Released under the John F. Kennedy
Assassination Records Collection Act of
1992 (44 USC 2107 Note). Case#:NW
88613 Date: 03-18-2025
JFK ASSASSINATION SYSTEM
IDENTIFICATION FORM
AGENCY INFORMATION
Date : 01/20/98
Page : 1
AGENCY :
RECORD NUMBER :
RECORDS SERIES :
AGENCY FILE NUMBER :
INSCOM/CSF
194-10004-10139
DOD AFFILIATED PERSONNEL INCIDENT INVESTIGATIONS
PAGE 372-373
DOCUMENT INFORMATION
ORIGINATOR
: USA
FROM : HAYASHIDA, MYRON K.
ΤΟ : USA INTELLIGENCE CMD
[ RESTRICTED ]
TITLE :
DATE : 11/25/66
PAGES :
SUBJECTS
2
: FROMER, DAVID R.
DOCUMENT TYPE
CLASSIFICATION
RESTRICTIONS
INDUCTION
: PAPER, TEXTUAL DOCUMENT
:
UNCLASSIFIED
:
CURRENT STATUS : RELEASED WITH DELETIONS
DATE OF LAST REVIEW : 03/07/95
OPENING CRITERIA :
COMMENTS : RECORD REGRADED UNCLASSIFIED ON 2 SEP 94. INCLOSURES
NOT INCLUDED.
NW 88613_Docid:34528580. Page 1.
REQUEST FOR AND RESULTS OF PERSI
TO: (Control Office)
CG, USA Intelligence Cmd
ATTN: ACofS, CONOPS
PO Box 398
Fort Holabird, Md 21219
(AR 381-130)
THRU:
CG, USAREC
.TE
ACTION
25 November 1966
ATTN: Security Officer
Hampton, Va 23369
(Enter name and address of the ACTION AGENCY to which results are to be sent, if known by
requester)
FROM: (Requesting Agency)
CO, AFEES
1515 Clay Street
7 DEC 19kland, California
CONTROL OFFICE USE ONLY
REQUIREMENT
REQUEST NO.
୮
CHIEF, USAPSG
ATTN: Adjudication Branch
Fort Holabird, Md 21219
L
I
ד
DOSSIER NO.
OPENING DATE
REMARKS
1. SUBJECT (Last name in capitals, first and
middle names)
FROMER, David Reed
4. DATE OF BIRTH
(Day, Month, Year)
21 July 1942
7. REQUESTED ACTION
8. TYPE OF INVESTIGATION:
NAC ☐ NACI
SECTION I – REQUESTER TO CONTROL OFFICE
2. ALIAS(ES), 1¥¥WFY¥¥
None
5. PLACE OF BIRTH (City, State and country)
Chicago, Illinois
VALIDATION
☑ INVESTIGATION
BI ☐ OTHER (Explain in Item 15)
10. TO DETERMINE SUITABILITY FOR:
11. JUSTIFICATION
INDUCTION
PAR 18, AR- 604-10
12. REVIEW OF FILES REQUIRED BY PARAGRAPH
NO UNFAVORABLE INFORMATION
RECORDS CHECK
3.
SOCIAL SECURITY NO.
564-58-8137
6. GRADE AND POSITION
N/A
9. a. FOR CLEARANCE AND/OR ACCESS TO:
TOP SECRET
b.
SECRET
CONFIDENTIAL
FOR LIMITED ACCESS AUTHORIZATION
C.
INTERIM CLEARANCE DESIRED
d. ☑OTHER (Explain in Item 15)
AR 604-5, COMPLETED ON
REVEALED:
☐ UNFAVORABLE INFORMATION DETERMINED NOT TO BE A BAR TO ACTION
CONTEMPLATED
INFORMATION SUMMARIZED IN ITEM 15
13. LATEST INVESTIGATION/CLEARANCE (Type, when, by whom)
N/A
14. NO BREAK IN FEDERAL SERVICE
EXCEEDING SIX MONTHS SINCE
N/A
15. REMARKS (If unfavorable information entered, transmit in sealed envelope thru intelligence channels,).
Request investigation of registrant in view of remarks made by registrant in remarks
section of DB Form 98 and DD Form 398. SSN: 4-42-42-204
Regraded
ective
automatic
mmation"
Headquartord
US Army Recruiting Comman
Hampton, Virginia 23369
INCLS
R
16.
INCLS
TYPED NAME AND TITLE
MYRON K. HAYASHIDA
1/LT, AGC
SECTION 11 - CONTROL OFFICE TO REQUESTER
NEW FINGERPRINT CARD REQUIRED
ITEMS
SIGNATURE
372
DATE
ON SPH (PSQ) REQUIRE CORRECTION AND/OR COMPLETION.
INTERIM REPORT FORWARDED. REQUEST REPORT OF ACTION TAKEN AND RETURN OF INCLOSURES UPON COMPLETION.
TYPED NAME AND TITLE
SIGNATURE
DA
FORM
1 APR 64
2784
NW 88613 Docid:34528580 Page 2
1
1
!
SECTION III - REQUE.
17. REPORT OF ACTION
INFORMATION NOTED
18. SUBJECT WAS TRANSFERRED
TO
R
SUBJECT READ
SENSITIVE
INVESTIGATION
MAY BE CANCELED.
HEADQUARTERS
19. REMARKS (If returning corrected forms, state here)
INCLS
TYPED NAME AND TITLE.
°
PER
INFORMATION CONSIDERED NO BAR TO
CLEARANCE. REQUEST COMPLETION
OF INVESTIGATION.
SIGNATURE
DATED
SECTION IV - CONTROL OFFICE TO ACTION AGENCY
20. RESULTS OF PERSONNEL SECURITY ACTION
DATE
30 MAR 1967
NO RECORD
FAVORABLE
MINOR UNFAVORABLE INFORMATION RECORDED IN ITEM 21
PRIOR INVESTIGATION INSUFFICIENT FOR ACTION CONTEMPLATED
IF NEEDED, INITIATE REQUEST FOR INVESTIGATION.
☑ FORWARDED FOR SECURITY DETER-
MINATION BY CLEARING AUTHORITY
TYPE OF INVESTIGATION
☐ NAC
COMPLETED BY
NACI
BI
☑ OTHER
USAINTC
DATE
DOSSIER NUMBER
29 Mar 1967
AA 81 40 20
21. REMARKS
8. THIS FORM. TOGETHER WITH ANY INCLOSURES, REPORT OF ACTION TAKEN AND USACRF COPY OF DA FORM 873
(if appropriate) WILL BE RETURNED TO THE CONTROL OFFICE WITHIN
DAYS AFTER RECEIPT.
b. IN THE EVENT SUBJECT HAS BEEN TRANSFERRED FROM YOUR COMMAND, THIS FORM AND INCLOSURES WILL BE
RETURNED IMMEDIATELY WITH ITEM 23 COMPLETED.
c. ATTENTION IS INVITED TO: PARAGRAPHS.
AR 640-98; AND PARAGRAPH.
AR 604-5; PARAGRAPH _ AR 604-11; PARAGRAPH.
AR 381-130, AS APPLICABLE.
INCLS SUBJECT'S Dos- TYPED NAME AND TITLE DAN H. DIETRICH
sier and that of HIS
father D8 03 23 86
Lt Col
AIS
Chief of Operations III
SECTION V - ACTION AGENCY TO CONTROL OFFICE
22. REPORT OF ACTION
FAVORABLE DETERMINATION, USA CRF
COPY DA FORM 873 ATTACHED
23. SUBJECT WAS TRANSFERRED
ΤΟ
こ
SIGNATURE
S.B. But
DATE
UNFAVORABLE DETERMINATION,
RECOMMENDED ACTION IN ITEM 24
HEADQUARTERS
Regraded U
jet P
RESCINDED PER DA MESSAGE
DA ST75, DATED 16 MAY 66
GATION AS INDICATED IN ITEM 24
Then Separated
DATED
153
24. REMARKS
INCLS
TYBED NAME AND TITLE
NW 88613 Docid:34528580 Page 3
37" at
OPT
This esctive
Mathing is Excluded from Automatig
Termination"
SIGNATURE