERSONNEL
MANUAL CHATTER MI
MED STATES CIVIL SERVICE COMMISSION
CERTIFICATE OF MEDICAL EXAMINATION
(Applicant must supply information below to heavy line)
(Typewrite, or Print in Ink)
& DATE OF BIRTH
1. MR.
MMS
(FIRST NAME)
Urlotte
(MIDULL INITIAL)
(LAST)
3. ☐ MALE
4.
Zehrun
January 18, 1889
☑ FEMALE
4. ADURESS
&TLE OF PUSITION
San 1.0 Gerden, Juyton 3, Olio
Statistical Draftsman
7. LOCATION
6. ULPARTMENT OR BURLAU IN WHICH YOU ARE TO QE EMPLOYED
Interior
-
Office of the Secretary
Division of Geography
Washington, D. C.
6. ARE YOU NOW LMPLOYED IN THE POSITION SHOWN IN ITEM 57 ■ YES & NO. IF YOUR ANSWER IS "YES,” GIVE THE DATE OF YOUR ORIGINAL APPOINTMENT TO
THIS POSITION:
8. (A) HAVE YOU ANY PHYSICAL DEFECT OR DISABILITY WHATSOEVERI
YES NO IF YOUR ANSWER IS “YES,” GIVE DETAILS:
(1) DOES THE VETERANS ADMINISTRATION RECOGNIZE SERVICE-CONNECTED DISABILITY IN YOUR CASE? ☐ YES ☐ NO
(C) HAVE YOU EVER RECEIVED DISABILITY RETIREMENT FROM THE U S. CIVIL SERVICE COMMISSION? ☐ YES E NO
Bign your name in INK as it appears on your appli-] SIGNATURE OF APPLICANT
cation in the presence of the physician for purpose
of identification.
Charlie L. Z
DOCTOR: All questions on both sides of this certificate and on the lower half of the attached Health Qualification Placement Record
must be answered. Before beginning the examination refer to items 9 and 10 on the Health Qualification Placement Record so that you
will have knowledge of the physical requirements of the position to which the applicant is to be appointed. Sign both this certificate
and the Health Qualification Placement Record.
1. HEIGHT:
2. EYES:
6
FECT 8 INCHES
20
WEIGHT
20
POUNDS.
20 20
(A) DISTANT VISION (SNELLEN); WITHOUT GLASSES: RIGHT/2+ LEFT 100 WITH GLASSES, IF WORN: RIGHT : 5 LEFT 30
(D) WHAT IS THE LONGEST AND SHORTEST DISTANCE AT WHICH THE FOLLOWING SPECIMEN OF JAEGER NO. 2 TYPE CAN BE READ BY THE APPLICANT? TESİ
EACH EVE SEPARATELY.
employees in the Federal classified service, as may be requested
by the Civil Service Comuniston or its authorized representative.
This order will supplement the Executive Orders of May 29 and
June 18, 1923 (Everutivo Order, Suptember 4, 1924).
(C) EVIDENCE OF DISEASE OR INJURY:
RIGHT.
WITHOUT GLASSES:
WITH GLASSES, IF USED:
R..
IN. TO.
To 2 IN.
R._
IN. TO
TO 28 IN.
L
✓
IN. TO
IN.
LEFT.
LT IN. TO 22 IH.
*(0) COLAR VISION IS COLOR VISION NORMAL WHEN ISHIHARA OR OTHER COLOR PLACE TEST IS USED? ☐ YES ☐ NO
IF NOT, CAN APPLICANT PASS LANTERN, YARN OR OTHER COMPARABLE TEST? ☐ YFS ☐ NO
3. FAIL (CONSIDER DENOMINATORS INDICATED HERE AS NORMAL RECORD AS NUMERATORS THE GREATEST DISTANCE HEARD) ORDINARY CONVERSATION:
NIGHT EAR 2.
LEFT EAR EVIDENCE OF DISEASE OR INJURY- RIGHT EAR
20 FT.
20 FT.
4. NOGE
•nrimal
7. GASTRO-INTESTINAL
5. PARA MASAL SINUSES
pyonal
LEFT EAR
& MOUTH AND THROAT
Tityna.
☐ YES ☑ NO. IF "YES" IS ULCER: ☐ ACTIVE ☐ QUIESCENT
DATE OF LAST X-RAY.
HEALED
(A) HISTORY OF PEPTIC ULCER:
HOW LONG
SYMPTOMS PRESENT. IF ANY (Severity, frequence, etc):
TREATMENT (L'so apeño under "Ramache” if troeded):
& HETASCLIC DISORDERS (INDICATE ANY ABNORMALITY OF THE FOLLOWING GLANDS BY A CHECK IN THE APPROPRIATE BOX, AND EXPLAIN UNDER “REMARKS,”),
☐ THYROID
☐ PANCREAS
☐ PITUITARY
☐ OVARIAN
10-25001-2
14-00000
9. HEART AND BLOOD VESSELS
Moment
(3) 15 ORGANIC HEART DISEASE PRESENT? ☐ YES ☐ NO
(A) BLOOD PRESSURE:
SYSTOLIC
MM. HG _DIASTOLIC 28
(C) IF ORGANIC HEART DISEASE IS PRESENT, IS IT FULLY COMPENSATED?
☐ YES ☐ NO
(D) PULSE RATE.
SITTING
IMMEDIATELY AFTER EXERCISE (UNLESS CONTRAINDICATED).
TWO MINUTES AFTER EXERCISE __ CARDIAC RESERVE.
Fars.
(GOOD, FAIR, OR POOR)
10. LUNGS.
RIGHT.
HISTORY OF TUBERCULOSIST
mamal
LOFT.
normal.
YES (X NO. IF "YES," HOW LONG HAS THE DISEASE BEEN ARRESTED?
IF THERE IS HISTORY OF TUBERCULOSIS. IS ANY TYPE OF COLLAPSE THERAPY BEING RECEIVED AT PRESENT? ☐ YES ☐ NO. IF "YES," GIVE FULL DETAILS
UNDER “REMARKS.” IS MEDICAL SUPERVISION NECESSARY? ☐ YES
(IF X-RAY IS MADE, GIVE REPORT UNDER "REMARKS.")
NO
11. HERNIA: ☐ YES ☑NO. IF "YES,” NAME VARIETY: INGUINAL, VENTRAL, FEMORAL POST-OPERATIVE, ETC.J
IF PRESENT, IS IT SUPPORTED BY A WELL-FITTING TRUSS? ☐ YES ☐ NO
12. VARICOSE VEIKS: ☐ YES ☑NO. IF YES," STATE LOCATION AND DEGREE
13. FEET: IS FLAT FOOT PRESENT? ☐ YES ☐ NO. IF "YES," STATE DEGREE OF IMPAIRMENT OF FUNCTION.
(AGNE, SLIGHT, MODERATE SEVERE)
14. DEFORMITIES, ATROPHIES, AND OTHER ABNORMALITIES, DISEASE NOT INCLUDED ABOVE
hone
15. SCARS OF SERIOUS INJURY OR DISEASE
½
onc
16. NERVOUS SYSTEM: (A) INCLUDE SYMPTOMS AND FULL HISTORY OF ANY MENTAL, NERVOUS, OR EMOTIONAL ABNORMALITY (USE ADDITIONAL SHEETS IF NECĖS.
SARY Js
none
(B) HAS APPLICANT EVER BEEN HOSPITALIZED OR TREATED FOR A MENTAL ILLNESS?
(C) WHERE (NAME AND LOCATION OF HOSPITAL):
(D) DATE OR DATES OF HOSPITALIZATION:
(E) DESCRIBE ANY RESIDUALS OF PREVIOUS MENTAL OR NERVOUS ILLNESS:
YES ☑NO
(F) ANY HISTORY OF EPILIPSY OR FAINTING SPELLS? YES ☐☐ NO. IF SO, GIVE DETAILS UNDER "PI MARKS" PELOM
17. EVIDENCE OR HISTORY OF VOLPEAL DISEASE IF BLOOD SEROLOGY OR OTHER LABORATORY KAMINATIONS ARL MALL, GIVE OLISILS UNDER "REMARKS."
16. URINALYSIS (IF INDICATED):
SP. GR
CASTS.
ALBUMEN.
BLOOD
I HAVE FOUND THE APPLICANT ABKORMAL UNDER THE FOLLOWING HEADINGS
'
SUGAR
PUS
REMARKS:
Bood physical conditions. Normal state of health.
19 SIGNATURE OF PHYSICIAN OR EXAMINER -
t
10. ADDRESS OF EXAMINING PHYSICIAN (Typed or printed)
NAME TYPED OR FRINTED
Albert F. Kuhl, M.D.
21. SO YOU HAVE FEDERAL DESIGNATION
IF YES, SPECIFY
DATE
2/8/51
☐ YES NO
916 Harries Bldg. Dayton 2, Ohio
☐☐☐ FULL TIME
PART TIME
800
ES BASIS
11-3701:
14-00000
LMR
(FIRST NAME)
MIDDLE
(MIDDLE INITIAL
(LAST)
MRS
MISG
ADDRESS
Cintriotte
Dearung
HEALTH QUALIFICATION PLACEMENT RECORD
(This section is comparable to Standard Form 90 promulgated March 1945 by Bureau of the Budget Circular A-14)
་་
2 DATE OF 315TH
Jury 18, 1929
5. TITLE OF POSITION
.
MALE
FEMALE
San Gurdens, Dayton, Ohio
Statistical Draftsman
cf
Interior
-
"of the secretary
Mvision of Geography
& DEPARTMENT OR BUREAUL IN WHICH YOU ARE TO JE LEPLOYE
& ARE YOU NOW EMPLOYED IN THE POSITION SHOWN IN ILM ST YES NO IF YOUR ANSWER IS YES,” GIVE THE DATE OF YOUR ORIGINAL APPOINTMENT TO
THIS POSITION:
7. LOCATION
Washington, D. C.
TO BE COMPLETED BY APPOINTING OFFICER: Sections 9 and 10
(A) BRIEF OUTLINE OF WHAT WORKER DOES
For the physician's use, set downs in brief and simple terms what the employee
dors on this job, including environmental details such a stairs to climb, distance
to rest-room facilities, cafeteria, work-shift, etc. (Use Section 9 below.)
(8) PHYSICAL DEMANDS OF THE POSITION
In Section 10 below encircle the number of those factors which are essential to
the duties of the position for which this applicant is being considered. The blank
spaces may be used for special facture not listed.
& TITLE OF POSITION AND OUTLINE OF WHAT WORKER DOES IN THIS POSITION (Aditor bar of dictionery of occupational ttica as guide, as applicable)
Statistical Draftsman
-
To assist in the performance of drafting, lottering
and incidental statistical clerical work in the preparation and revision
of index maps, showing the location of approved and disapproved names and
the extent of features to which names apply; charts. graphs and other
illustrative materials in connection with the functions of the Research
Branch and for administrative purposes.
TO BE COMPLETED BY EXAMINING PHYSICIAN: Sections 10, 11, 12, 13, 14, and 15
INSTRUCTIONS The Itered below indicate the physical requirements of
the position for which this ludividual is being considered Intiate the individual's
physical capacities for this portion by placing an X in the appropriate clearin
te the numbers encercle 1. If the individual has any other physical haitations
12
relating to physical reja verents not encircled or not covered by this form, inficate
these under "Romney" on the reverse side. Whenever PARTIAL capacity has
been indicated, expisia under "Remarks,” giving specific quantities
PHYSICAL REQUIREMENTS
ENVIRONMENTAL FACTORS
1 outge
2. CUTSIDE AND INSIDE
1 EXCESSIVE KLAS
& EXCESSIVE COLD
1 EXCESSIVE HUMIDITY
& EXCESSIVE DAMPRESS OP CHILLING
PY ATMOPHETIC COMPTIONS
& EXCESSIVE NOISE, INTERMITTENT
2. CUNSTANT NOISE
11. SILICA, ASBESTOS, ETC.
IL FUPER SHORE, OR CASES
23 SOLVENTS (
*CREATER AIRO CELT
1 RADLANT FERGY
I
LECTRICAL IN Y
125 DURFACE
CAPACITY
FULL PARTIAL NOME
FULL
CAPACITY
FARTIAL
NINASE
WORKING AROUND MACHINERY WITH MOVING PARTS
11 AN OBJECTS OR VEHICLES
WORKING ON LADDERS OR SCAFFOLDING
21 WORKING BFLOW GROUND
_ -
2. UNICAL FATIGUE FACTORS (Specify)
21 WORKING WITH HANDS IN WATER
2.Es
23. VIBRATION
WORKING CLOSELY WITH OTHERS
27. WORKS ALONE
CA PROTRACTED OR FROGIALLAR HOURS OF WORK
---
IN SPECIAL FACTURI (Sport)
10-05-2
14-00000
STANDARD FORM 57--NOV 1947
US CIVIL SERVICE COMMISSION
A LIGATION FOR FEDERAL EMPLOYME…….
INSTRUCTIONS. In order to prevent delay in consideration of your appli.
cata, answer every questurm on the form clearly and completely. TyTe
write or print in INK. In applying for a specific United States Civil Service
esamination, read the examination announcement carefully and follow all
directione If you are applying for a WRITTEN esamination, follow the
306603
APPLICATION NO
U130
ANNOUNCEMENT
| NAME OF EXAMINATION DR KING OF PUSITION APPLIED FOR
Statistical Draftsman
"E OPTION(S) Ul mentioned in esamination announcement)
instructions on the admission card regarding disposition of this application.
If you are applying for an UNWRITTEN examination, mail this application
to the effice named in the antement Be sure to mail to the same office
any other forme required by the antement. Notify the office with which
you file this application of any change in youst address
PLACE OF EMPLOYMENT APPLIED FOR (City and State) || 4. DATE OF THIS APPLICATION
Washington
MI25
First name)
DO NOT WRITE IN THIS BLOCK
For Use of Civil Service Commission Only
MATERIAL
☐ APPOR
Fob 16 140C
NOW APPOR
NOTATIONS:
(Marden, if any)
(Last)
Charlotte Louise Zchrung
6A) STREET AND NUMBER OR AD. NUMBER
San Rec Gardens
(8) CITY OR POST cence (including postal sone) AND STATE
Dentory 9 Chic
LEGAL OR/VOTING
Ohio,
mynt (1010)
DATE OF BIRTH (month, day, your)
January
་
KRU
| (A) OFFICE PHONE (D) HOME PHORE
12.1929
16.
MARRIED
✓ SINGLE
11 PLACE OF BIRTH (nity and State; if born outside US, name city and country)
Bayton Ohio.
18
✓ FEMALE
HEIGHT WITHOUT SHOES:
5 NOT .... INCHES
(B) WEIGHT:
13.2 POUNDS
14. (A) HAVE YOU EVER BEEN EMPLOYED BY THE FEDERAL GOVERNMENTS ☐ YES ☑ NO
IF SO, GIVE LAST GRADE AND DATE OF LAST CHANGE IN GRADE
| ENTERED REGISTER.
SUBMITTED
RETURNED
AF2 RETEW.
APPROVED:
OPTION
GRADE
EARNED PRESTA AUGM.
RATING
ENCE
RATING
3
37.
.
POINTS
(TINT)
"
2
94.
G3:1233
ni
☐ ☐ ☐ ☐ ☐
"0
POINTS
WIFE
OR
WIDOW
DISAL
BEING
INV13-
TIGATED
15. (A) WHAT IS THE LOWEST ENTRANCE SALARY YOU WILL ACCEPT? $
PER YEAR.
You will not be considered fus any position with a lower entrance
salary
(B) CHECK IF YOU WILL ACCEPT SHORT TERM APPOINTMENT IF OFFERED, FOR
☐ 1 TO 3 MONTHS
NOTE. Acceptance of relusal of temporary short-term appointment
will not affect your opportunity to obtain a probational appointment
☐ TO MONTHS ☐ 6 TO 12 MONTHS
(C) IF YOU ARE WILLING TO TRAVEL, SPECIFY
☐ OCCASIONALLY
☐ SPECIILY
CONSTANTLY
16. EXPERIENCE It is important for you to furnish all information requested
beknew in quiboient detail in sale the Civil Service Commission and the
appointing offers of agencies give you full credit in determining your
qualifications. Use a separate black Sve each position. Start 
with your
present position and work borsing clearly the principal tasks which
you performed in each potion, accounting for all periods of unemployment.
Experience gained more than 15 years ago which is not pertinent to the work
for which you are applying me he ensurized in one or more of the blocks.
if your duties changed materally we working for the same employer, use
a separate blink to describe earth. You may include any pertinent
DATES OF EMPLOYMENT (month, year)
FROM
TO PRISENT TIME
PLACE OF EMPLOYMENT (osty and Stato)
JETTY
INITIALS AND
DATE
5.18.
(D) CHECK IF YOU WILL ACCEPT AFFOINTMENT, IF OFFERED:
☑
IN WASHING FOR, D. C. ☐ ANYWHEGE IN THE UNITED STATES
☐ OUTSIDE THE UNITED STATES
IF YOU WILL ACCEPT APPOINTMENT IN CEPTAIN LOCATIONS ONLY. GIVE ACCEPTABLE
LOCATIONS
37 47
reinpous, etvie, welfare, or organizational activity which you have performed,
either sath in witliout compensation, slowing the number of mare se week
on weeke pry year in which you were engaged in such activity, Military
experience should be described in the space below in ste proyer arquence..
(a) If you wriver shiployed in any position under en different from
that shown in ftein 5 of this application, was under "Description of your
k" for carh position, the name o
(b) If you have never bern employed of are wow unemployed, indicate
that fact in the space provided below the "Present Poution."
PRESENT POSITION
EXACT TITLE UP YOUR PRESENT POSITION
NAME AND ADDRESS OF EMPLOYER (hem, organization, or person, if Pederat,
name department, bureau usessablishment, and division)
'
CLASSIFICATION GRADE OF
in Federal Service)
SALARY CR EARNINGS.
STARTING. $
PER
PER
HAME AND TITLE OF IMMEDIATE SUPERVISOR
KING OF BUSINESS OF CRGANIZATION (• 4, wholesnio at, insurance agency.
manufacture of lucks, ato )
NUMBER AND KIND OF EMPLOYEES PAISED BY YOU
DESCRIPTION OF YOUR WORK
REASON FOR DESIRING TO CHANGE EXPLOT
(CONTINUED ON MEXY PAOF)
455--1
14-00000
** CONTINUED
15..4
TATES OF TROY NEXT “Amonið, rear)™
June 'yon Sept '49
יח
PLACE OF EMPLOYMENT (and States
Doyton
EXACT TITLE OF
clock.
CLARIFICATION GRACE SE EARNINGS
(if in Federal becice); StaTING
SOME AND TITLE OF IMMEDIATE SUPERVISOR
FINAL
MER
PER
Chio - Son Rec Gerdes Co-owner. Ray F. Mckechnic
MAVE AND ARE OF (manation, or person&UR ORGANIZATION. We sit insurance agency,
name department, buretor vatablishment, and division)
Ray F Mchechnic
San Rac Gerdens. Dayton O.
NUMBER AND KIND OF EMPLOYEES SUYASED BY YOU
hanc
DESCRIPTION OF YOUR BORE
clarked
in story.
in charge of books.
manufacture of books, etc.)
Gift shop
SEASON FOR LEAVING
return to school
FROM
DATES OF EMPLOYMENT (month, year)
June yin Sept '47
PLACE OF EMPLOYMENT (city and Stare)
EXACT TITLE OF YOUR AXITION
Dayton Ohio Frigidaire
NAME AND ADDRESS OF EMPLOYER (Rrm, organization, or person, if Federal.
name department, bureau or establishment, and division)
Frigidaire
Dayton O.
NUMBER AND KIND OF EMPLOYEES SUPERVISED BY YOU
nonc
DESCRIPTION OF YOUR WORK
CLASSIFICATION GRADE
(if in Federal service)
SALARY OR EARNINGS:
STARTING S
FINAL
PER
PER
NAVE AND TITLE OF IMMERNATE SUPERVISOR
KIND OF BUSINESS OR ORGANIZATION (whoresate silk, insurance agency,
manufacture of ticks, aro.)
manufacture of Frigidaires
REASON FOR LEAVING
return to school
worked on assembly line mical laboratory.
Warked
in office of
CLASNICATION GRADE
(it in Federal service);
"NASE DO THAT OF INMEDIATE SUPERVISOR
SALANI OD KARNINGS.
STARTING }
PAL
*ዞ
PER
BATES OF EMPLOYMENT (id, year)
EXACT TITLE OF YOUR AN'AN
り
ཅ་
PLACE OF EMPLOYMENT (eity and State)
AND ADDRESS ( organisation, or person, if Fectoral No of News OR ORGANIZATION (Wholesale mik, insurance agency,
same department, bureau or establishment, and
tre of locks, etc)
NMBER AND KIND OF EMOTES SPERVISED BY YOU
DESCRIPTION OF YOUR WIK
REASON FOR LEAVING
10-013-06-1
14-00000
・U.S. Civil S
Washington;
Dear Sir:
4
RECEIVED.
MAY 10 1950
00023. MAY!0'50
2601-16th ic., n.w..
Washington, D.C.
May 9, 1950.
seninfratirial for the
unavalmbled yams for a
a 
Setistical
Draftsman, the amouncement
number which is 130.
I have moved the
المدن ان تسعدك تعمل
Womed
you please make the curry
Echanges s
О числе
dddo.
7
I vådrum was!
2401 - 14&fo., nw.
Washington) A). C.
*
my
My
A
Dayton, Ohio
امعة سيد
Santa Eläkelasi við
"
1.12.411
Wank you very much.
Sincerity.
Charlotte L. Zehrung -
ch
14-00000
UNITED STATES CIVIL SERVICE COMMISSION
RATING SHEET-RATING PROCEDURE NO. III .
(Handbook X-105)
PREFERENCE
B-PT.
APPLICATION NO.
10-PT.
NONE
Charlotte
NAME OF APPLICANT
L, Zabrang
POSITION TITLE
63-1533
POSITION TITLE
statistical Draftsman
ANNOUNCEMENT NO.
U-130
BASIC RATING
ADDITIONAL POINTS
EARNED RATING
VETERANS PREFERENCE
FINAL RATING
EXAMINER
REVIEWER
COMMENTS:
POSITION TITLE
ANNOUNCEMENT NO,
BASIC RATING
ADDITIONAL POINTS
TARNED RATING
VETERANS PREFERENCE
FINAL RATING
EXAMINER
REVIEWER
COMMENTS
do
QUALIFYING EXPERIENCE
ANNOUNCEMENT NO.
GRADE GS-3
GRADE
85
BASIC RATING
2
ADDITIONAL POINTS
87 EARNED RATING
VETERANS' PREFERENCE
QUALIFYING EXPERIENCE
G3.2
90
q
94
FINAL RATING
DATE
EXAMINER
DATE
5.18.50
RAMIC
5:18.50
DATE
REVIEWER
DATE
GRADE
POSITION TITLE
QUALIFYING EXPERIENCE
ANNOUNCEMENT NO.
BASIC RATING
ADDITIONAL POINTS
EARNED RATING
VETERANS' PREFERENCE
FINAL RATING
DATE
EXAMINER
DATE
REVIEWER
GRADE
DATE
DATE
QUALIFYING EXPERIENCE
CSC FORM 4909
MAY HIS
14-00000
High
2
years
2
years
14
½ year
Education to be Substitutia
for Experience
years
year
School
mechanicse Drawing
and
algebra
Geomitig
Trigonometry
College
(and)
визнали
Great Statistics
sikus.freets, decis
/wick Laboratory
}

14-00000
Tom 13
February 1946
UNITED STATES CIVIL SERVICE COMMISSION
PROOF OF RESIDENCE
Birk By Number 60-8050
Applications be appointment. In the spentioned, dequartmental mentre must be geromboned by a certificate alviwing bengal be wording sealdance in the State of Terri
by comel F of let me your next preceding the date of misking mylication The inyunt in the operationnel Jepartmental war the
foliowing questions muel la answered, and the furnt and Officer a Certificate of Fire modif Fullure ki uimit this firm premorly equi
"with your insult in kies of conesSaration for pntment in the oitentures who now hold permanent patios in the opportione
dette to have the Office Certifies on it Am in the upset vie"
T.
Mr.
MOVE.
MIN
name) (Micklin
(ruban, il-uny)
Zehrung Charlotte. b.
Street and number, or aral, K. D. number
2601
16
n.w.
Post office (including postal mone) and State
Washington,
#725 11
5. Home of est
Statistical Draftsman
4. Option is any
☑
6. Place and date of written examination (if any)
(a) in what State of Territory do you
I have
Legal residence ...
Ohia...
Voting residence
(b) Length of such residence in Biale
or Territory
(a) In what county do you have
(d) Langth of such readience in auunty
Legal residence'
Mantgomery
From Jan 10.2710 Feb. 16 Viting residence.
(Month) (Yr) (Months) (973)
From 11 19:29 10. FCt. 1940
(Menith) (Y)
7. during the past year you have not resided continuously in the State of Territory in which you chatm legal or voting residence, or are not now actually living in such
State or Territory, Indioule in the following blanke the dates of absences, and lotion and cocuratione during such absences:
(a) Date laſt (Munth, Year) | Date returned (Month. ((c) Location during nil
Ing 
sence (City and State
Boun
Sept... 149 Dec. 184
Jan..
-
ny
Washington
0. If you are under 21 yours of age, fill in the following blanks
(a) Loyal residence of parent or guardian
State
le he a voter in that State? Yes No
County
Length of such rosiionce
(d) Occupation
student.
mat Dok
(c) Prosent post office address of parent or guardian
State
From....
10.
19.
City or town...
"(Month)" (fr.)
From...
IU.
County.
(Month)
(Y₁)
a married woman, fill in the following banks
(a) Date of marriage
() Loyal rondonico uhus
Clate
( Langth of such olderice
Proin....
19.
b
Is ho a water in thul State?
OY #
(Month)
(Month)
Froid....
County...
(Month)
10-1971
19.
(fr)
JURAT (OR OATH)
This jurat for both) must be executed before a notary poklis, the car lotity of a United Data were board of or in inera, ve her officer authored admiris
ter but for before whom the applicant mul appeur in person.
1 the undantanel DO COLLINLY WOR AF775 14) that the statements made by me in rawer to the broguing questions are full and true to the best så my
knowledge and Last of
al
I finalu, profe" or "Mrs" and if married, use Signature of applicant
your own on non, ne "Mrs. Mary I. D
Charlot
Vito apvan nanya,
niting to by the rompered yet, this
NOTARY PUBL
AHON D
MY COMMISSION EXPIRES MARCH 11, 1954
and this for t
nature of offles
(Official tal
OFFICER'S CERTIFICATE OF RESIDENCE
Instructions if the applicant's claim is need on legal rendence, the costicate mult
wary publie, county, muridunt, or police ann desk.
mayor, Juanes of the pence, or other officer in the county or aty in which the applicunt claims recidence.
com laad on voting resince alone, ita corticate
must be executed by the rapistrar of rotera of her ráncer of the Board of Election In other case the ritzer wat ke an actual prinderi ant officer in the city of county
claimed by the applicant, and the coruhente must favor his official seal, ut. in Huns therent, cortitions of sal humeter by the proper citator urine official seal.
The applicant is not required to appear in person before the officer who osecutes this certollosti, but the othear should sutidy tumsnit from prekinis and
compotent evidence na tu luc to which the certifies,
La Notary:
Cetton outlet liter
do hardly certify that
is now
cf.
Dished t
of the county of Montgomery..
and Terntury) of .... Ohio.
Charlotte... .L, Zahrung the applicants the vein connexion with a civil service causation,
Montgomery.
exactly with some given at 
over
... role of the county 
of
Legal
or "ter; it," "voli." or "ljal on sang")
Ohio.
Want. Carrollton.
Onio
(OFFICIAL SEAL
_ and State (as Terntory)
months nost preceding the date herock
and State for Tentury)
and how been such resident for 21 y 1
bounty of Montgomery..
14th day of....
C
My commi-nion expires July-19-1952
H
February 15.50
Bloss,
The Official sual must not be omitted. If casure or correction is made in the "Officer'. Certes," comfication must be made on margin by the officer
who executes the semilicate, showing such correction.
#. & GINENT PRES
10-393-3
14-00000
Her Cent
120
180
Index Numbe Pator Cost of all forts and a four
Selected Commodities
1925-
FORM 1
"
Fruit Veg.
1.
Beverages
170
1601
100
E385
All Foods
Mests
Charlotte & Schrany.
20011 
167..
hington, DC.
Jan12/1729
Stational Draftoman
140
130
1201
110
30
70
1043
1
14-00000
114
112
110
108
106
10%
102
100
98
96
84
42
x
१०
57
86
57
52
PARKIMI
2601 16:27
skinton is
./18.24
#130
INDEX OF WEEKLY EARNINGS BEFORE AND AFTER ADJUSTMENT.
FOR: COST OF LIVING
84
'31
1923
20
$24
'sc
34 '35
36
'57
138 139 14
Index of cockly Earnings - 1937-34-100
Inder of wackly farnings-1988-39
arenage
dollars,
14-00000
مدر
116
190
25
80
"
80
75
30
19.4
TREND LINE FOR INDEX OF PRODUCTION OF MINERALS.
1919-1940
01.
11829
No
x. 6 mo.
brigin 1329-1920,
110
35
36
139
yo
FOR21 1
14-00000
1521
42171
United Stat
17509
Change
in
Population of Unites
✅ United States
and and 1790-13017
250
garithmic 25
15,000
iec
22570
40
120
102
60
+0
༡༠༅རྒྱུ:ལྔ ཋ
1
milkon
1790
1800
1810
1820.
1830
1730
1840
1850
Rhodal
500
13
1830
1300
1910
(3 150
1920
12 103
1930
1940
2012
14-00000
1.
i
144
135
isal
125
120
1115
2288
110
:
105
100
95
90
857
80
75
75
05
45
40
35
30
251
201
Scatter Diagram
10
5
-MAT
Relationship Between, value
of Land
X
Y
FORM 1
A
76 TRE. 9.
1247/7871.
خرید بیمه
14-00000
40
80
10
Frequency Distribution of Batting Records of 157 Reguler American ent National Leogum,
"
17
+
1.
590
210
2304
250
.270
.290
.300
.330
.350
.520
2407
7/37
14-00000
% of
drivers
20
16
ད་
1J
12
"
10
$
2
I Wages of
10:30 1
Cumulative Rstribution
%'s of union
of tharly Water
ictor Truck Drivers June 1, 1940
A her thon Cumulative Distribution
Charlie
#130
101/1924
.55
255
100
56
kain
14-00000
150
14°
130
110
100
"
go
10
60
5
*
309
20
1940
Cumulative Distybution of Batting Aversies
Chenal Leagues 151 Requr Players
of American en
Purving stated average or hers there.
Charlotic ru
20161
#130
,207
299
-267
284
309
.389
.349
307
Metion.
14-00000
Millions
145
L
140
135
€1.50
180
125
120
116
110
105
100
95
90
8:5
80
75
70
65
ན
50
50
45
10.
35
8
00
AP
20
16
10
1790
Population of Continental (United States and Rhode Island
A.C.
flame
1790-1940
FORME
128.141
Blairs
jemle

14-00000
i
:
MMENT
Win Fodral
'50)
CALADY OR EARNINGS
STARTING 1
SIMAL
數量
NAME AND TITLE OF IMMERNATE
pyt..on
(month year)
EXACT THILE OF YOUR POSITION
TD>
SLAGE & EMPLOYMENT (city and State)
GAME AND ADDRESS OF EMPLOYER (BA, organization, or person, if Federal,
name department, bureau of establishment, and division)
KIND OF BUSINESS ORGANIZATION ( & wholecals silk, insurance abonny.
manufacture of heks, ofc)
HUNDER AND KING OF EMPLOYEES SUPERVISEL BY YOU
DESCRIPTION OF YOUR WORK
REASON FOR LEAVING
If more spare se required, use a continuation sheet (Standard Form No. 3) or a sheet of paper the same mese as this page. Write on each sheet your necDE,
address, date of birth, and examination title, Attach to inside of this application.
17. MILITARY TRAINING In the space beate any training servival in
the Armed Pervices (not already listed under Item 16) that would assist
appointing officers in placing you most effectively, Indicate actual amount
DATES
LOCATION
of training receivers, such as hours per week. Detailed informative regard
ing any special service you attended is especially important
pages may be used to give full descriptione)
DESCRIPTION OF TRAINING
FROM
TO
18 EDUCATION (Cucle highest grade compiales):
2 3 4 5 0 7 $ 9 10 11 12
MARK (X) THE APPROPRIATE DOX-10 INDICATE SATIS ACTUARY COMPLETION OF
ELEMENTARY SCHOOL
☑
(C) NAME AND LOCATION OF COLLEGE OR UNIVERSITY
Pyroguae
(A) GIVE NAME AND LOCATION OF LAST HIGH SCHOOL AFTENDED
(D) SUBIECTS STUDIED IN HIGH SCHOOL WHICH APPLY TO POSITION DESIRED
HIGH SCHOOL 7
STIGH SCHOOL
MAKIR
ANDI
CMCIALTY
DATE ATTENDED
YEARS COMPLETED
GEGATES CONFERRED
VISP
n's.st
FRIV
10
NIGHT
TITLE
DATE
University
☐ A
4racuse, n... i
Unir, 28 Quetemale Spon June July!?"
(0) LIST YOUR CHILF LAGU IGRADUATE COLLEGE SUBS
A
LIST YOUR CHIED GRADUATE COLLEGE
(E) OTHER TRAINING, SHGU AS VOCATIONAL
STUDYES GLEN
TRIFUGH THE ARMED FORCES INSTITUT, Laha upuse a heaton
of school, st' IN SLAGICKTHAINING" IN PUBLIC OR PRIVATE EMPLIMENT
PEALING
POBEGN LARGjoka
SUBSTUDIED
DATES ATTENDED
FROM
ΤΟ
ANY TRACER
42 ARE NOW ON MANFRED RANA LICENSED ON LEPTIFIED MEER
(such as pilot, electrician radio aparatur, teacher, lawyer, CPMAICA
Spanish
French
YOU HESTED IN ANY
INDICATE
()()TES AND LENGI von jent notar a s
(3) LAS OR Fto oultery carti, LUSTIG, educa
tion, Creations
.
Moxic0- Imo recreation
Guatemala-amo education
21 LIST ANY SPECIAL SKILLS TO AGGELSE AND MACY STRATEJAMENT TUAL
KARA SANT CERATON SHOW WAVERATIS MAN COMPTOM
STRA, AUCH TURNEY LATHË, SCIENTER
AL DE 23
Calculator
PRATS DAT
☐ Y
☐
PRAY LICENCE OR CIT
LAPER LICENSE CA L'PRSTATE (AM
LICENCE AND STATE:
23 Gustast, army to tEMENDAMINE IN YOUR APPLICATION QUA
(do not about Lepas untaxequested)
(1)
(TENTS AMIN
( KKING EN
2.)
(1)
M
IN SCENTING SUCHTEN SIE
10-4736
安防
14-00000
}
24 SYNCES
the wrene kaing in the United States or Territories of the United States who are NOT related to you and who have definite knowledge of
3 our con' Me and Riness for the position for which you are applying Do not repeat names of supervisors listed under Item 18 (EXPERIENCE),
-PAL.NAME
L
Mc. Harry Schwartz
Miss Theodosis Moran
Mr.
PRESENT BUSINESS
(Give complete current address, including street and number)
BUR OCCUPATION
113 Remacy Are Syrecuchy teacher.
Cazanoria n.y. 130# teacher
Personne
Herbert Hauldermen 11 Winding Way Dayton, & Frigidaire
INDICATE “YES” DE “RO¨ ANSWER OF PLACING “E” IN PROPER COLUMN
25 MAY AQULAY BE MADE OF YOUR PRESENT EMPLOYER REGARDING YOUR
CHAS CALIFICATIONS ETCE
26 ART YOU A CITIZEN OF OR DO YOU OWE ALLEGIANCE TO THE UNITED
STATES
27. ASE YON; NOW OR HAVE YOU EVER BEEN, A MEMBER OF THE COMMUNIST
PARTY IT SA GRANY COMMUNIST ORGANIZATIONE
-
ARE YOU NOW OR HAVE YOU EVER BEEN, A MEMBER OF A FASCIST ORGAN.
ΙΣΑΤΑΝΑΣ
29 ARE ONE OR HAVE YOU EVER BEEN A MEMBER OF ANY ORGANIZATION,
ASNVIATA MTEMENT GROUP OR COMBINATION OF PERSONS WHICH AD-
VOCATES THE OVERTHROW OF OUR CONSTITUTIONAL FORM OF GOVERNMENT,
OR OF AN ORGANZATION ASSOCIATION MOVEMENT GROUP OR COMBINATION
OF PERSON NICH HAS ADOPTED A POLICY OF ADVOGATING OR APPROVING
THE COMMISSION OF ACTS OF FORCE OR VIOLENCE TO DENY OTHER PERSONS
THEIR RIGHTS UNDER THE CONSTITUTION OF THE UNITED STATES OR OF SEEK-
ING TO ALTER THE FORM OF GOVERNMENT OF THE UNITED STATES BY UNCON.
STITUTION
If your answer to question 27, 28, or 29 above is "yes," state
in Item the names of all such organizations, associations,
movements groups, or combination of persons and dates of
members
Give complete details of your activation
therein and make any explanation you desire regarding
your membership of activities therein
30 SINCE YOUR 15TH BIRTHDAY HAVE YOU EVER BEEN ARRESTED INDICTED
OR SUMMONED INTO COURT AS A DEFENDANT IN A CRIMINAL PROCEEDING
OR CONVICTED CRIMPRISONED OR PLACED ON PROBATION OR HAVE
YOU EVER SON ORDERED TO DEPOSIT BAIL OR COLLATERAL FOR THE VIOLA
TION OF ANY LA FOLICE REGULATION ON ORDINANCE (EXCLUDING MINOR
TRAFFIC VIOLATIONS FOR WHICH A FINE OR FORFEITURE OF $25 OR LESS WAS
IMPOSED
If your answer is "Yes," list all auch cases under Item 39
below Give in each case (1) the date: (3) the nature of the
offense or velation, (3) the name and location of the court:
(4) the ty imposed, if any, or other disposition of tho
case 11 anointed. your Angerprints will be taken.
31 HAVE YOU EVER BEEN DISCHARGED OR FORCED TO RESIGN, FOR MISCON
DUCT OR UNSATISFACTORY SERVICE FROM ANY POSITION!
If your answer is "Yes," Live in Item 39 the name and
address of expiover, date, and reason in each case
32 HAVE YOU EVER BEEN BARRED BY THE US CIVIL SERVICE COMMISSION
FROM TASTRO EXAMINATIONS OR ACCEPTING CIVIL SERVICE APPOINTMENTS.
11 your answer is "Yes." give dates of and reasons for
auch deba. mont in Item 37
31 HAVE
N HANDICAP PLEASE OR OTHER DISABILTY
WHEN SANCONSIDERED IN A SIGNING YOU TO WORK
you" complete details in Item 39 so
that cater noan be given to your phytoal fitness for
the rod
34. DO YOU RECEIVE AN ANNUITY FROM THE UNITED STATES OR DISTRICT
OF GRURAL GOVERNMENT UNDER ANY RETIREMENT ACT OR ANY PENSION
CRO COSATION FOR MILITARY OR NAVAL SERVICE
If your war is "You," Aivo complate details in Item 19
FOR
ITEM NO
YES NO
✓
INDICATE TES" OR "NO" ANSWER BY PLACING IN PROPER COLEM
35 ARE YOU AN OFFICIAL OR EMPLOYEE OF ANY STATE TERRITORY. COUNTY.
OR MUNICIPALITY?
If your answer is "Yes," give details in Item 33
36 DOES THE UNITED STATES GOVERNMENT EMPLOY IN A CIVILIAN CAPACITY
ANY RELATIVE OF YOURS (BY MOOD OR MARRIAGE) WITH WHOM YOU LIVE
OR HAVE LIVED WITHIN THE PAST 24 MONTHS?
If your answer is "Yea." show in Item 39 for EACH such
relative (1) full name; (2) present address. (3) relationship:
(4) Department or Agency by which employed, and (5) hind
of appointment
YES
по
SPECIAL INSTRUCTIONS FOR CLAIMING VETERAN PREFERENCE
A. If you are claiming preference as a PEACETIME VETERAN who has
been awarded a campaign badge ne service ribbon, or as a DISABLED VET.
ERAN, or as the WIFE OF A DISABLED VETERAN, the WIDOW OF
A WAR OR CAMPAIGN VETERAN; attach Veteran Preference Claim,
CSC Form 14, together with proof specified therein.
B. If you are WAR-TIME VETERAN not claiming ability preference,
you should NOT submit your discharge with this application. Preference will
be tentatively credited to you and if appointed, you will be required to submit
to the appointing officer prior to entry on duty, offrial evidence of separa
tion from active service in the armed forces of the United States in time of war.
37 (A) WERE YOU EVER IN THE UNITED STATES MILITARY OR NAVAL SERVICE
DURING TIME OF WAR?
(D) IS THE WORD "HONORABLE" OR THE WORD "SATISFACTORY" USED
IN YOUR DISCHARGE OR SEPARATION PAPERS TO SHOW THE TYPE OF YOUR
DISCHARGE OR SEPARATION?
(C) WAS SERVICE PERFORMED ON AN ACTIVE FULL TIME BASIS WITH FOLL
MILITARY PAY AND ALLOWANCEST
(01
YES NO
ކ
DATE OF ENTRY OR ENTRIES INTO SERVICE DATE OF SEPARATION OR SEPARATIONS
BRANCH OF SERVICE (Army, Navy.
Marine Corps, Conat Quard, eto)
SERIAL NO (if none, give grade or
rating at time of separation).
33 (A) IF YOU SERVED IN THE UNITED STATES MILITARY OR NAVAL SERVICE
DURING PEACETIME ONLY DID YOU PARTICIPATE IN A CAMPAIGN OR LAPEDS
TION AND RECEIVE A CAMPAIGN BADGE OR SERVICE RIBBON
(B: ARE YOU A DISABLED VETERANI,
If so, and you have not listed your disability in answer to
Item 33, explain in Item 32 below
(C) ARE YOU A VETERAN'S WIDOW WHO HAS NOT REMARRIEST.
HEY ARE YOU THE WIFE OF A VETERAN AND HAS A SERVITE CONNECTED |
DISPUTY WHICH ALLEGHIM FORELAND
TES 40
THIS SPACE FOR USE OF APPOINTING OFFICER ONLY
The information contained in the answers to Question 37 above has been ver
fied by comparison with the discharge certificate un
Agency'
TEANGAIMS TO OTHER QUESTIONS (Indicate item numbers to which answers apply)
ITEM NO
Title:
_ 12.....
"I trace is required, use paper the same are as this page. Write on each sheet your name, address, date of birth, nad examination rele
of the arrange
Attach to unde
Before agning this application check back over it to make sure that you have answered ALL questions correctly.
I CERTIFY that the statements made by me in this application are true, complete, and correct to the best of my knowledge
and best, and are made in good faith..
False statement on this application
panohable by Law (U. 8. Code.
Tale 75, Section Su)
* SIGNATURE OF APPLICANT
Charlo
(Sign your bin INK fone given
Jal origittels, and surname). If feroale,
pechs Miss Mis and it married use your name "More")
D. 1. COVERMENT FRUSTING OFF99!
10