2. Su 230RV POTENTS AL a . : —— — ene ne gee eet cae nen mart nies a - PDERSCTIONS: Answer this question: las this person the #bility to he superviene?§ (_} Yes C7) se Tf your é level of supervisory ability this persian will eeach ABTER . SECRET : af * pahen Filled fas 7 ro FITNESS REPORT (Part Il) POTENTIAL __ EMSTRUCTIONS instructions for completing this ¢eport. we ete te tee ene coe one enter er FOR THE AIAINISTRATIVE OFFICER: Consult cuctent FOR THE SUPREVISOR: This report je a privileged commimication to your eupervieng, and to appropriate career manages ment amt personnel officials concerning the potential of the caployesr being ented, Ee ta NOT to be shown to the rated erpioyre, Ft de recommended thet you read the entire report hefore cumpleting any squestion, This report is te be completed only after thr ecaployee has been under your sunrevision ror AT LEAST 90 BAYS. Tf leas thon 9O0days, Uf this is the INITPAL REPORT an the employee, however, it MusT be hala amd commlete after the godaye haw classed. compbeted aad fareargded to the GF no later thet Sddays after the due date aimdicated in item RB of Section “E* te tow. SECTION Es Te ecco SEERA ene ee : t. MAME (Laat) (Pieat) (¥rddle) 2. DATE OF BIA Te 2 Nov 1908 &. GRFTCTAL POSETEOM TETLE Foreign Documenta Of ficer » SEAVICE DESIGNATION SD-0D S. GIFICE AIVESION/ BRANCH OF ASSIGRMENT | O0/FDD/USSR Branco Pr. GRaok @. DATE MEPouT OVE IR OF . B. PERTOD COVERED fr tuts REPORT CEinceliusive dares) ___1 Dee 1956 _ June 1950 - 20 Nov 56 nena ee, segcian (Specd fy) to, TrPa oF REPORT Ki rweareas PRATT GRMENT RUPE aVIRTE {Check one) canner CERTIFICATION — EPORT BEPRESENTS UY BEST JUDGEMENT OF THE TROEVEOUAL BEING RATED renee meee ape Senet nae RVISOR’S OFFICHAL TITLE SECTION Fy 1. FOR tat MATEO, F CEATIFY THat THis & a regan ee eal eee FYPLU OF PRINTED NAME »y SIGNATURE OF SUPERVISOR IC. SUPE a. THIS GATE 8. ntsch b,2¢.1e94 € Lets Avhief, Industrial, Section, @EO imiS HEPORT AND MOTEG ANY OF ER wEOM FN ATTACHED MiMB DSH pe INTTS WAWL AND SI GRIN, OF Ri vpLwins wenn ty , (4 Talbot “Bielefeldt 7 (t< & _ ESTIMATE OF POTEWTIAL fosamund E. De TeTLE OF MOVIL MING OFFICIAL nief, USSR Branch 10.Dee 1956 .. SECTION G. f, POTENTIAL TO agSuue REATER BESPONSTIBI TEES . ia ah nia anal Xiccpaatenneiacniincnnnnan ternal aoe SSDs eee me nee teense ae eet and type of assignment, rate the employea’s potential to assume areater TERSCT ONS: Considering others of his grade responsibibitias. Think in terms of the kind of senponsibitity encountered at the various fevels in his kind of work. . ALAEAGY ABOVE THE LEVEL AT WICH SATISFACTORY PEO ORMANCE CAN BE EXPECTED » HAS REACHED THE MEGHEST LEWEL AT @etCe SATISFACTORY PLAFOUMANTE CAN BE euP ected : = MAKING PROGRESS, BUT NETOS MORE Tiwt BEFORE HE Ca® BE TRAINED 10 ASSUME GREATER ACSPONTIGILETEES READY FOR TRAINING IM ASSUMING GREATER RESPONG IATL EPIES B1k PROBABLY ADJUST GUICALY Fo wae BESPONSIDLE DUTIES wi THOUT FURTHER TRAINING RATING * ALREADY ASSUMING MORE RESPONSIBLE TIES IMAN EXPECTED AT iS PRESENT LEVEL » aM EXCEPTIONAL PERSON @rto 1S OnE OF THE FEE OHO ShULD BE CONSIDERED FOR CARLY ASSUMPTION OF HIGHER ee Rg - hums LEVER RESPONSIBILITIES Me wean = ear ee eee tne meet agsece ie YEN dicate below your opinion of guess of the SUETABLE TRAENISG. Indicate your apinion By placing the number of the descriptive rating below ehich comes closest to expressing your opinion in the appropriate column. ff your, cating és beeed an observing him supervjse, note your pating in the “eetuel* column. Tf based on opinion of his potentisl, note the rating in the "potential" column. a ere tenner annette MR MIS SUPERVISORY POTENTIAL EN THES SstTuation . . th THIS KIND OF SITURTEON DESCRIPTIVE O + HAVE WO OPINION ON $+ BELIEVE PMOEVEOUAL WOULE BE & BEAK SUPERVISOR 2 ener4 . GELLEVE PNOPVEDUAL BOLLE BE AN AVERAGE SUPERVISOR té THES ATMO OF SETUAT EON s 3+ BELIEVE INDivVHOUAL BOYLD BE A STRONG SUPERVISOR tN F415 SITUATION . . DESCRIPTIVE $1 fUAT EON ST TE TT MY errryrTy - - techniciana aF pro fessional spe- actual POTENT EAL | ou pmequawt (Fireé line panne ane fn ttn ee —— a pa Gaaur GONes gestc so@ (track Sravors, srenagraphers, Cialgats of various hinds} estet CONTACT Gere FAMED TATE SUBORDINATES supervisor} : : _ aRacT tae Banec JOB (Second fine supervisors) ee enema @ GAOUF OF SUPERVEST ES euo 8 i NN A I 2 TEP E See FOOs, BHC 6H BC SF ORI ELE ENA BAIDR PEAKS. OxGami ratios a Nm (8 690uUP, Bro way GE BAY REET seg eaouecy (Executive ftewel)} RE A tt A Buacedemates 19 NOY FeCGUERT eet CONTACT Sa tH comma AP ATE , - : Aep wEED CAGETUL COOMBEBATIOR- ACTHVETESS ARE DIVEHTE oucs PMMESTATE SUSTEHLAATES® cence enn tA AEE I OC o___ “‘Por~the reasons st ated on the-Perfornance Papert; I feet tt, Fp ie otmae eq fr & vO f t = itt ae tas Se ofr cll ooo RIPLACES PRERSDES ROITEONS SECRET Potential (a Ae 1) (Part Li) or roms as ano ase eview “ A@E OBSOLETE. bectyot wheeass OF THE OPP OHITE SEF
“SECRET fa@hen Febbed Ind He ENDEC ATE tee APPR UR EMATE sumer CF MON TG Tet: Barr ephctr OF beAG HESS yeory yQue l_monthe cee eee pen sane et TE ER A AO a. COMMENTS CONCE AS 166 PoTra teak I feel Rx very definitely that Mre Tarasoff's overall ‘potentiligd Araypreater than he has had an opportunity to show thue far. This will doubtless BA reflected in his next evaluations MAN Reay . SECTION He FUTURE PLANS a ne ee +. TRATA ING OF OTHER DEVELOPMENTAL CRPCAEENCH Pe ARNE FOR Tok moO eV DUAL Since Mr. Te dhas been on duty such a short time, present plans are eimply. to give him further tral ning in his present job and to allow him to develop to ; his maximun capacity theree He will soon be enrolled in the 1.0.C. y. NOTE OTHER FACTORS, tN CLUGING PEMSONAL CinCUVS TANCES, fo BF “pamtt thTO ACCOUNT 1% POT WVIQUAL'S FUTURE ASS 1GNMENT His native Russian fluency should be taken into account. REVIEWING OFFICIAL'S COLMENTS: 1 do not think he 50 noarly average in all respects ag indicated in Sec. I, below, 1 do not know hin well enough to disagree with most of of the ratings, but I would rate him "4" on items 7, 15 and 29, at least. Quiet, unobtrusive, modest, cooperative. Have seen few indications off initiative, but such not to be expected while hg is learning 4 new job; no reason to assume incapable of initiative. T.Bielefeldt . DESCRIPTIGN OF AMOIVIOUAG cen em SECTION ne Frm nners DIRECTIONS: This section in provided as ai aid to describing the inflividuel as you are him on the job. Interpret the words Literally. On the page below are 8 sesies Of statements that apply in some degree to most people, Te the teft of each statement jen box under the heading “category. Read cach statrment and insert in the box the category number which beat tells how mich the statement applira ty the person covered by this report. Ros MAVE WOT OBSERVED THISs HENCE. CAN Give hO OP ENTON AS TO HO@ THe DESCRIPTION APPLES TO THE imorvEoual APPLIES TO THE INDEVIDUAL TO Tot LEAST POSSIBLE OEGREE 16 CATEGORY NUMBER Zo APPLIES TO PROEWE DUAL YO A LesssTeO GEGREE ge APPLES TO INOT VIDUAL TO AN AVERAGE DEGREE 4 + APPLEES TO INDEVIDUAL fO Aw ABOVE AVEGAGE DEGREE 4. APPLEES TO TEE VIGUAL TO AN OUTS TAN DENG GEGRER careaoar| STATEMENT CATE GURY STATEMENT eee rere nee cnt en mt tent em nome es ee _ 1. sori fa 348 Aan tweet 14. #83 wicw sfawpaaes OF ate 1S Feeect Eve Fe CASTES: . , s1onS HoH aSSaCHATES Pein? Ge vite BOnGer ei Iai ew F 3 pe nr mnanemem 2g. IMPLEMENTS DE CE SH OVS aoe GARPLESS OF CEN PEER INGS nO ener ce es et ne IRR LC Gam BARE GEC EVETHS OM HID ; £2. Suoes seeGrwatt ty ae dete HIER BAESEY ce | naan, ' ! 43. SCTEP TS BaSesurr Ibs . Pd. 1h TeGuawTeul oF OTM ces H . Ra were ars i g. was ft 4 ve rees 3 5 es a ee | BL cane ee A } @. 1S bwAL YT IG fe HES reba : Lig. suet rs wis CeRORS 24, Ones HELL UMDER PRERSUSE 3. a Oe BL a i §. Btaeers cCamstawiny FOw * sareGaod wah TI SUPER ' ° : 1 . TPS. Ge see aAv@? juogtuiet 3 t wee BOSE GE BAD bDEASD 4 yi Siam i} oe Ss nee oe (en eee | dee . awUes anew FO SEER . GOES mPa 258 BI THOUT 26. Us SECuaETE Comectous 3 | aggseraect 3 _ ee eee ween pe Sones a —— ts ob ge cam cat aecmG sity FEGRET p7- GoM 2. 1S wROsATINE 4 ra PROaLews | : > ee ee meee pent cae : 1. ee a — 3 TT Tierse re { dea. mis cartace sw §% COR ' g., wat wteone FOB Pacts ' 3 sVau creed veces  ecne t emai ns CN eee le meee e } . } @. oats twiacs S348 Be. caceagTares gucmte OFC RRs 4 yiom GF 41S QFFESE ee re eee ee COMPLE TER ASS Guus ls JO. So's wot atauret 2rHoRs Bad COMTEMUOUT SUPE Ret eater ALE OPABLE TIME 3 trerts ‘ Stam 3. a see ween eee ee Ra NL AA RT, 3 { 1p. Cae CORE wf Th awe agencres : a ee aa ae wt SECRET 7° f ew eag-s a
14-00000 .. Wait) st . SESPET . seeag MEMORANDUM FOR: Director of Personnel THROUGH 2: CSPS CCS/ NOC Office of Security ci Staff SUBJECT : Summary of Agency Employment - Mr. Boris D. Tarasoff. ¢ l. .Mr. Boris D. Tarasoff, a Translator/Transcriber with the Agency since February 1956, will retire effective 30 November 1970. Your approval is requested for him to use the attached employment history. 2.-°. For your information, we have been advised by the Mexico City Station that once Mr. Tarasoff has retired to Guadalajara, Mexico, except for establishing new social relationships, he will probably not be asked to go into any detail about his past cover jobs that would require anyone to call upon these firms for backstopping confirma~ tion. In the event he should become involved in any post- retirement activities that might require checking into his past, Mr. Tarasoff will contact Headquarters for instruc- tions, , Richa BY Wright Chief, WH’ Support Attachment: — _ Employment Resume /. os f
14-00000 SUBJECT: Summary of Agency-Employment - ‘Mr. Boris D. Tarasoff, ee é AL! Fo ‘Date LM sx W Date : Date pr Staff : Date “Thiet | SECRET |r. t 262 meennone memecetneneenns?
\rS - , ay i 4 e -@ \ : : . . gags 2ago: 7 worked for various pote iishie nia in Wachingten, D.Ces = g tres heter fron Bussisn inte raghicny cucu se the Library of Concresss A yerious ovher teanshetsng Pire.sy igen gbount 33 Vash dngven, Wa solar veryins gn secerdaonec Ltn the euspat of beogce Rated matorisls fyorm 3500 200 to 2,000.00, per month. ; ~ 4 tants ioe U VUrRS Brarrra[Slrndo A, Daph Cornette Urrel Ve.” eee dene con peny. mador._conlasee Fo 2% in Bp ferhre ae Bibel ane be tne Dept Oe tory 8 whnaten= extos -EEvieren? o L worked as an analyst an ranslevor, ab hove most of the TLDs translating and analysivs arbieclos fro noLspa pars mia teehnicsl magccine Se { was peid 33,00 for 3,,000 words for erdin- ary mater’ lag i$ op for teshaiert and w12,60 Lor natentifie smbjectse Aliso, I vas Stheyeyy tne Dept. of State to bo an intorproeter for two ' Soviet det gations at 525,00 por diem plus bxponsede X spent five | acy anes £06 ty oa weeks With exch of them. 2963-1970: After leaving usJPns 1 ears to Mexico woth my wife and children te avoid tho, weathe:’ oxtronos of tho USA KSKEIXS eri to Look into possipilities of profitablo Investments that could ev we fine ancislly sfter mY yotirowint. Ny tncora dering this poriod can from annuitios end tle moneys lent to my brother-in-law gn Cleveland, Ohio, who is 8 successful real estate men and the omer of an amusenent machim s business (Cadillac susie Coe) in vhich IInd invested sore money previously. ok: a—b3* ’ PRETO - 2 ‘ ney wy
14-00000 ‘D.C., as a translator from Russi Library of Congress, and various other - the output of translated m month. eo - (1959-1963: I was employed by USJPRS. Bure of Commerce, washi ae # 1956-1959; I worked for various establishments in Washington, an into English, such as the translating firms, which - abound in Washington, with a salary varying ia accordance with aterial, from $500.00 to 1,000.00 per au of Standards, Dept. ngton, D.C. 2 worked as an analyst and trans t of the time, translating and analyzing articles d technical magazines. IT was paid $8.00 for $10.00 for technical and $12.00 jator, at home mos from newspapers an 1,000 words for ordinary material, for the scientific subjects. Also, Y was utilized by the Dept. of State to be an interpreter for two Soviet delegations at $25.60 per diem plus: expenses. I spent five weeks with cach of them. 1963-1970; “After: leaving USJPRS I came to Mexico with my wife and children to avoid the weather extremes of the USA and to look into possibilities of profitable investments that could ald me financially after my retirement. My income during this period eane from annuities and the moneys lent to my prother-in-~ law in Cleveland, Ohio, who is a successful real-estate man and the owner of an amusement machines business (Cadillac Music Co.) in which I had invested some money previously. -
_ rad ‘ ELECTION, DECLINATION, OR WAIVER IMPORTANT ’ AGENCY INSTRUCTIONS OF LIFE INSURANCE ‘COVERAGE | ' TRY FEDERAL EMPLOYEES GROUP LIFE INSURANCE PROGRAM ON BACK OF ORIGINAL TO COMPLETE THIS FORM— e Raxi the back of the “Duplicate” ‘carefully before you fill in the form. e Fit in BOTH COPIES of the form. Type or use ink. : » Donot detach any part. : 1 FOLLOW THESE GENERAL INSTRUCTIONS: FILL INTHE IDENTIFYING INFORMATION BELOW (please print or type)? 7 boo! agi) 7. GATE OF BIRTH (evonth, day. your) | SOCIAL SECURITY NUMBER i... . foe oe “LOCATION (City. Stete, ZIP Code) , - CET semen coches nee te I. HE BOXES BELOW [do NOT mark mote than one): MARK AN “XIN ONE OF T ELECTION: OF OPTIONAL (IN ADDITION TO REGULAR) INSURANCE ~ Mark here 7] if you : - J elect the $10,000 additional optional insurance and authorize the required deductions WANT BOTH . from my salary, compensation, or annuity to pay the full cost of the optional insurance. optional ard This optional insurance is in addition to my regular insurance. regular insurance (A) DECLINATION OF OPTIONAL (BUT NOT REGULAR) INSURANCE Mark bere oO b ~ 4 dectine the $30,000 additional optional insurance. | understand that | cannot elect o9- the effective date of this declination and unless if you DO NOT WANT . tional insurance until at least 1 year alter under age 50 and present satisfactory medical evidence OPTIONAL Dut! at the time t apply for t tam of insurability. f understand aiso that my regular insurance is not aftected by this dechina- vogulat (B} tion of additional optional insurance. insurance Mark hece WAIVER OF LIFE INSURANCE COVERAGE if you | desire not to be insured and | waive coverage under the Federal Employees Group Life WANT NEITHER . - insurance Program. | understand that L.cannot cance, this waiver and obtain regular in- reguiat ror surance untd at feast 1 year after the effective date ‘of this waiver and unless at the time options? L apply tor insurance fami under age 50 and present satisfactory medical evidence of in- . (¢} sucability. |. understand also that f cannot now or tater have the $10,000 additional insurance . optional insurance unless | have the regular insurance, FOR EMPLOYING OFFICE USE ONLY SIGN AND DATE, IF YOU MARKED BOX “A™ OR "C", | 4 COMPLETE THE “STATISTICAL STUB." THEN RETURN - THE ENTIRE FORM TO YOUR EMPLOYING OFFICE. "etticiat receiving date stamp) a | SIGRATARE (do not print) "yee Table of Etfective Dates on back of Orignnal ORIGINAL COrPY—Retain in Official Personnel Folder STANDARD TORE fo, 76-7 i : : : Aged 14, 1968 {Sar uve only wabl 6-E
t oes r ‘ \ Fs oot . . » 4% _ . . Lae ADaINISTRATIVE INTERNAL USE UNLY } ul i; 3 JUN 1965 ¥ Tiraah. tte b: MEMORANDUM FOR: SUBJECT ‘ _ 3 Retirement Planning @ : 4 . 1. The established policy of the Agency favors early retirement of its employees who, as you know, are normally expected to retire when they become eligible for a full annuity. The prospect of retirement deserves serious thought and planning, and you should therefore know that you will be eligible for retirement, according to our records, during November, 1970, 2, Planning ahead-can bring about, with each passing year, definite progress teward your.retirement goals. The Agency is anxious to assist you in planning for your retirement. It is even more important, as an ernployee, that you begin now to plan for this occasion. 3. You deserve to know as much as possible about the general subject of retirement and more specifically about the retirement policy itself, your annuity, life and health insurance protection, opportunities for other employment, Social Security benefits, and educational materials available on the subject. The Agency feels that this type of information and advisory service should be made available to you at least five years prior to the date of your eligibility. 4. You are requested to call the Executive Secretary of the Board, Mr. Howard G. Phillips, on extension 6872 to arrange an appropriate time to discuss any plans you may have and benefits available to you upon retirement, Ja) Roward G. Feillips Lawrence R. Houston Chairman Agency Retirement Board AD*INISTRATIVE INTERNAL USE ONLY | agua?
Serer OS FIELO REASSFGHMENT QUESTS ONMAIRE __00- i HOT “COMPLETE "RGR HEADQUARTERS USE ONLY ese peeudo oniy Tf $4) 34) OATEC Fece ites S<Dimawe OF suPaRyv esr Carwed poate Cfrow itee $-3) “9 *§ Herbert Manel) 22 96 SOPSPaTer NyuMngas OATE WECEEVED GY CAREER SRAVICTE HMMT-4963 ; “TO BE COMPLETED BY DPLOYEE » OUR CURRENT POSITION, vereg 4, SVation OF Baad G. Cave? ror . . CURRENT cover ; ; : aed G@ADE 1908 - | Intell Officer Mexico DF, Mexico ‘ | GS-12 vs c OESIRTGO Oates TO ecroRy TO ouTY CxPECTEO HATE OF FIRST Go. APTEM LEAVE “CHECK IM AY HG Ga, BATE OF PES anBtvaL So. RT QUESTEA GATE OF ee. te 6 1g80 oe Pan tuRe : 5 June 1963 5-6 Dec, 1965 | 13 Deo 1965 15 Jan, 1966 OCPLUGENTS WHO BELL TRAWEL WET YOts 7. NUMBER AMO AGES OF Wife » 43 Son = 17 PERSONAL CIRCUMSTANCES PHA SHOULD BE COMSIOTRED th DEVE Rai eG MEAT ASSIGNMENT? ‘There are no health or other personal circumstances perventing 4 return to post or assignment to another foreign post. However two factors, of operational and personal nature, should be considered: Subject and family have already initiated and are in the procesea of completing the relatively complicated procedure of legalizin: thotr continued residency in Mexico as “rentistas” (retired persons), Secondly, Subjept'’s _son's secondary school education is being completed in Mexico, Transfer to another sie Nade Gould megatinedy afraat- the completion-:of hts Seeondary schooling, . (else atiach personal cover questionnaire in accordance with CSE-F 260 aa i, Translation and transcription of Soviet technical product, 2e Preparation of charasterization and assesanent studies of the local Soviet complement. .. ; tO. VRAUMING BESIAED: INDICATE BRAT TRAIMENG VOU BIL Ieve vou SHOULD WAVE Dua ins ee wee SEVERAL YEARS if returned to post for @ second tour, continuation of Spanish language instruction, . . FORM pesove re PotvEgus SECRET . c on a wa soaa 202 tertions . ; <a t TAN oneT
SECRET tt, PRESTR ECE FCM MEAT BSS UON MENT TYPE OF BORK YOU BOULN POPFER FOB RET ASS EGHUEST IF DUP LOENT Face Treat iF VOU HAWE MORE Teate ONT PRETERERCE . IMDECATE YOUR CHOECE. geo tcateo gba. OE SEO ERT BRIFE LY Ta ime STEw wo. 8 apOoWE, HA, INDICATE §f VOU DESIRE TO EXTEND YOUR CURRENT TOUR BY CHECKING IM APPROPREATE BOUL ALSO INDICATE PREFERENCE FOR WET REGULAR ASSIGHMENT BY IMSEREENG 7. 2. & 3 ffeor dat, Bnd, and Jed choice) tm MEMRINING BOTS, COMPLETE ALL ALVERRATE CHOICES AMO OFFIONS $M ALL CASES EvEM PmOUGH YOU ARE REQUESTING ar ERTENSIOm OF YOUR Tour. CTEM TOUR oe A MONTHS AT CURRENT STATION 10 moi. HOC ambER L966 toate INDICATE YOUR CHORTLE OF DEVESTON, STAFF om orrice. HD CHOICE ea. 0 BE ALSIGNEO 0 wOQTRS FoR & TOUR oF Duty: 997 CROCE ENG CHOICE BE aAgSiGnta 760 AFIELD STATION). CNOICATEL PROICE OF GEOCMAPHTE AREA OR SPFCTAL ESAT ION 3) Spark ano crorce, UTUuguay _ 340 cuolce —fuenos_ Aires FET Croce (D1 werurn vo wy cumrent varios (Please note that planned departure is Dec 6, due to festor that gon finishes his school year on 30 Nov 65.) . FG BE COMPLETED BY FIELO STATION i% CONSIDEGATION OF THE EXPERIENCE AND “PEREORMANCE OF THE FMPLOVEL AND HIG PREFURENCE FOR NEXT ASS EGMMENT, tMDICATE Your RECOMMENGAT LON FOR HIS HEXT ASSEICRMENY ANU TRAININGS * ‘o . . 8 _ The- Station recommends and urges that Headquarters approve Subject! 8 return to Station, His performances meets every Station requirement. For Subject! 8 work, continuity is essential to obtain maxienum effective product. , os a + ~ : TO BE COMPLETED BY APPROPRI ATE HEADCUARTERS OFFICE 1% COMSEOLRATION OF THF EXPER TENCE AND PERFORMANCE OF THE EMPLOVEEL, HIS PREFERENCE FOR NEXT ASSTCAMENT, AND VHE STAPFING REQUIREMENTS OF YOUR COMPONENT, INDICATE YOUR COMPONENT'S RECOMMENDATION FOR MES NEAT ACSIGHMENT SAD TRAINING, WH Division recommends that FEINGLASS' tour of-duty in Mexico City be extended until December 1965 as requested in section 6 B, and that he return for a second tour of duty ees home , leave. i . . soak , . : 2 Booger "oS nmencnommn, S1GNSTORE Be a FUTLE OR USE BY CAREER SERVICE 3. 46, APPROVED ASSIGNMENT: , Approved extension to end of 1965, followed by home | leave and second tour, « EMPLOYEE MOTAF IED BY OPSPaTCH NO, sae SUD - OaveB: a CABLE NO. DATED: Llacerg h Lt A. Cali. ~ofy - CAREER seavice “nmemree._Debahe Me CAling pate? 22 Dec 1964 (srematured “ol, 5 SECRET
14-00000 ) ns "ROUTING a SLASSIFIED. MESSAGE . a tee Bustos (/ ; eer OUG, @ e vil WH/3/Mexico INF I's ECRET EXT 4 (1) NO INDEX 5940 CU FILE 14 CS FILE NO. 10 + MEXICO CITY | gROM: DIRECTOR. CONF: Ww /e- Infod §=CL0LS~ (or Ay cx OA VE 10 MEXI INFO . CITE DIR 0 i 9 2 0 REF; MEX 8219 (IN 19291)* HDQS HAS POLICE STATEMENT OF GOOD CONDUCT FOR Sines HAS NOTARIZED STATEMENT FROM BANK ATTESTING ANNUAL DEPOSITS $5,500. SINCE BANK WOULD NOT INCLUDE IN LETTER MORE THAN ACTUAL DEPOSITS, HDQS OBTAINED NOTARIZED LETTER FROM COVER DIVISION NOTIONAL FIRM “STATING PEINGLASS HAS YEARLY INCOME $6,000 FROM VARIOUS INVESTMENT SOURCES HANDLED BY THEM, HDQS PLANNING MAIL THESE THREE DOCS TO MEXI CONSULATE ASKING THEM AUTHENTICATE DOCUMENTS AND MAIL TO PO BOX ROUTINE WASHINGTON WHICH USED BY DYVOUR. UPON RECEIPT HDQS WILL POUCH MEXI. END OF MESSAGE Requested what ection Hdqs taking to get bank statement *WH Comment: for FEINGLASS to facilitate his processing @ rentista petition. CCG/NC Baladea (by phone) Jo | - ; LENE MAS, . “ Sp fon, J WH/PERS WiT#@@an (by phone) (ge 4. WHITTEN HD . C/WH/3 on COORDINATING OFFICERS RELEASING QFFICER j ° tt gee ag | | AUTHENTICATERG : : , declassscation ‘ OFFIcER REPRODUCTION BY OTHER THAN THE ISSUING OFFICE IS PROHIBITED. — Copy Now EER ot ete, set
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t i i + # auch Care & © ye eu Eeceise. wa 2 Fes Tcipadien in such programe cas’ he peturve > stints orpenization, Whether parti- rrpition rn a@ part ctula: cover fae tty pregram iu involuntary will be determine by tore ar ean eation. You are hereby authorized Noa. tance with applicable orpanzuticnal currepdly thig premium pay is ten per cd daaeble Cai peosarion ta efficiai Cove: feeuances Kor @. Nunoit ong? oped esp era tete : yt are a@eiesed veder rae: i eho ate ct RT ma Sor tee Bap uw ath ope red ame qQeatica. “8 Ear pert ose ott eed te tev eb trans meetatan siudoetog peu, er a cee Gf thes cuvantcatien pote lt > Soothe ot mo a te erie d anti be OC cn, 2 2 pcdigs sort oy bey ole were ot CONOR OFUGALEEAaAR nS iF Se ee Se } Pra bat tate , % a hf ved Re assent ¢ t wb by ‘ mothe date of vueur arrive estrus ob enatl be suauner Vokad Co aad © oe a a a he ae oe oe r vari taaleadd ba bre Waters bey ec pemarties SPR o sme nb mag a phat ost Uae geezer er ot vated door iee the firs whee at hep dey cae ts pod efarape Affects ¢hait be Ghieprirys i, 3 rar Catée affer the terest year of daty, but : y peGiers ahs. mutiar aciaes cd te. above petupe travel Bt Cecn rn are bt rapertibary & for tr oe. ard feanan warged by the et beover cf i in Ree we og Vv mint bok vee wef fal) Crop mab proses: eel@ake foe ave Keinecare De. ony Casht om anthes Fie Bley aft aniended, and (ther asppliahoa lew WS ARM ONT Wit his
» SECRET ba eenemenemnainne mpeienesnenneremeemmmanenanateeneeminnnnent Ther bat te CARE OFencae T ae OR ay : CONT RACT JRFORMAT! Se Ce ubesta c/a tet ane ehon 18800 ero aa? | PLePwges Fate sti cy 608108 Fee Be operat . ibe toe centre te EEE @, $LO% ma, ga, PaORCT PERGARTAT STATI Om 2a. ryaos texbeo Gaby. Neston CT — @. FMDIVIOVAL HAs Lim Facsug> BY Cha OR ATS ALL LED ACP RVEPLES 6% SOME CaPactty Pa1o8 To tess comtmact, mi! Tote UL pt (fe pee, veacesde aad taclede dates ‘end gelare } None 1% o Present brett rag Foyee 20 Feb CORTHACT 18 TO Ba OF ETE UN FPERELE FORM y SeCumety Cheasance (Pree and dete) ra - whe icay Che Reanee | r a a - Sraft- : NX] covsrero] [oot cance. Ate, *U.d. Out ehel NT (ik van ( ] ae 9 FSP SINUAL DIRE Bowe iemogwe Me tarwoydes CMOS FE. Rw AR OEE 9a. va. “POLE cCavreaee (Contvece agent, MOM AGAY PROM SBE SF mlm AMT PR ar MOE SME R Cee CLR eT TH OF ' fC ndese ft eastosee ofe 8 State TwPLOVEL G8 SVAle ROTGT : ; _ Ace - wy vee FJ ae . cel od Avent LECTION te . - ; : PERSONAL DATA | ; : oo Some acca n ange emene cnet ot a som com coments Seeersoa ar cd ves "E BSF Le, Cerrar, PRBOCWEO wa 88 & Pi Sma- Tas! ALE gre Gate of Brat @Heath, Gap. peas) ‘ : * mae Bis vee? a Lote . . . bee nano a ene ——— wr bette ae at A ee en 1S. LEGAL @ERIDEMCE (Coty and atere ee counter} : 08. CyUMAERT MESIDENCE (Coty and etete ar counte DR © * fasbins 5)G9 ath bt, wey tye bob's to, MARITAL STATUS (Check ae appragerete) [~ etegae 3) seseise = [~] eteowse (7) ssevanee (Th esreearee etegecas eect! PMOCWEDUSL FG RELATED TO A BIA0> EMPLOVER, STAFF AGENT 64 1B ROMMER OF GEPERDERTE (Hot émeladiog sndivideat } : a9. ReLaveoeande ama ages AM CRMBIVIDUAL CURREGTLY BOAR ING FOR Tak AGENCY 16 SOR Caeacaye ee 186 Cj ee : . BEL AT TOMS . Wife, 40 Oo Sun, 14 drother SUCTION LEE U.S. MILATARY STATUS ; . . at, VerERan 22, $F RETIRAD, imOICATE CatEgoRY (Longevity. coadaet diss Yes ebsidtp, eerviae disability ava-aendss ) Nee BRANCH GF SERVICE ga. Raw GR GRADE DRAPT CRVGIBLE 2a. ORAFY HEFCE COTAINED 4.5, Ate ; : Ent. _ (TJ ves GO jee Oy CIA F-") vee (%) SPCTION FV COMPENSAT 10K ; 20, FEOCRAL TAR Bi reeds O1as 28. COvfO GBrestdowa, of snp} Basic SaLaRy 89. POST Ore TeRa MT Eat CS-tL SR575 “LETEOR Y ALLO@aART eS (#OReALLY GRANTED ONL Ti. quaaceasW7 Lam Dwr. eoer TO RESIDENTS OF FHE UMNETED SYATES) _. 73,000 Wie ret! ascent inder nen ga. COVER (Bragkdows, If any) caffilechal cover. oh aD , “Ste Tear we . TRAVEL se trees aire OLPanoENTS pe) eee Co) eeurecne ereeatigaad Cc } Foartem Ses earitaak . Ca ves { } ae , ro Fa: “PHUREF ARTE A VERICUE PST 9G. PERZOMAL VEMICLE TE Bi SHIPPED went 70 8¢ STCATD ae. USED 608 OPE GAT OmAL TRAVEL | Wife, U.S., 40, 5 May 1923 Son, Ue Ses 4, 20 Mar 1949 Dau, U.S. 17, 22 Dec 1945 ; ee ee ce em PERE B08 wr ang 6) Pave? AWS acCOunTassneTy Bara BE tm COnrOkmance wile fhe SeeeLaveoae cr ] coves PELTCHED gan PROCTAGETS SECTEON VAT OPERATOMAL EXPENSES 49. TUTLAT A Goons wT 62 PuMCmasd GF far Co aeT | oe ad. Otuee oe Yes Yes ae Paumim? AMD ACCQUGTABIL#GY @Eh& BE bm COmé cBmance Bhee wed oh Wt Ue smesendne tetenee te Te eee rem ert es oe
14-00000 Pr ne Se | “f.. SECRET % f & TAGE KOR tC Ee pe ade Dh bead db pea de CONTRACT INFORMATION AND CHECK LIST (CONTINUED) WITE SRE FeSTBUCTIONS ON PIEST SWEET. Ta EP me Gate eN EN 7 ~@ . 368 ~ Ma BYR SECTION. WEAN ; LL DIMER RINE EATS ae. etnarsys (Fee 8 38. 629, 8 30- 620, 8 30-670, re 90- 1000. aed UB 20 a20- a “as 46- 1600. a and/or Surceanar segulateere Fer benasite spplicable. fe vactows categories of contract eeeserael.) ‘ ALL benafits applic ible Co Stat Agent Noneal fav dal cover premdiun ptye SECTEOM 1K ; ee LOWER ACT OVET | . vee * srati easoesse 148 oy eg peorsia’ ‘ fevetenen === ffeseeesi” . (Check) suteortente (Checd) Svasrecteo eine teasy 18 COVE Paveia?s ake COnteMPL Atay, Ost Stra BE E°FECTED OW Bi iwauasamie Basis C vag (Clee “. - (TT) cowrcare . an DTT SECTION . OFFSET OF TNCOME 39. OFFSET OF FMECWE AND OTHER CuGiuUdals OCRIVEO Fase Covra actevetres q8¢ dees thas eheal, sustity tm separate aeee eereched hereto.) &] eres CI Paareay (3 aoug Ste TON 18 : “ i aant oars € - pes Gereetive Bare : 4042 — : GE vee Cl] ee FOR RES*CHATI OM PRIOR FO CONTBACT TE Ba swATIC (Jes 94. TEREIMATION MOTICE (Humber of dove} Oo. FORFEITURE OF Ak tyan TRave, er ee SECVTIOM EE $6. PRIMARY PUMCTIGH ¢C%, £8, PP, ether) SECTIOM Kosa OuTies BY. GERERAL SESCRIPTIGOm OF GUTEES TO ‘ot PERFORMED Translator ~ Ronit, Spanish SECTION 4E¥ i SUAL EF ICAT IONS se, CRPERIERCE : 20 Feb 56 - Sep 1962- ~ FDD/USSK Bronch/ tgs . Full time spinel Language Cn abning FO seem atin + Scp 62 - Present = = 99. CHuCaveanw | 8 aot FEmegL A | ed Gat Geneon ehaguate HESS BEASGOL EBay PE . (arn frdoinea) || BetIGie FEHHaL BoaBwetE I tlesaetecses BCHOS, Seaiye PE . CI | [es Tee. Level Attetwed, _—_ . ine i x] Corrace (No degree, i: feartage on onte _, i Ali i 10. SAmGysGEe COmPETincy RAN GUAGE SPCaR erate teBivibuarea 9 ag we Fe a8 20 oe Pa9e viage AvesagarocePs coumTay oF Oa 1Gis Cheet Appropeiete osns RA cee pee ef Degree Coupeteney : ae Russie Pali Stuvic_L AVATHTR Hae 08 SOE 62. anga auOe. 198E USSR, Turkey, AL! Western Zurppe in wat, 4@ nos. Meatig Lg LOVME NT Pace i TO Ca SECTIOm KY een, - Sted teCLUSsE Gales. PORiYiom vetig Ge vVred ARO BEasow roa Liaving, See staff employer affielal Fite ood . tarYeoeae iter GAwAT BOR SECTION Kyl — —— SUSTIFOCATEGHS Of ERP ARATIONS (Use Grher aide sf necessary) 6. A0Os TIGA CH YRMUSUAL AFGuUIBEwewa Ts, (levee ce ES ES TP GL ITT SA APPROVAL ee arte nee a earreemeeccgest ——_HeuAceON ERAGE PETITE ne rset ninaan eaten O® YS DOES ann Ps eo. ae persm { Safe 808 TyPER MAMA H& Gi oma tera
° ear’ = ope Re Sire STATEMENT OF PRIOR FCDERAL AND MILITARY SERVICE IMPORTANT: The information oa this form will be used in determining creditable service for leave purpose and retention credits for reduction in force. The employce should complete Part I and the Personne! Office should complete Parte 1 through IY. PART 1—THIS COLUMN IS FOR PERSONNEL OFFICE USE 9, RETENTION GROUP PART L—EMPLOVEE'S: STAPEMERT 2 DATE OF BIKTH 2 Nov. 1908 1. NAME (Lest, Meat, siddae crrtiald Tarasoff, acris Meritei - B LIST THE FOLLOWING ENFORUATION COMCESNING ALL FEDERAL AND DISTRICT OF COLUMBIA STRYKCE YOU HAVE HAD PRIOR TO YOUR PRESENT APPOINTROATS (Ov aut inchade mulitacy seevire.) 10. C°¥. STATUS (Foe péemanent employees only} Owe On ewe | Ge OP . TYPE OF © it. SERVICE, APROLET MINE ssrecterenrerermere iF KOKA MAME AND LOCATION OF AGENCY CIA 4 LIST PERIONS OF SERVICE IN ANY BRANCH OF THE ARMLO y FORCES OF THE UNITED STATES. IF YOU HAD NO MILITARY SERVICE, WRITE “NONE.” ‘osenance (Hon. of Jiahon. 7) ' , Pt Cae ch 12. TOTAL SERVICE , Sone fF tae 13, BOMCREOITASLE SERVICE (Leave purposes only}: 3. DURING PERIONS OF EMPLOYMENT SNO@N IN ITEM J, DID YOU HAVE A TOTAL OF MORE THAN 6 MONTHS ABSCHCE WITHOUT PAY, INCLUDING PERIONS OF RESONANT MARINE SURVICE, OURING ANY ONE CALENDAR YEAR! [—] ves 977 HO IF ANSWER 18 CYES.” LIST FOLLOWING FSFORWATION, YPE I KOA FROM (LZWoP, Fuel, Susp, AWOL, Mar Wars yeaa | mune 14, NOCNCREDITAARLE SERVICE (RIF Gur poses only}: & CURING TRE FEOERAL SERVE USTED TN ATTN 3. DID YOU ACQUIRE A PERMANENT COMPETITIVE cit SERVICE STATUS? Cvs fix (if answer & “Yes, in wher agony were you employed ag the time statua waa acquired?) 15, PEEMPLOYMENT RIGHTS Js Cx 1G, RETENTION KIGHIES _Cm Ce 17. farina rion DATE OF RETEN- TON R IGHTS 7, ARE YOU. 8. THE WIFE OF A DisapLeD veteran? (juss [7] No @ THE NOTHER OF A DECEASTS OR OESATKED VETERAN? a va [[] x0 C. PRE UNECSERRILG WINK WY OP ANTTERaa - 4 yes NO RUSE OA OTHER PERSONS AUTHORIZED tO ADMINIS TE! ER OATHS. an of my knowledge and belief. & TO 6E EXECUTED BEFORE A NOTARY I swear {or affirm) that the above statements are truc to the bes? arin FOCG heh wee (siemaruRe) = 20 Feb, 1956 oO Seis (DATE) Subscribed and swan to before me oa rnis LOtF y of 782° 1952 g ___vesh ini ton, Dd, Ce _ (Mow Tp . City) i H  (statQ SEAL ~ A Yr falé NOTE: Vf oath is taken Scfore a Notary Public, the date of expiration of his Commission should be shown. (OVER)
PART U1—OCTEAMINING CACOITABLE SERVICE ANO SEAVICE COMPUTATION DATE FOR LEAVE PURPOSES _ TRTAL SERVICE (fe aete 48D cesses reer eetetees aed ereeseee CAA LAe OnE nnn eN ENE OREAASAg OE Heeenetemaneapaann nese ot CREDITABLE SERVICE (Leave purposee)...ccccccssssssssssescsesssnnsennscesssecsrsssanueuesecteseesnansensesietel ENTRANCE ON DUTY DATE (Present agency} 0.0... deedaseeneevennes Sv eseeeentereesteneenagessen tees wPe " . LESS CREDITABLE SERVICE (Leave purposes)... eres ceegeteceess SERVICE COMPUTATION DATE (Leave purposes) PART {V.—DETERMINING CREDITASLE SERVICE . AND SERVICE COMPUTATION DATE FOR - REDUCTION IN FORCE PURPOSES (To be completed only in those cases when the amount of creditable service for reduction in force purposes differs fram the amount creditable for leave purposes) TOTAL SERVICE (fees TaD. eee denne aman nese ene nee ares eden eeen eee eet nsaneenanmmee bene ecnaes Sa enee none’ eesensee Pe seeseeanes NORCREOITABLE SERVICE (feom 94)... prteseesreensenseseees pte neporeenens tee CREDITABLE SERVICE (RIF purposes) .. EXTRANCE ON DUTY DATE (Present agency) 00... tesessensvevesancenes seensayevesses sesassessesercneeaecseceavensees LESS CREDITABLE SERVICE (RIF purposes)... SERVICE COMPUTATION DATE (RIF purposes) (Sncer as the “sevice computation date” on the employee's “Servies Record Card,” SP-7} —— REMARK TE eee & B. COUCPRMERT ORINTING OFFICE «= 1S —“COASO~E
14-00000 . CONFIDENTIAL a ~ 08 Ren Billed In) Complete in duplicate. The dota recorded on this. formis essential in-defermining travel expenses allowable in connection with leave at government expense, overseas duty, return fo residence upon separation, and for providing current residence and dependency infor- mation requitedin the event of an employee emergency. The original ofthis form will be filedin the employee's official personnel folder NANG OF EMPLO RESIDENCE DATA PAS POY MEME SME PIT NEY APPOINT Ee dD. io TEO AS PERMANENT RESH GENTE ae as abere. freee en atte cn ers | | MIOOWE D aNMULL ED DATE OF MARRIAGE PLACE ie CONTINENTAL U.S, SER DENCE \ Che SS. ce)¢ SiIngLa [Manmeo —— ta Ni 3 a eet re if MARRIED, PLACE OF MAGRIAGE DATE OF DECREE : LP Qe “ ee NN ROE ENTE FAT SAA tN fe em RE te nt AS SM rsp Ete teeter wee (eee erate hate re tert ete IF WIDOWED, PLACE SPOUSE DIED DATE SPOUSE O10 : LL are. ee iP PREVIOUSLY MARRIED, INDICATE NAMELE) OF SPOUSE, RE ASORIGT POA YEHMINATION, AND DATELS) es . . MEMBERS OF FAMILY NAME OF SPOUSE 5 jes 4 PLA oe NAMES OF LOREN RUORESS DATE OF BIRTH Cf DO Oo nN F, FATHER (Or m oO guardian) ADDRESS FA NA SEF PLT RE | 22 bee 4S as ue he Oe. 20 Man VG NAHE QF MOTHER (Qr femal Auardion) “| aDoRESs . Ts TELEPHONE NO, HAASE fm 1, TPO aE oN WHAT MEMBERIS? or your PAMICY If ANY, HAS BEEN TOLD OF YOUR APFILIA H THE ORGANIZATION IF CONTACT 15 RRs es QUIRED IN AN EME@GENC YT. A, : ot te ; ’ Sls LO, SOME LL ry 4 PERSON TO BE NOTIFIED IN CASE OF EMERGENCY (3 wrens isnt [ RELATIONSHIP aes 4 a ® “ wt dt Er? thd Adu HOME TELEPHONE NUMBER _ ° ; lia eRe OP EMP COTE, TP APPLICABLE BUSINESS TELEPHONE a EXTENSION Bene meee - oon Senmeaienianentens ane. ween and addreas of organtza> ! VES | 1S THE INDIVIDUAL NAMED AGOVE WITTING OF YOUR AGENCY APFILIATION? {Ii “08 give name tian he boltaves you work for) . IONS ON YOUR SEMALF? (Tf "No® give name and address of petaon, if any, who can make such decrsiones in case ad omergency.) NO | OOES THIS INDIVIDUAL KNO@ FHAT n= WAS BEEN DESIGNATED AS YOUR EMERGENCY ADURESSEE? (lh anwaur ia “wo® yes | OS expla way in ever 6.) . Snuaanes camienen jao | The persens named in item 3 above may also be notified in case of emergency. 1f such notification is not desirable because of ° health or other reasons, please so state in item 6 on the reverse side of this form. CONTINUED ON REVERSE SIDE CURRENT RESIDENCE AND DEPENDENCY REPCRT ito" 61 eetrronss CONFIDENTIAL co a
14-00000 7 a CONFIDENTIAL rege Billed fred . VOLUNTARY ENTRIES 4. 2 pyie fence in the hendling of employ. what yo nes ace ale an dius ia Wsenre of verte! nel deta often ce! s art compl estee the settlement of estate and financial matters, The inhoemation requested in this section may prove very uselul to your family em oey in the event of your disability o¢ death and will be disclosed only when circumstances warrant, wee ” NAWE AND AGDRESS OF ANY BANA G INSTIFUTIONS WITH BHICH VOU HAVE ACCOUNTS AND THE NAMES IN mniCe ‘tHe ace Lwrets ARE CARRIED, ne od ge ~ aad - 37 yt ~ . 7? SN Bt Fatil 20) ee adyf BMP Og Ho ahrertige, Lg #2 4, oe AMMA TF PRE =a ee TOU COMPLETED A LAST WILL ANO TESTAMENT? G&S Yes if “} NO. (ff *¥ee? where te document focated®) Ie Ota Oe PEAS Oe wa so TOU PRE PLANNED AN ARRANGED GUARDIANSHIP OF TOUR CHILOREN IN CASE OF COMMON DISASTER TO ROTM PARENTS? Sod res =) NO. Uf *¥ ee" give namela) ond adireea) corn DATE . TS SIONATURE fe 2 GF | yi. vf GPA SF nis are ‘3 CONFIDENTIAL
14-00000 CERTIFICATE OF ATTENDANCE I certify that on __-MAR1S 1956 have attended " gpeves the Induction Course specified py Regulation 25-110. BORIS DIMITHR TARRSOFF fsaueg « Please priat CI cusercen (CT) sreesosarure ral etage ortice. DDP / Fi GS. __f— . (Grade) Feo Ho. 4a7 SEP aces FoR 93+ 927 s 6€8 g¢ eaice aay BE YEES.
STANDARD FORM GF (Revisro avGcuUST 1a8Q PROMLACATCD BY CIN Sit ice COMMISSION FLOARE, PLRSUANTL MANUAL, APPOINTMENT AFFIDAVITS IMPORTANT. ~-Belore swearing ta these appointment aftidavits, you should read and understand the attached information for appointee CENTRAL INTELL. Tunacs AGENCY dashington, 2D, ve . seereneeenecenene eee eweal on meee) Garcea or division) “Giae of eapicymcat) Boris Dimitri Tarasoff : , do solemnly swear (or affirm) that-— A, OATH OF OFFICE - 4 Twill 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 dutics of the office on which Iam about to enter, SO HELP ME GOD. B, AFFIDAVIT AS TO SUBVERSIVE ACTIVITY AND AFFILIATION Iam not a Communist or Fascist. I do not advocate nor am I a member of any organization that advoentes the overthrow of the Government of the United States by force or violence or other unconstitutional means or seeking 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 Iam 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 | 80 engage while an employce of the Government of the United States; that I am not a member of an.organization of Government employees that asscrts 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 The answers given in the Declaration of Appointee on the reverse of this form are true and correct. a . _ ee . TA ef ‘ : ay 2° a 20.Febs 4956. mee EE ED Se et Se (Date of entsance on duty} {Henatuse | of ‘evpomase) . h Feb ) Subscribed and sworn before me this. . __ 2th vlaeeweee day Of occ ccccccc nsec cre cee veceeeeceeeee ele Ae DL EQ. 3 at. washington, | De . oe ce ec ceesecese cee ceateee  euuugeneutuccepeteuetsessee. =: ceva tues tesececeseeesenecese!” vee “(ens ; . Site” ot < é ~ re a ' 1 ae Tar’ ode “as 2a. pee e ne emew ene eee ene ne ewes ene [seat] > Sone sive “sr “by (Tiky NOTE.— If the oath is taken before a Notary Publsc the date al tom of his commission should) Bo Ae be shown.
DECLARATION OF APPOINTEE This form is to be completed before entrance’on duty. Answer all questions. declaration will be grounds for cancellation of application or dismissal after appointment. eriminal offense and will be prosecuted accordingly Any false statement in this | Impersonation is a@ 2 (A) DATE OF BIRTH (8) PLACE OF BIATH (city of down and State or country} =} ‘ af % ae ae [rs aa * aloof mhe Now 2 1G e>. BERGE VIM ES Le . & (A) IN CASE OF EMERGENCY PLEASE NOTIFY (0) RELATIONSHIP aits4n iets SEALE. [enh TELEPHONE se. , , a . oe gat . — SENNA TAaRASCFE wile DOES THE UNITED STATES GOVERNMENT EMPLOY, 14 A CIVILIAN rue past emonrasr {J ves [2] No : . If 90, for each auch relative All in the blanks below, if additional space is mneceseary, samplote under Item 46, _ os Tp POSTION Gp TYMPORARY OR HOT MAR. oo POST OFFICE ADORESS pi DUPARTMENT OF AGENCY IN WHICH aoa | RIO Singhs € M MAME P i eae {Give street musndor, af any} D : i MPLOYE! (Check one) ACITY, ANY RELATIVE OF YOURS (ETHER BY BLOOD OR MARRIAGE) WITH WHOM YOU LIVE OF fe coeneserencneseseneasienee % nv cnencenavaneeennemeonsenaancemnnnesene| re eet cette 2 cevcenennnsenneeansceeeneseee ee fi er nprarenenennecteneanttmmm| are Bc penevercccesesermese we coeerssomeenn INDICATE “yES" OR “NO” ANSWER ‘BY PLACING °X” iN PROPER COLUMN ee er BARE YOU A CITIZEN OF OR DO YOU OWE ALLEGIANCE TO THE UNITED STATES?.. TEE Te THERE . COUT T wr = TECHN Er perenne gE A RA eA f& ARE YOU AN OFFICIAL OR EMPLOYEE OF ANY STATE, TERRITORY. COUNTY, OR ML NICIPALITY? Bf your answer eee ete rn Nt 2. bO YOU RECT SVE ANY ANNLNTY FROM THE CNITEO STATES OR DISTRICT OF COL) VBIA GOVFRN MENT UNDER ANY RETIRE MEST ACT OR ANY FE. 2 OR OTHER COMPENSATION FOR MILITARY OR MAGAL SER WICEY. e I your answoe in Yea", give in tten lO reason fog rerisement, that 2a, age, optional duatility, of by reason of voluntary er involuntary separation after 3 years” service, amount of retuament pay, and under what ¢etirement act: and rating, if retired from military or naval service. eer renee A & SINCE YOU FILED APPLICATION PESULTING IN THIS APPOINT VENT WAVE YOU, BELN CIECNARGED, OR FORCED YO RESIGN, FOR MISCONDUCT OR UNSATIS FACTORY SEATILE FROM ANY POStE Ore? "Vos, give dotails in Eres: £9. Byour answer fe You. givoin item 10 the name and addresea af employer, date and sesson am wach case. errr At @ RAVE You BEM ARRESTED (NOT INCLUDING THAFFIC SICLATIONS FOR WICH YOU WERE FINED $25 OR LPSS, O8 FOR FITTO COLLATERD sh OR BESS) SINCE YOU FILED APPLICATION RESULTING 18 TNS APRON MENT? OW If your answer és Yes", Hot all such cases under lrean 10. . Give in each case: (1) The date: (2) the nature of the offense * . oe violation, G3) the name and hwatiwn of the vourt. (4) the nalty ampored, if any, or other diepositivm af the case. fF appointed, your Angerpeints will be taken, INSTRUCTIONS TO APPOINTING OFFICER , ‘The ‘appointing officer before where the foregoing certificate ia male elinll {hy Age.--lf definite age limits have been established fue the position, it shoukd detensine to bra own satisfaction that thie anmantment would he ia conformance be drtermined that sppicant i rot puteide the ege range for appominend, w@ith the Civil Service Act, aprheatic Ciwil Servive Rules and Regulations and Uae each determination is nade, the sppomtinent may not be consummate L. acts of Congress pertaining to appanntiment . Q@ jeenship —Th ‘ “ ate fe S " 5 7 : + 8, ‘p e appunting officer ia responetic foc ubserving the The juem should be checked fue hobting of office, peasioa, suitabi ity in con: citizen hip proviniuns of (PV the Civil Service Rules aad {2} appropriation acta, aectina with any record of seceat diwharge ut artest, amd gartivalasty for the Forme G1 6.3 te an nth iave G4 both purpores and is acce table pronf foitosing: Guuacasnip atatge in the abeence of conitivting cvicence, In doubtful caves the ‘oppantinent should aot be consummated untd clearsme has boca a:sured from the certifying ofhee of the Cit Seewwe Commusmen, GY Members of Family Section 9 uf the Civil Service Act provides that wheneves there arc alteady two or moe mbera cis famely serving uncle Peobanenadl of permanent appuintment in the Competitive serving, HO other merniber of suck family ag etig bee for probstional ce premanent » pattiimnent in the competiteve aervice, The aprantmenté of persona enntied to vercrag pecteverwe are nit subsect to thie fey rement, The members of farnly provisicd dows tot apply fo tempneary aprmesntene ats. Douleful cxers may be refercod ta the appropetate office of the Caval Service Commanon for dec caus, (QD Identity of appointees --tt ie the duty of the sppointing offer to + guard againet inpermnatinn and to determine beyormd reatoemable deubt thar the epintee ia the ame pereon whose agimeniment wae auther al The appawntee’s signature ont handweitng are to ke compared with the apple sto anive other patinent papers. 1f the appeantce Qual tend it Q written exami~ Baton, the ugnatuse on thie farm shuld be ramparcd with the a:guature om the declarstiom eheet, whith woe oned ia the pe aminaten ‘pecen, Hae physiead aperarane may be thevked aganet the medwal certtiate. The aprmenice be qucitioned of bin personal history for agatement with hie previous 8. 6. eoenauaaut paiatine Corece | Le—'85190-8 . rene
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SECRET Wes we fEof goo PERIODIC SUPPLEMENTS’) “qe information you have furnished previoualy, d@ widl be neceasuvy faticety. You nead cowpieote Sections VEE theough NEL the: sorgenisation of 88 you belseve the stem requares @ SECTION 4 t. FUuLe name ¢Leat-F GENERAL 2. CURRENT apoRess fNo., Steeet, City, Zone, Siatey 3. PERSONAL HISTORY snares RE gen Thi form provides the @eans sherehy your official peraunne! wach beth 77 fe hept current. Edenithawgh se duplicate of you i complete pele Se me tipes affe bee 6h, © B8NCe oe entered on duty wath 8 KOVS cope ag A Vie aniggalrwr neaoe ted. . ow? { { THIS Gate LD) 11s 2 oe % £ through Bgoan their “TARASOFF ,. BORIS DIMITRE STATE, TERRE TORY, ‘Washi zton, D.C. tf. mame (LaostePagateSeddie) PREFTAAALY RESIOENG tN U.S, Tarasoff, Anna HOME ADDRESS (Vo., Street, Caty, Zone, State, Cauntry}. GUSINESS ALDHESS (Vo... Street, City, Lone, State, Countey j« HOME TELEPHONE NUM8Ee &- BUSINESS TELEPHONE NuMBER INDOTCATE AME OF FIRM Of EMPLOYER, _ PERSOW TO BE NOTIFIED IM CASE OF EMERGENCY @ aS acer erteteneetn “PERMANENT ADORESS (Nu. , Street, Carty, done, State) 2 POSSESSION OR COUNTAY Ih WHICH YOU NOW CL ALW RESTDENCE U.S.A. 6 Z. HELATION SHIP wife if APPL ECABLE tN CASE OF EMERGENCY, 1S NOT O€SIRABLE BECAUSE OF HEALTH OR OTHER REASONS, © SECTION 488 a. FURNISH DATE, MARITAL STATUS PLACE AND MERSGH FOR ALL SEPARATIONS, OLVORCES WIFE OR HUSBAND: lor husband giving data sefow for aif previous morriager. if you Aeve been marcied more than ance, GTWE® CLOSE RELATIVES (Spouse, Muthor, Father) way aung at noterieo. PLEASE 30 STATE. RIDQ aD including annulments, if marcciage ia contemplated, provide same deta for fiancee 7e GUSENESS TELCPHONE EXTENSION If SUCH NOFEFICATEON SEP AR ATC Bryoreeo ANNULLED OR ANMULMENTS ade #8 separate sheet for former wile 3. NAME {Fersty {#iddie) (aiden) _— (Lease) Anna Adamoviez Tarasoff 4. & PLACE OF mAMAtAGE (City, State, Country) Cleveland, Ohio . 6. OW . Seate, Country) U.S.A. Je REVING @. DATE OF DEATH .P9. CAUSE OF DEATH tO. CUR £ Give fase. address, jf deceased | RALED Ti. PLACE OF BLATH (City, Stare, Country) Cleveland, Ohio, U.S.A. $3. IF SCRN OYUTSIOE Y.S.°CATE OF ENYRY | 14- PLACE OF ENTRY to. CHTPZEnsMte (Cuundsy) U.S.A. 38. OCCUPATION 96- GATE ACQUIRED 17. At birth . . unemployed, emporary Leraca, position _ 20. EMPLOVER’S O8 Business apnoRess (Mo., Street, City, State, Country} WHERE ACQUIRED (Caty, Cleveland, Ohio 19. PRESENT CuPiover (Also gave former fase two eaployers) State, Country} U.S.A. a or ef apouse i6 deceased o¢ SECTION Bt! CONTINUED TO PAGE 2 FORW NO. , 1 DEC Se GUD use pacvious eottions. SECRET - i
14-00000 SECRET t ahem Felted fay SECTICN TIT COMFIMULD FROM FAGE 1 —_ gt. MATES CH VILA TARY stavtch Crag. aad Foo ) By WONTH AND WEAR 4 Feb : Feb-3 94 20-1 LTE? : : TOUNTOYV WIT Beice MAL ETARY SNECR AFP ECI ATED 22. aaance CF SE@QICE 23. Vrivk, 2a, PETALS CR OTSES COVERNWENT SEMVICE, U.S. OR FORT CH @ 2. RELATIONSHIP CUTUTENSMae _ Cventey) be FREQUENCY OF CONTACT, CURR mame (haste Feree-Middiey a RELATION SHEP &. ADQRESS OF TANTS) 1 HHECH RELATIVE RESTOLS cit itneeie ,aventcv) 6. FREQUENCY OF CONTACT. RP. BATE OF Rast CONTACT tT) FULL NAME (hoat-FersteMiddle) Be RELATIONSHIP : t. S 3 a. ADDRESS OR COUN IRY in WHICH RELATIVE RESIDES. CLTeZEw See ¢ Country} . &. FREQUENCY OF CONTACT DATE OF LAST CONTACT cinerea eneenmne enn nn Te FULL Name (Lase- Farge Midiley’ 2. REL ATEONSHLP IN WeEtCH AELATIvE RESIDES € ADDRESS CR COAT ey Ro CHTILENSH EP FCountey) @. FIL QIENCY OF CONTAC 2. DATE GF LAST CONTACT S. SPECIAL Riwaans, UF awy, CONCTANING THESE RELATIVES . e * ® | section ¥ FIRANCEAL STATUS t. ARE VOU ENTERELY CEPE NT ON YOUR SALARY? Ix ves . "| [se 2. PE YOUR ANSHER 43 "HO? TO THE ABOVE, STATE SOURCES UF OTHER INCOME MMIC VOU HAVE ACCOUNTS anpatss (Cate, Grate, BS. BANAING EWSTETUITIONS BETH Courtew) - wawi CF LNSTEFUTOON : SECTiOm V CONTINUED TO PAGE & * - SECRET 2
14-00000 SECRET . . : . CBhee Fibded Inj Sstctios ¥. COMFINUED £208 PAGE 2 - 4. WAVE VOU CVER DEtf 3%, OF PETITAONED FOR, GANRBUP ICY? orev! [Re vee vee [ — Lanpanddhante = ont ectetie ot ae sat ae cannennnntrntnnns a se “cca cr Rea SSEEVER in retina eta DTI A LEE cee ene ne eg ne @ oF ou 2. 2 22 c MG COURT AND GATEES) . nanan AL RO ane, &- 00 YOU RECE TYE 4m ANMUETY FHOW THE UNETED SVatEs OF OrsTaect ‘OF COLUMBIA GovERAWiNT UNDER ANY AETEREMENT ACT, PENSION, OF COMPENSATION FOR MILITARY OR NAVAL SERVICE? | me a ~ momen erin seat tr fn ee re 7. oF YOUR ANSWER FS ves” 70 tHE ABOVE QUESTION. “G1VE COMPLETE OLVAILS nee renee en eects Meee mes ntnneretng TET eee mo ne eta tan eee eee nt ne eR titan eked eeeeptreteenttaetnt @. DO YOU HAVE ANY FEINAMCHAL INFEMEDT 1m, OR eR ECHAL COMMEC TION BET, NONSU. &. CORPORATIONS OR BUSINESSES OF 1h OR Bite . RPORMAT ION 8 Ey US PAN TE A: bl 4 , oT WU. 8. CORPO ONS OR BUSINESBES HAVING SUBSTAN LF OME 1 Gee INTERESTS mi fe)*e fe YOu HAVE Give cowere DETAILS ON A SEPARATE SMELT AND ATTACH 1” A SEALED FHYELOPE, answracy "WES" SECTION Vi Civi ZEm sui? e i: PRESENT CETIZENSHIP (Country) 2. CLEEZENSWIP ACGUINED BY © CHECK Tn} ONE: U.S.Ae (_Joretn [] wanerece ‘eh. (Specify): Naturalized Wave Vou Takin Sf€F$ 10 cwance vouR [a- Give Panticuass SS — PRESENT CUTiZENSHIP? (res Lx] xe ea enema Sr ee ee een nner mm inne TP VOU HAVE APPLIED FOR U.S. CETUZENSHIP, INDICATE PRESENT STATUS OF YOUR APPLICATION (fieet papers, ete.) e oe inane EDUCATION — ee nnn ry CHECK tx HIGHEST LEVEL oF EQUCATION ATTAINED over te0 YEARS DF. COLLEGE © nO OF OBEE ESR Team MEOH SCHUTE Perrerrr Nene vercteeente cnc ecenmia nner tarts nn STE er etOnRe me ent Gm Rr BACHELOR’S COGAEE GRADUATE STUBY KEAGENS PO HIGHES OF GREE acuooy Gaeouvata TRACE, GUSHHERS, Of COMMERCHSL SCHOOL BRoaVETE eeereecrarere teers Hane ETRE Spt RA EEE I Yad YEARS COLLLGA UR LEED waste nse peaada ~ ooc tun’ s Cf ABER ener essere me 2. COLLEGE Of UNI vERSETE STUDY. guage? “DATES ae AY SEMC QTR, MANE AND LOCATION OF COLLEGE OF UNIVERSITY oeonet aS nOURS a Russian University of N.Y., Ne T.C. co cS i 3. “TRADE. COMMERTIAL Auf SPECIALIZES SCHOOLS NAME OF SCHOOL . STUDY OR SPECTALIZATION —— downs “Cooper Union Art. School in Ane Atos | sS«a927S—*«CS;:«C«C?s«d|:«it P COP er en Mork Loy. . ° _ 927 a Cooper School of Art in | Commercial Art — 1950 1951 val __ Cleveland, Ohio_i_. Gan Gane ised pchoola such aa Ordnance, intelligence, Communications 4. MILETARY TRATBING (Full time duty in spec ‘ Raves ATTENDED MAME OF SCHOOL + STUOY OR SPECIAL TZATION ence aret teeter: wate mart MITC Camp Richie, Ma CIC Course atyarsity of Penn. Philad,.'Pa., German Language, CIC S$. OTHER FOUCATIONAL TRAINING; ROT iMDECATED ABOVE Advanced CIC Course; s Oberursel, Germany» in July 1945 SECRET 3
14-00000 @ | secTion wilt SECRET . F “pthen Felfed toy “F Ee ABILITEES ; : + iN omDTR puisie wom ACQUIRED owe TaN teen L warep a eustn? ous ENT laprouate vorauatel ue Laweren : fua bi Contact ,ACausMic, Foe WATEV rm Y ‘ dg watiyv & pce ie eNO ML ECGG © leeovowced faire SYUY AEST ARCH TRAVEL - PRUEMEY Toaeten a ! coum tmy [RESTOENCH: PABENTS fake eve.) | Revenss A AGU AGE een rte I thast Belse pach fanguage at mhech vou porsene any ‘Yogree of ceapeteace. fndscate your roficre to read, write Pp aceency fo ea ar @ . SPAR ® + wRITE 5 Shy AK fapeak dy placing a chock (Xj an pen pcm the aspropeiate doxes raiel si at or Hite 2. FE YOu wave CHECKED PacaorMic BUOY” UNTER “wow ACQUIRED™+ a onl AND UMTENSIYINESS OF atupy pm ences nr nent RE a UAGE WOHK TNVOLVENG VOC ABUL ARTES anO TERMINOLOGE Ot THE sctamtiric, g. SCSCRISE YOUR ABILETY T2 OG SPECHALIZES Vasu ANY OIMLA SPECEALIZEO FIELD ENGINEERING, TELECOMMUNTE ATIONS, MILETASY OR GEOGRAPHIC AREA KNOWLEDGE RNO SLEDGE GAINED AS A AE SULT OF KES OLNce, TAavEl, INDICATE TYPE OF KHOAL EDGE suc at 8 ‘SeeTi08 ux aire seer ret . REST BELG ANY FORE PON REGIONS OR COUNTRIES OF wHiCH you” HAVE Study OR BORK ASSTGRMENT, UNDER COLUMN “TIPE OF SPECHAL IZED RNOALEDGE "+ BRALN GQASTE, NAGGING 2 RAILROADS tak R PAR. , Dates OF ANCWLEDGE ACQUEREG BY NAME OF REGION OR COUNTRY TYPE OF, SPLCYALEPED KNORLECGE RESTOENCE. peste WO RK ° TRAVEL | STyoY | 4559 GN: TRAVEL tte. . OEece . Mint Native Russia (Ukraine) General _. 1945 2, INDICATE Tee PURPOSE OF wisit, RESHOENCE OF TRAVEL FOR EACH OF THE REGIONS O& COUNTREES GESTED ABOVE. 7 Russia - I am a native of that country Turkey - Tf lived there as & stateless person for 3 years TYP UG And STENOGRAPH ic iC SKILLS SECTION & i. PP ING (9.P.M.) fe. swomtuanog #. P.M. y. SNORTHAND SYSTEM USED + Gnttn 8) 30 [ ~ peeeec[ [srceowni ting] [svenoreed] “Tate ¢ ING CAPERTENCE OR TRAINING (Comptuseter, eae @. INDICATE OTHER BUSINESS MACHINES @i Th amicn You WAVE HAG oPERAT Mimeos graph, Card Punch, ete.3 . Section Xi SPECEAL QUALIFICATIONS a LIST ALL HOBAIES AND SPORTS IN BHICH YOu ATE ACTive OR HAVE ACTIVELY PARTICIPATED, INGHCATF YOUR PROF ICFENCY iv cass” Badminton = fair, Soccer ~ Fair, Photography - good, Philately » good, ‘ Oil-painting - good, Reading - good. nina. somienianon Ae ae a. reprcare ANY SPECTAL QUAL LE RECATIONS. RESLLTING ¢RoM FRPEMLENRCE OR TRAENING, GWICH mictt FET YOu fom & PARTS OCULAR ersivsox oe twee of worn §=My training ani experience with the CiG would indicate the type of work for which I am best qualified. RUSt anv y SPECIAL SKILLS YOU POSSESS RELATING TO OFHER EQuiPwENF OF HAW FURAET LATHE, SCIENTIFIC and PROFESSIONAL DEVICES, ere. B. ERCLUDENG EQUIPMENT NOTED IN SECTION &, CeInMe$ SUCH AG OPERATION OF SHORTWAVE RATIO. MUL TILE TH. i te $e wOy ARE A LICENSES OR CEATIFEEO MEwaTe OF ANY TRAOL OR PROFESSION (Pilet, Electcicaan, Radio Operator. Teacher. Laver. CPA, Medical Technician, #t¢.). EWDICATE THE KIND GF LICENSE OR CERTIFICATE, NAME OF [SSUING BIATE, ano REGESTRY NUMBER, OF AMO BM. - . . te 6. LATEST LICENSE Of certificate (Year of dawned) gS. FIQST LICENSE OR ceataricate (Year of jasue} ‘SECRET a
9. LEST Ane PUBLIC SPEAKING ped PysL_icasioe OAT, revels, short atorset. eter) J. BAST ANY A Se ee Putas enOUcate THLE. pects. Public Speaking _ Greater Alameda TO. LIST amy POUTERS ONAL, AL ALEMIC 0 wraate, LOST AC ADEWIG woeORS YOU Chairman of the Circle of ¥ The National CIC: Association, SECTICH Xtt ORGANIZATION WORK E A RONDR ORY Mave RECE TP IMELUSEVE OATES (Frome 2 Mar 1956_to a 89. OF EMPLOYEES UNDER SUP CAVES ET none 1g. pesca ThO4 OF “UUTIES | Regearch, ana including exte ¢. inetuseve GATES (Prone | | 27 Jun 1956 ~ 9 Sep 1956 _.| Lua. OF EWPLOVEFES UNDEG YOUR pirect - guregve SION A Bone @: DESCOIFYEGN OF CUTIES ' Reading newspapers and ert | b. PGknSe¥e GATES (Peum Sep 1956 = present ENO. OF EMPLOYEES UNbER YOUR OIRECT SuPEaeb Si Or none 6. OESCAIPTION OF BuTIeS Abatraction of intelligence and compiling it into reports. ee f. INChUS# ve GATES (Fros {_e ¢. HO. OF EMPLOYERS UNDER FOUR 27 Jun 195 ead To} Sg. GRaul|3- vi age eee ae POSITION Tithe Tri" Intelligence Assistant. rGuR OFRECT 3. lysis, an cowargr aie oF ae an® ved OF aRi TING translation of maberials in the Russian Language, SECRET (then Feited En) 4 Oy BRE THE ay THOe (be a {¥one fredian, scnent ne ene argmene acto Bud PUBLIC RELATIONS PRPC REENCE and public relations experience on th CGORTIBUED FROM PAGE & nn tt A EET TT era SET a 8. INGECATE Aer CL¥ICES matte FOU HAVE INVERTED AMD STATE WHE RHEA OF BOT THEY ARE PATENTED Council... ee a Tt Ow OR WERE FORMERLY & ASVOCERTIONS OF gocrategs &% awib. outh "Russian Culture", New 1956 = present APERUENCE - SINCE LAST COMPLETION OF A. PERS OFFICT/OL VES) OMS BR ANC ppp/FI/c1/1eD e oF piv eguewted) pfan setecded, qeniecal interest tut 6 Executive Board of wetcw YOU &@ 10 FORMERLY, York, NeYe 1937 - 1940 & ASCHNEL “quanirl CaTions QUESTIONNAIRE ” or ASSEGHMENT . naive work with microfilmed materials. ene nese and Fa-} 12. GRADE ene - ond Vor) - end For) ‘oinect. | 8. SyP EQ 4a SiOM 4 : . 6. cEScaIPeION OF CUTIES nn ee ome g. FMECLUSIVE DATES (FFOR? and Fae} fz. pe | 4 Oo. 5 SUPERVISION : [____ ee en G- GESCREPTIGN OF ouTeEs | erence ett Qe CMPLOVETS UROER yOUR UIRECT {3 emennene nel , periodicals, _ value and compiling it into reports. _00/FDD/BU gs, OFF ITP AL POSITION TITLE telligence Assistam abstracting information of intelligence GhADE 19. ae Orr petan PostTiOt TETLE SECRET $ information from Soviet newspa everett > OFEACE/DIVIGIONS DRANCH oF ASSIGNMENT cere scene mtn At ON I nears memento siete OFFIGE/ DEVE SIONS grants OF ASSIGNMENT — __00/FDD/BY______ » OFFICAL Position Tate : __ Poreign Documents Officer a pers and periodicals een en i A I — 2. GRADE] 3- DFFICE/OIVESICN/ BRANCH OF ASSIGNMENT ee A NT oe a seen GEFICEAL POSITION Tete — i 2 GRAOE | 3 OFFICE/DUVISION/ BRANCH OF ASSIGNMENT a {ise additional pages GF re qaue ed}
CHILLERS ASD. ommre CEPENOERTS ° section kite a. anges aoe THiuoRES tm (ine lyding ne stepehitdreny ang adopted chaddreny ano at urwvaRA1EO, D UNOCR 22 YEARS OF AGE, AND ART wot Shire SUPPORTING. BR. PROVIO’ THE TOLL ALLATEOM SHIP Ast Aruba BYB50 Barbara Tarasoff Raymond Tarasoff Seren! eGR SE aT A RTE SDE TIONAL COMMENT AND/O# COMTENY Places of residence’ 18 Feb 1956 = 7 dul 1956 7 dul 1956 = 1 Dec 1956 1 pec 1956 = Present ence et oaing THO ORMATIOM FOR yatioy FOR ALL erie. and OEPe SECRET When Felted Try Tae #8 NOENTS ¥EaR OF BIRTH a OEP END ON vee BOD Date: arr ears al Fe “@, 7-24. BEE. Be ghee LANG 2 Airy Ses as soe OF Pe. MUN AER OF OrMEe pert Bo parents, stepparent ie ete.) SUPP Oat, es oyer 2t 20 Fob 1956 SECRET 16 wi ARS
14-00000 “Form Ho. 97Q a oct $4 SECRECY AGREEMENT 1. | am aware of the fact that the Central intelligence Agency by reason of the sensitive nature of its work, must observe very strict security measures. , 2. lagree to honor the requests of the Central Intelligence Agency relative to my application for employment or rendition of services whether it be accepted or rejected. 3" agree notto inform anyone that-l.am being considered for a position in the Central Intelligence Agency, unless specifically author- ized by a representative of the Central Intelligence Agency. 4. | agree not to disclose processing procedures | have observed in the Central Intelligence Agency. 5. | agree not to discuss by name or otherwise, any individuals with whem | have talked in the course of my application for employ- ment to the Central Intelligence Agency. Signature ' Witness ora)
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14-00000 CONFIDENTIAL (Phen Filfed Fay _ STAFF AGENT CLEARANCE VOUR REFERENCES = Request for Security. Clearance datel 28 May 1963 A tA a 104887 CASE RO. Chier, Contract Fersonnel Diviston v0 ATTA. SUBJECT oO mivise that a security clearance 13 granted for the employe ft 45 a Staff Agent, GO-L1, by Dor/wil/3, in the capacity of 1. This ment of the Su oF 90 foe OF T2 ot Operations Officer at Mexico City, Mexico. subject, a re ice. 2. 'f-your office should desire at a laters date to change the status or quest to cover any proposed change should be submitted use of th € to this off sure made within 60 days for entrance on duty within es invalid.- 4, As apart of entrance on duty processing: [ JA personal interview in the Office of Security must be arranged by your office. , [xx] 3 personal interview is not necessary. [] . » Cuore, HROsOmmen RECUEETY DAWEEEOe., OF fone 1989 CONFIDENTIAL — “(940} 3
oN CONFIDENTIAL HO, ; eecuniry wroRmaniod . SECURITY APPROVAL | oo - “Pate: ak December 1955. TO: Chid, Records & Services Division Your Reference: 6-1235 DDP Pereonnel Office Sc , FROM: Chief f Security Division ee Case Number 10,887 . Personnel ° : ‘ SUBJECT: TARASOFF, Boris Dialtrt 1. ae de to advise you of security metion in tho subjoct case as indicated * elows ; - : . 6: Security approval <s granted the subject person for ugcess to classified inforcation. Cl Provyiatonal clearance for full duty with CIA te granted under the provistons o® Paragraph Dot Regulation 16-9 which provides for a tumporary appoint- gont ponding ecrpietion of full security tnvestigation. Ct The Direator of Central Intelligence has granted a provisional olearance for full duty with CIA under the provisions of paragraph H of Rogulation 10-9 : 2, Unless the subdjeat Forson onters on duty within 60 days -from the. above... date, this approval becomes invalid. . 3. ‘Subject is to be polygraphed as part of EOD procedurese wee ae na Slo ° . ran cf ad o ; 4° a ‘ . pt Grint (Axo re fee Ermal P. Geiss a, _ . 8 a +3 i % we ane CONFIDENTIAL wet oa FORMNO. 59-101 | . FEB 1952