SECRET Dio» 4O —Dcoucler | 648 Intelligence Agency Street, =. %. waSL ingten, De. tC. fentlecens of the Central Intelligence Agency ency may deem it in its best interests AS post, it is understood and agrend : al Intelligence Agency to serve a . period of twentyefour ments at my place of employment outside the rental Vnited States, a2 if I regien or terminate my appointment or to the wnited State tePere the expiration eof twenty-four months Post, umiess separated for rensons mee Agency will not pay my return 1. In accordance with that, except as Central in vo reeall er transfer xe ty me fo snall be required he the ted States. acd @greed by xe that I shall remain in the Government service f weelve ronths following my arrival at my - overseas post unless seo: SP. #aceons beyond sy control. In the event im this paragraph, any monevs expended travel, including per diem while in a expenses of transportation of my inmedi- tation of my Reusehold gocds and personal idence at tine of appointment to placo i United States, and for such expenses to my place of actual residence at time ated States, shall be considered as a a a violation by me the United States | tonserary dutv status tte fanily, and expenses 3 erfects from any place of es employment outside tha conti en my return from such pest ¢f 44 er assig grment to duty outside debt due by me to the Snited States. (lu
_ STANDARD Fons GT Crevisen auciar nay PROMULGATED BY C0 SERVICE COMMIS BIO8E PLULRAL PLUSUARTA, MARUAL APPOINTMENT AFFIDAVITS ; IMPORTANT. ~-Before swearing to these appointment affidavits, you should read and understand tho. attached information for appointes - Cla visigantatint aa sapasgy TTT aetna a alesse igi ip atitney en Co revton 9, MILER | - . ota TAN OD oe 2 I, ececcsnsneneveessseancaceeere se nlasemes puannsanvansananesseseuceuecseeecensesecees , do solemnly swear (or affirm) that— 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 frecly without any mental reservation or purpose of evasion; that I will well and faithfully discharge the duties of the office on which [am about to enter, SO. HELP ME GOD. B. AFFIDAVIT AS TO SUBVERSIVE ACTIVITY AND AFFILIATION Tam not a Communist or Fascist. Y do not advecate nor am Ia member of any organization that advocates the overthrow of the Government of the United States by foree or v iolence 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 affirrn) I will not so advecate, nor will . - I become a member of such organization during the period that 1 am an employee of the Federal ’ Government. C. AFFIDAVIT AS TO STRIKING AGAINST THE FEDERAL GOVERNMENT — Tam net engaged in any strike against the Government of the United States and that I will not so engage while an employce of the Government of the United States; that Iam not a member of an organization of Government employces that asserts the right to atrike 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 promined to pay, any money or other thing of value to any pergon, firm or corporation for the use of influence to procure my appointment. a £. AFFIDAVIT AS TQ DECLARATION OF APPOINTEE The answers given In the Declaration of Appointee on the reverse of this form are true and correct. , 36 March 1955 (Dete df entrawe on duty) “_ ; . cGe farch Subscribed and sworn before me this ....5 Gth cence day of........0..... Vars! * hese tecenceseereneaeens ,A. D. 19.55, Otc eee ee aeneseaneaeenee cece et cceeescesee caves s cussneesassesnsvnvitevinnecses: . quay) GBiete> | forar] a (eae Se w . seseeyeDisaeeeearacaree sae inen | scasecaeresanneassesaesnansernarans NOTE.-- If the oath is takon before a Notary Public the date of expiration of his commission ahould Bs A eae be ahuows,
— DECLARATION OF APPOINTEE This form is to be completed before catsince on duty, Answer nit questions, Any false statement in this declatation will be prounds for canectiation ef application or dismissal after appomtiuent. Impersonation iaa \ - eriminal offense and will be prosscuted acewrdingly. 2 aa and teambes, SEP REE ST UW WASMMGTON. DC —f Mage, 1920! MASOU Ct 4p LOA. ———— , |" SPACE OF LUST Qeitr on feats Land Stata ae countiy) ' BG) CAN ENESSENCY FRBASE AUTIY am ea eens CEC) STREET AND RGMBET CITY ASU GENTE EA 2-38 66 Wsr vw | | Mas. i. WE UA ta, bie ASE LOVED Wl 4 Ors TP UVES SS CUVRUGS CAPLCIEY, AMY RELATIVE OF YOURE CELE OF Be wo on MARTHAGL) Warts WHE WO Ee © t 7 ‘ ree pass cewearess [] yrs {C] x0 Pf ws foo eer such celatire Allin the Blente® Bode, Tf act. i@rmmal space ie ‘neee au sunan . RST OPTIC ADOT ST ans a bag (Gree ae a mumber, sf any} DLPART MEST ON AELNCY a WHEL eects cera ASDC | MAMAN Te PEAR I ae a sik ie . INDICATE “YES” OR “NO” ANSWER BY PLACING “E™ c 4 eres ANSWERS TO OTHER QUESTIONS | IN PROPER COLUMN aw | Walle (4 LIFT COLUMN MUMOCAS OF LEME TO Wri DLTULID ANTAL NS APPLY ee ceuusnansenamenmimmmenmmnenamnmned Renmmmaal @ ARZ YOU ACTER OF SP 0 20 YOU OWE ALLEGIANCE FO Teer NITED STATERE. er nena @ ARE YOU AN CPPICIAL CA EMPLOYEE OF ANY $1ATE, TEQAETUAT, COUNTY OR | PUMICIPARIT ES ne FF poue sagwee te a9", give datails in item 3, | H seereacrenreemaeremen ermal P sone ete etree : y, BO YOO Breese GNF ANNUITY OROM TUE ESET ED STATES OR OMSTRNE t COLE GET RN WENT PEC ER ANY RETIRE MEST ACT OR AND PRAGA Ot OTHER COUPE SEATING POS MILITARY CM RAYAL SEALE: Yoo, grain fiem lO reason foe refireinant, ff wvour anseo¢ thar at, ag wut or ammaheniaer 3, petererment pas, & sé xav.tod Grou guitare af Maval saree. af Uieabilty, oF Ay tego of valestarr Es Bare. moron al ation after Ji APSE IO REIN CO SLS TLS IN ToS OPe ey ee eT be wu; UME POR EEE TO ROSS fod MISCO THE | B TOT TA REDS Sed eas PACIORY DENY CR PPRDEE ANY AD a EWORE LL. eee rer eee | Vigour anemeria" Vor, dice in dieu 10 the aame atid ati cag’ enipiater, date aind reseun in sach C260 a eeenemeel mel ? oo4 G Kave Yorr BET AREESTID (mF deck fe THATIFS VR et ral Were’ sa HAY ESE FINED EE OR ESE OF PORE TITERS Oe CATHAL OF Oe Baad) SAS ON ated BPFRALATION P50 IMO Oh Ents AARNE BESTT at Tf pour gaswee ta Yee! Lat all such capes wmiee Team ry Give ret un Ae 6s Fhe data, (ayibe mature of GNe oy on me Bey or eeatacron Lop the cette Bed he of ot Che comet .ad Ee Pom pes of are. OF ther Gaperertied ui PhO yao. Y aprotncedt, pows Gigessecpta well be bakon a err ig BF INSTRUCTIONS TO APPOINTING OFFICER . Tre arpreettng 08 ce bolas whore the Govegare covticwats te ouwie ool CP Age —Ef beAnite ag: Umits baee been ever bhebet &e the prentbeun Fe ehemehd ed Geter ming ts tea cen vabeF atta TR at 1A 8 afpiaatnent Bom. Abn eeaeftea ate & el that aqeaute wank @ ed anak ee 16 ENG age Farge Fit Ogee tial ate ont, ella Viesd Teese @ Hate oved Pe srelaat sovet ddedescsnmates te csade, ERE Berperesf ars Maag Oe LG co aeby oT Otte re ee, ee mere serene amie, WEN tat iets Seev ee Alt wy gare of Cant gay pert ates cag tar agteeetre at Tras fraay ed be she bah Pe Rvahag dg Re geass a, Bolt oh Fey by come etn RUA amy Cred od gcd Gin barge ae sevest, sort preven tts ba the 8 us ae bag diy ddsante of apueenios wit te the dete preaest wy nenat OF Cee erat cw Bnd ts Leese mule Pee tet eaeteeee te poke blee | fe 1 Sack pare wee weet eae ant ewterbiseg ape dt 2 wk bie o; oyiee rocwp ed bi tee Cyeib Bereie Base entcat fre 4h Paceemee cmt te tpt wt peel ot fa Bde enee Be Tete e AG ATO oath mw the ateene ad com tetiog fink & vemOuasra mate Sogn tel «Bh ae pee 8 Bese Perey Gee ed SO ot SP Rae eee Feat ae ee parte gs agate - Pr er rd the vores trong ate tad the © fe Metehaes od Puan <2 acm dof tha Mind Beeue o mee garebere mt o bem. 6 tes od the eneeemed cf or 14 famwtd taat ote ee deena algurets 18418 we abeois I> oe granite et are nine Ga te Bed pops eten that me en tee Rat eee et emrer tbe By Beate res we tuceccanh qrageeze TE Bind A gereree Kone Find te 8 Be chem 1 Ome dt peed. pein Vie ecg aetie ont hee baa the S Ba scam met @ 78 TRE ge rte e am RETO ESE ®t dah base peo eg nE Ee Renta eth 8 pee ree me mp a cement oo Teed ester aknce #hoed, when Bae eget mths Fee met ramm Oe pa me Ee 2 magma sats a stern de te here ® tet Aereres Pee er er a oe eer rrr OE Por ie a Phe amnenbur es t4ae a6 6 8 fat ates bee quvnermend 6a hie poreeansi Eebrety fou eye omenema Gees ber pe ee cmeg ne: st aap bate Be ew peek ay be er torre kee Bere agg ese cere oie ed OP PE he BAM Reeds coe ore Ree oe 08 a soem e, DG wferaegnes Gpratnen ofamg te bItRe Eg
Bo SECRET (therm Pilfeé tmp ¢ . ? Be . “ lias QUALIFICATIONS UPDATE _ READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING, TYPE ON PRINT, AVOID USING LIGHT COLORED INKS Now thal your quatificationsa are a matter of computer recard, fhey must be pertodicall updated. This is dene auta- matically for much trformation; however, some must be obtained directly from yon, Thts form ts for tkat Pur pase? , Section fo muet be compleced in all cases, You need provide other information only Hf there tiave been changes since yuu submitled your Forimn 444). “Qualifications Supplement to ihe Personal History Statement,” oF a previous aprdule form. ff you are in doubt whether information has been previously submitted, enlerit in the ay woprigte section, Te signed und dated furm ahauld be returned through administrative channels to the File Room, hee of Personnel, Room SE-1} Mealqguarters, whether tnfurination ts added cr nof, Additionally, a qualifications update muy take place at any time there is information to be added or changed simply vy completing and returning an update form on your initiative, Fret ee ttt Acvion ¢ s BOG RAP HIC 225 POSETION DATA >, 238, wy, ane (heet-Pievot-widdie) ~ . Date OF DFAT ap GRADE O12773j MILER, Newton Scott 03/01/26 | D COUC ATi Oa ee HIGH SCHOOL AOURES4 (City, Seate Country} YEAR ATPEMDTO ( From. Fo ji GMaduatEe Cy] ees mmo Bronte ¥EAa MO, SOM OTR. wecrie ion pl une. (Specify) ce a tet eae ere ee rs re ann ete enn Oh een ner ean eer y oe 16 @ 4PeGuatd GELPTE was Otte ROPED AROWE @utcoe REQUIGEO Suowlas10% OF A GOETIEM THES? , dmDrcarE Yog FERRE OF THE Tre tid a95 O8Ff FEY SESCRIBE 199 CONTERT, eee er et ERM in errr ane et th Ae cert wees smn ft et nen et ee ee cn et ee ear er trene TRADE, COMMERCE MANO SPECIALIZED SCHOOLS a ee eereentirrerse ee arent ny mare pg ee Dawe 206 609145 OF geHOD, STuby UB sPiCraue zation SO. OF MORTHS oe penne aera areeetaeree en SO et ent GEnty EOUCATION OR TaAiNING HOT INDICATED ABOVE aes 26G Boeke GE Erno, i RPueGY GE Peli acs sateon Fete a RO, OF month cree _ttuer es aetcistinatias [a ae MART an Te bee erred cae eee ee aber ei HAR) PA, SPATYS Sp TT EN Ne cee tte a a eae oe ge meer ne eae ene SECT ICS fag saerren ee tees neers tpl en Tee A tts Nee renee see 1 PREste? Ghats fdsegio Barened Catmacd sepas ce S sewe a rt as bee 5 —s (Peeaes a ee fatey Te arten pe ee rae NAR eee We atten tee gene Ge Smee ree poten sont Re nna cect et ae Reem Yoo emt tenn unuteae re ney FP £8°S §f preea i” Peart BE Bere se eae S¢ase Conte g) 5 = = aot rene aos. ee ae i a ae . . “ “ a as = oe, _ i 8 thet ot gm. Pe Pec atwd geri wves : . enero eee = - RT et en tee Deere pe ~ oe -. fo. an ~ DT, Drm tne gree to meee ee “ £ fete btogaie Ve Pum e fi hrsh acu iigg 6 MGtR Orgad i* fete wok eahesa my eenp as oaree ° ; H esting 12 FHP soto) Cmir ete aed OePeOniere erveg man GUE NF wee mn no erie mt een eet, we . -_ ~~. as ee Setar leeieemeetdlensteneeneieataae eee ee . } one # Tess atevmtnae aark bac Fe ers oh Biante Pcrbatparered Pe teeneat aepegeg - - wee ee ry e oa ‘ a. 7 aiden - - ere ie ‘ 4 H i j Pt sarees i - 4 oa . i } ; rf owe { ¢ ; i ° i ? Hy } } - oat sacle. : et ed
SECRET . FRReon patte.t Pad GUGSAFMEC AFEA BROW EOGCE ABD FORTIGA TRAVEL. AMUAL ENCE aC Query Be-- SecTica ¥ reeeR (8) RaweT OF Bt nite fers OF apscr arises Heer G Or Travel, Bate @ Phare =e } eaee met i r mene ! an Couxfor Bnoeinne oe BFsingace OF 4Stuby prace [t@eent fase fousiae. oS - , wie ee nent tenet sree EAs nM se ee a on nee fe oe tee en te errr on cee ae een mare tens feta ene nen f eter amen rrr at 3 4 of 2 49 i Sof re cena cmrvnmmin eet ney ect tnrttent Pent wettiee fm mae cea f wmntanenye tn geome a SCCTIOM Vt : peer sreerernncis pentane a A att tener ta te hen ty eee! Se a. TOP ENG {oP itn qoute FeaM Ol BPH >| 3, tmmicaty swcetwant 5 ¢ Seytin Usene -cueea tap aPPonPeeATE Eff te : acy OFT E pres Cl SPteneaatine: StemaoryPE Ul] erecety: ‘SECTION —SPEChAL QUALIFICATIONS FuBL Ese MATER UALS OD DEVICES welCH VOU May paAUE Jane “enn nt sneer E PEOVICE BSP ORMAT INS OM MOORS, SPORTS, LICENsEs IMve Or ES SECTION Wied . _ ILITARY SE semvice CURPEAT ORAFY STATUS to MAS YOUR SPhEOPive SEavece CuasaIF ication cuanct oe 2. we CLAGQIP IC AT FOR {) ve9 . ([] x0 AMO ADDRESS | 1? OF PRTOFD, Gtvk AEASON 3. Loca. SeLective SCRVECR BUSPE fe MILITARY RESERVE, HATIORAL GUARD S$faTus CuCR RT BRYE OF LUASU. GeGAanie Cc} Aawy Cc] MaRing CORPS C) coast cuaap a MATH ONaL 4:495 om-ta-es F i . ° ~ FATIOW TO MICH Fut BEL OME C) havy a ain porce gO AIR MAVOO SL CARO 2 nee ee nae etn a pee ae Fe cet pt atten 2 nee canteen caer (4. CURRENT BANK, NRALR OM HATED. DATE OF APPOINTMENT 3% CUERENT RANK J.C RPI ATION DATE OF CUSHENT OIG A Fite 4. Cretan CuURME mT BES ave CAVEGOaY [7] et any aeseave a L_ Lf tree £ “uae. 76 “BMICTM AGSIGHED O8 ATTACHES pany WOR ‘: MENT $. ae B. Mite lany wORIR EST ION ALTIGHMENT _ ~ MILITARY SCHOOLS COMPLETED (Parended ‘itive. Boverve Outy. oF “ne Cividdan) a a a rr EArt etatertmet Prt a ran arenes ne - STUDY OF SPECESL TRAP! v COMPLETED f: Mag ana ALDSESS OF Se nbGL wens penne eee Se ins i section (Rs wna PROFESSIONAL SOCTETIES ARD OTHER ORGANIZATIONS. nas ——— Dat? oF wed wROR Zar HAUE BRD FuAe TER ADOMESS (Nuober Street, City, State, Cauntoy) ‘ eae F SECRET
Setacf (#8en Filled Pony} QUALIFICATIONS UPDATE REAR INS : TH ONS CARFFULLY BEFORE COMPLETING ING LIGHT COLORED INKS TYPE OR PRINT, AVOID Naw thet 4 your guatineations are a matter uf computer record, they must be perisdicatly updated. This ts done uulo- matically for*much information; Aaweter, some must be obtained directly from you. Tats form ts for that purpese.- Sertion £ must he completed in all ences You need provide other tinformatio#i onty if there have been changes since’ you submitted pour Borm.444f, “Qualifications Gupplement to the Personal Histety Statement,” or a previous update forme, if you are in doubt whether information hay been previously submidled, enter il in the appropriate secttan, The siqued and.dated. form should be relurned (heough adintulstrative channels fo the File Boum, Office of Peraunnel, Room SE+12 ‘Headquarters, whether information ls added ur not. Additionally, a qualifications uplate may tuke place at any lime there is information to be added or changed simply by cumpleting and returning an update form oon your iniftlalive. pour Section t BIOGRAPHIC ANO POSITIGH DATA rn te Fer, sre. wo, Viur Thovt Pivel wradley . : . Gals OF BIRT Ven ema an oe, 012773: MILER, Sewton Scott i n3yois26 | on] 16 ee “SEeTiog 11 — aa EDUC AT ON ° ; vo. HIGH SCHOOL ; LaSh wiGe SCHOOL arte moe D  favueess (City, State. Country) EARS ATTEMULD (From-To},  TRAQUATE . a . Cc eae C) BO ~ 2 COLLEGE OR UNIVERSITY STUDY ~~ ee MAME END LOCATION OF COLLEGE O8 uerecosity faba at rennin} oremee veas |NG. abecore. . PMO Tae. J weevaven | Ech v EOL MAS. (Specify) sen oe Basen er Lo HE QUIRET SUGMESSEOM OF A aE Pree Trt hig. feGtcatt ret Fayue oF Fee if & 4 @aduale mas GEt om TE Sis SMO ORICFRY Begeeine £96 COnttal, ae Erik cae CCOPHERCIM AND SPECIALIZED SCHOOLS SSCS ; fAMe AND BOfRESS OF 4hUOOL STUDY OR SPFTHALE PATI ON to NO. OF MON Fes ee tee center terme caperrivenent ate a ee ere ee Bat meee oe WAVE AMD AODPAGD UP ratus t Davarvet danuilecd Semereie it) qaF SicTiGn Tre 4 +. SbF SPT gfarus (Siegte bertbod Yytose dd Lepara io mawe oe ePouse: fheary tFeeet) isthe) (Warden) @ Plate oF pimiw eraire Meare, Country) 2. GAT? OF PEATs0 aiat ferto | | eee eine ote semen tere ne then et ter i. ---—-- FP Teles tmgweie &@ Gad O CePise eso sP Osh CGyumraviinas - . @ Oats Ub. CIP a mame at gules oO a we nw be ee oe ae ve eT PL euANtn? - ee te ee eet ee tn tee ie fetes atten = bowen ae ge . - ' bg i H H } A ee ee Ci) te | QO gore ds ! i } i pea SOBA cor tees SECRET eT seca A vane RSI
SECRET qBher Feilee Feat SECTION ¥ nates oF Tees bate & Lace Peep ge wher par gee h- on mesiaince | me Styne - 4 Beat EUs awe CF BEGIOR en Canney geben emer nen ocean tie nett fan ee | eet tc ener JUN i erence ates oe nt ie Seer nin te Ne iH a “prpine and 'svtacci arate BL TCaT oe 1a) aPeROPR tare TEt te 2 siti PVP ING (FPH IE. Geom PANO, BP a Zt I. TROICATE Suge thaND 8 tate ato 0 sPEroesi ries (lecteorere ~ SPECTAL QUALIFICATIORS ee heceesa ds. Fuel bsHED waTE RIALS OR GE Tees [laercrey, Arne rene oe ners ncn eR ERT eet stcfioa vil PROVIDE IRF CewAT ION ON apepds, FORTS. boAWE iMvENTED. weer l VE MA ; Sectioa Vila ; Litany SERVICE a e OURPLAT ONAFT Status ” ET TOUN SELECTIVE BUBVIC? CLAUSIPICATION CMBR Ate Tinwnuatieoe (] wes {J} se B. LOCAL HLLACT ive SERVICE BOARD MHWOLR snp A008 3S CT ive GERVICE BOARD iy erecrly ) ores ens Favay ee eet et en . WILSTARY RESERVE, MATICAL GUARD BTATUS re een eee ee et paseo nce ac tenn RP ATO i a. ro (7) wat amMast Ge HOS fwiCe PESTAVE OR GUARD OBGAME (TJ seu cc BAR ERE COMPS Cc COa3st Ouanp ZATION FO BHC VOU BELONG . OQ waAY't Oo AIR Poach C] AIG HATIONEL S803 Te aerwarys EBPIGAT YA pate. t anim Gala GF APP OisbmewT te CURRENT Baws ee 4. CuRALwT Rare, GRaOf O@ Bareyz. me GaN SHY, wTive) BCsrhve wei? 39 waitin app baneD “Ge BPTAL MEG | a “ts — eect 4. CmMECH CUMATRT HFTEDVE Calgary C READY Bite weve #. MILE TAMy WODTLIFATION ASS I Gis oT serene a aetna erent Bee ree eee eee ee occa rant nn Nt A I I | MICETARY SCHOOLS COMPLETED (Farendos Avrire. Beserve Baty, ae a6 Civillan) MAwe ae AODRE4E OF BENOOL Shure Of BFE Crap aati om Fo ORE SSI GMAL SOCIETIES AND OTHER OPGABS: Zari SecTiog ix D OTR? eee mawe ab CaP rds ere etn menaintne 86 aoUHE S$ (Huoder Steoet City State Cauater) reteset an IO ee EPRICE TI Gate SECRET
‘ SECRET pt 8em Bette we Pas - . QUALIFICATIONS’ UppaTE Cr rere ene te ee tererettnn, ANSTRECTION AEP ULL BEFORE COMPLETING, TYPE OR PRINT, AVOUT OSENG LR T COLORED INKS en ei he peciodieally updated. Pris 33 Ceme culty. from goa This porm is for that purnyy, only if there have been chances s Statement” or a nre: is Che appropriate sec v FRAO your qualifications are a matter of co elivualy for much laformiation: Ravever, some Section @ must be completed in all eases, You need peor sted pour Form 444), “Qualifications Suppieme ROG Sabs it are in douwhl whether iiformation Mas been : m. em cated furm should be returned fhrouga adr Prakive whanueds oo tte Pile Roum, Offce of Perso: nee Meudyuerters, whether information ts added or not. nally, a qualifications update may take place at eny time there ig Esfermation ta be added OF Changed simply oy completing and reCurning an upilace form oon your in ire. roca en mre Batt OF BEAT 03/01/26. BLOGRIPMIC aD PONTICN CATA naa - ee pwawe Cheat Pasar irdeies ! Miler Newton Scott ; *ectiow ti ~~ Rae ae ~ HIGH pyraes attingeo CFroe-To)}  Gaaguaty | [Ci-ss Css ADDSESS (Carty. Stare CASh Mite ge wooK ATVEinmot DO. ret ee ee oe ter nts aatr re e belles J . COLLEGE OR UNIVERSITY § Ind. seweure, learceaveol wecerven HRS. (Specify) Mee ee we tenn m G n . i Se eS Lo as ee WE TOTkE OF tee IF A CHASUATE DECREE Hag Stim KOTEO AnOyE mercy PEQUIGEM SuRurEesSieN oF Te€$tS ano pRiteLy DESC@tet 175 CONTENT, . . rr nae a en ean ta peer eee a ee ete TRADE, COMMERCIA. ARO SPECI Mt cree Llarios . OF BONTHS NAMG AND s008¢353 o8 SCHOOL STUY oe sPrye CATION OF TRiininG BOT rac; OTHER NON- AGENCY ou ae tn Eg enn in ew a —7 _ eer ane AOSPESE GF SCHnng »STuar oe 1 Peatlarign i rae WO [.°: or WENT s sete epee ee a Oe oa ' ' ff fet Beserese 2) gercuey, ts fey SECTION Git PRESEN! STatUG f4emgle Garzaed Vartnorl Separatet Divorced! ds aiden (First). aPQ 2 same o Giary (City. Stare Couette) 2 GATE OF BiBPen i 8 Foam CETTE Naming } , CPs rt mre oe Orpen ota wear ares 2Tefe Tye SPOUSE areata ice ee Tene Piswerea’ Liv tee HQin SECRET : - te gee ee wns e vie are Ree ee ant ne
7400000 - an as a 7 (ihe Pedfew Bay SECTION ¥ GEOGRAPHIC AREA RROWLECGE aml FOREIGR TRavey ete Rea attra ee pontovinees Se ae NAGE OF BE GION PyPE OF SFecraLesen panes or rea yeu! OB CduNtay RMAC OC OF PERSE HES | '. : ? SECTION Vi aerate tee tl VP ING ge Pe} ape CBP athe rrgigte pee “Dh rteeanir ine (CU stewsteee StCTiOW Vis ; “SPECIAL QUALIFICATIONS ETAL UAL FaOVAOE INFORMATION OF MODBIED. SPORTS. LICENSES PUL ES a er ttt prea  entteee NED waThot ses Of OLVECIS weriu vay way Mask near Lerig sectiow Vl ; ~ as a eS CURRENT OR. rr Pe wag WOUW SELECTIVE SERVICE CLASSTF CATION EANEE DTT [7 Nl@ CLASUFPICATION 7 ves Cl a9 : 3. CEA SeLee rive StRVICE aos nO aooaess oe “Te OLFES@ED. Fiul REAgON _ ee oe BL —-- —— ~ , “HILITARY RESERVE, RATIONAL GUARD STATUS — i CuCcCK RESERVE O89 fuaaD ORGAN. ARMY Sa, ‘7 « OSl i teal Guaed CATION TO BMICM YOU BFLONG fa avy fa ee Ci] coast scaay 5 At wats towat Gand a tn ere te 4 CURRENT Rane. CRaDE OR RaTEl? Dale OF APPOINT MLE im CuRRE SY DAweR %. Ceheaten Tar OF CueR En CMTCR CUBAENT RESERVE carecoay Cj READY RESERVE CJ Tana wire) f] Stanp.py fmnceney 4. 3. MILETAAY WOGEL IZATION ASSIGNMENT [ SESER OE UMET TQ Onis ASSIGNED G9 6° "55 aLY HILITARY SCHCOLS COMPLETED (hereodea dctive, Fevesve Duty. o Civili ~~ — NawE aNd ADOUESS OF SCHOOL ei yercerers H ie LT EG I ! ! athote-setaszera. PROFESSIONAL ‘Socieines AND OTHER ORGANIZATIONS ——— — no . earner bo 2STE OF EEE S SHER 4009733 (Number Steve? Cary, Stare Couvres) ne t sane t ta or tt H i i eee ee Nt Qh ere eR fan eel re eer nara, REBPPKS a ne artnet eee wee SP er rn adiaatantaaaalieneh teoetngetanectetetan "3 Octoten bt a Seas pUaile, SECRET
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pfden Frbbew fas pre cm mene cet re eee me a eee ee ee an @ SE2 Ge a SER TIBGEG Fao Paes a yr. irs et RraNiF ican? Pup@Lt thet MATE TALS OF oeeeee vs aac th a tece (RO eOT eubert vapree untewe terucstedy ec eemiahe wel rchee, general saterewe eute Pee ada Teri b, Pam Pea ri oe 476) AND TYPE Of ae tine pau. beettan. Beets. novela, short aterries, fe. 3 ey ARP PATENTED B. ONbiCAT! ANY DEVICES Olen vay way a TRVEN TED 29> STATE BNE THER O@ AQT 9. LEST ANY FuOL tC SPLANING Be Fuel ec REUat Pha ec Pee STINE e alioual a ¢ eonute Cle Cover aahigu ca MONGRARY ASSUCEATHONS Qn SOCTETIES te aulce vou awl noe oa sine symsard Ly A ry OU MAVE RECEIVED, Wea True ly _ ORGAMT ZATION Li ialal EXPERIENCE = SINCE LAST COMPLETECR oF A PERSUMNEL _QUALIFICAaT1OR 3” FUR RETA were reeen aa ee pct Lustye pares ot ¢ ya» and Fos , - cwane | 9. oft PADIVES: es ae vee OF ANGI ANME ssf < Se ee 19S8 _joor/ er stTaFE/oPERA tS /egtsess SATELLITE - ant ree usbyR fa wet filled” : CHEE Cok ps] SATELLITE, B RAUCH -~g10-e tise “amy “pROFeaS 7T at At ats fe y wiwoh ea, age ACADEMIC 50 Ce! “ Covsuledialcl Ye gear E ACE LU LCT COM CEALLLE G eoosdusatron - Aguiues, weet Ace, ert, Fe SAFertrfE ove A heea arch , wralicis wifes an /?, rare depele” ger behets, DI Re Web Taped. 168 1HY | pete cel pee eee , shea | 2 NO. OF FePLOVERS uNGta «AR pimect } oe OrE: Chae Po rian ! Cheon ps QQ CHEE Paeje Peoject Menotont’, CHEF E), em Fil ceeeeeeenteenet eesenaoeteeen teat eee i BESCHIP TION oF ead . cage | 37 3 ie do : f. feelusiveé Gav “UFroa. + and ‘Tay 7 Es (7ss - saisee at 13 DP EE, :4 nO. Co PeMPLOVET S UNDE Pe. ormect aes OFFrci aL DSiTION Tee SUPER stom ff 3 ——-———-—- —-_- 7 Ouries ZL ¢ i474 aot, Le vee Tooele, he Harueat wu FE, : 8. TIN CLUAT YE, pares (From. and fo } iz caso}. OFFICES Piva Stagg 40a. ALE dD Ernmnbatbantd L CAE, FP _| | 7Ee > Af bec [te | Ld SE DOP FES aise __ Sursavi sion Sha eran “Lev DEPEND Séetiou ff we ae cena bene ene ater Ot — “Ske PrrON or aire ——- talieunck fir actly ae dana es7 oF aud amber) Tek tte re recuuse vio pares | were nee ad Fo. p fay ae ane Ye TOP ICEF DIV SIGN @ pean Loe _ bocce tg ao, UF TweLGeaed abee voum giaic? a OFrictay POstTio’ The — $, teh Ete ES1O% i DESC BAP PEON ut fu tse 4 eee ee ee eee i pee sits teunel pogoe afl ¢equerads SECRET 4
a> SECR { faen fF, 7 @ f sectice §at CHILOREM AMD CURSE Le feaceals r) china — ee eet en __o——ee ee ane bE. muerte OF CwIL Uae fincleding atepchéidesn Qe ofertas 4 and adopted chisdren, wed sat UneAaR EO ' o. @lepparer te, . : : . wet TEP END Ow ve, #2 OF LEAST EOE ie Ue eeeating. OF a8, ant AGE ROT SILF . @ euPsoee, 28, Ter eeen COVES IR VT ARS baie : arene a on EE Qu ARE WSL _SLLI aL P SRLS : Ap mweATION FOR ALL CHELDRES and oF arts : i sau i . DELATION SHIP YERR OF Bree i ce oe aleaess ! - - « -- t } ; i t i r aa ene ok aaa aes era aaa . ADDITIONAL COwMENT ARL/Ge CGmTimyatiGr OF PRECTOING ITEMS e . fi id - ee — — -g os or) ne Pe ete ae ee et em en A A fi wale ryf Law tS S WA | | ~% . ~ 2 SEGRE ee $ -