SECRET SECRET Security Information PERSONNEL QUALIFICATION QUESTIONNAIRE . Serial No, {no entry) é. NAME: (last (first (rniddle 3. Oltice -. MileR  WevOw Seo voPfey - 4. Date of Birth | 5. Sex: Mo omale {i Martial Status A 6.CIA Entry Date: 7 oe ARCH 1926 female (2) | Nr. Dependents # , Citizenship: [8. Acquired By: (1) & Birth (2 Marriage (3). Naturalization x U.S, . (4) Other(specify) — ; Other Year U.S, citizenship acquired, if not by birth {SEC.T. EDUCATION 4d. Extent: (circle one) ¢ . — . i. Less than high school 4. T.wo years college, or less 8. Masters degree 2. High school graduate ®. Over two years, no degree 9. Doctors deyree 3. Trade, Business or | Bachelor degree Commercial school - Post-graduate study graduate (minimum 8 sem, hrs, } iy — renee ere rer memmeemagetaeeeer renee 2. College or University Study: jfeame and location of Dates att'd| ¥rs Compl Sem [College or University |Major|Minor|From 1] To Day IMight Hrs, 'DagrTmouTh Collar | Eco, [AVAL ApPRor [Hanover “MH. 1&0, [ciead 9491461 AB SETI 730 3. Trade, Commercia > an pectalized Training: School 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.ma's Study or Specialization i\Y-1d & ANOTE : | ae Lou TH 444 G46 RE | Aewemnt Live . . i } | | | SECKET 1 ‘ FY Security Information - Nena
14-00000 cee ne ee ee ee ~é> : “Si varity_ formation ey : _— sec. MH. WORK EXPERIENCE — ne i i. CIA Experience: State the srevifte nature of duues performed with CLA and , CIG, starting with your present position. Take position titles from your of- ficial personnel papers. if vou mave personal copies. Please do not requcst ‘ area and subject matter. : 2. Include geographic ssification title such as ganization cht » | your Official Personne! Folver. dealt with, ifcapplicable. Fesition Title is your cla Geographer, Intelligence Cot Duty Title indicates yuur OF position such as > Section CF Administrative Assistant, is to be filled in only if dilterent Approximate dates Use a continuation sheet, if necessary, to seer, “fe. tet, Branch Chief, to the Position Title. and (month and year) are sufficient. adequately deseribe your Cuties: ; oe 2 Tot.mos. Description of Duties: 2 ie iFrom Ee To Peaseatt . ffice FEY CLILES Bi S £9 Position «- 0° Ss i ¢ B des XESS S -} Title: o We ae aot” Cte WCE S ad) £G) Duty St{tion, it versus: £eAaleh SECIEI go 2 Duty 6 oe Title: SECt7i0as CHEF “TDescription of Duties: 2, Fromyygag fe Ful sziot.mos. / ; ; x 5 eal &F _. JA FAI paey: irade sede Salary @ - 2 0 } eg, é hfe 2 Pe : mo é: 7 ; £." | a y 7, - 7 office FES 2. {6 err) re a aek mes Position : . ; title: I, fa = est Fu dial et Duty oo ee ; os Tithe: fieal CHA EF. ; Duty Station, if overseas: J 3 ° Frompeg Sf To ped GZ Tot.mos. ik Description of Dulies: sya ! Lis wh oa ; rade f Salary- Ve a rr aha Ab ta 19 FP Office, FE 4 ; , aa -. : Position nly 4 oT , * : ‘ ttf fz 2. Title: Z. é. PP ta a rag ie efn2sr govt Duty we . } Séctiew CHEF - Duty Station, if overseas: fee Title: Description of Duties: tb arene q. Frome At? Topecs] Tot. mos. sf : sw. Stn-e ond 4 Gradeff/Fs/zSalary E968 - FE GS vee < EE ghee 2 Office FE. ; - fic ; —~o ir. 0.’s Position j me yon fh eee PtA_uhi j me Fane Title: Z. 0, Py - AIP CSS § BE. & Duty . ‘ Sit. eh a ae? Tithe: o€chiaa CALE F Lian Stetion, if overscan: 2 Q . cttaakes g SECRET ° Security Information : ; y . . ao i
14-00000 L SECRET SECRET Security Information SEC. U. WORK EXPERIENCE (CONT'D,) Other than CIA: (Describe work experience for ithe last 15 years in sufficient detail te nermi?f cnrerifie endina af vane aualifiettiane Boros beerden wor bien mse vecen te ~ : Work Ex eR IBNCE otek _than CIA | Work expenience consis ret -@F PA 7) FoLLowin fist. eee! fats Ne erupt mg0T 1934-4 Aad er Tue MAras! OR. BUMMER emp lou MENT _ (wre otto has BEEN to SkhaniesS | 8INcE REuéue oall WEAK iMpeatAay, Tinké portion Fale (duly - Aug - seer) a NeumBoy , Widow DRESSER Cois pay), SIGS Pemtinitr , G eoceey ; clea, TRuemert Prego IN BAND, UAB Eea & ASHE RY Cleak, Soba cleak, LaBoaer , CARPEATRY APPRENTICE E (a 4e) And House prvoriug &. ad ach aL ae sm Pn gutting, Number and Glass ot Employees Supervised: Employer Kind of Business or organization {i.e., paper products mfr, public utility) From To Tot. mo's Classification Grade(l in Federal Service) | Suaiary Number and Class of Employees Supervised: Employer Kind of Bustneas of aorpanisation Duty Station tf overseas: Exact Tithe of your position Deseription of Duties: : a terre rrr ERP er eS TEE, (eememetearem te Og eR cP EE EEE EEE SFE OD A sete re mee Gle., paper produ: ts mir. public a en ni re eee cert renter remanent utility) Duty Station vb overseas! H TT Se “SEO ee ee od ap i} Trae” Se curbty feferrees adtases ~
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