tot pA WISTORY ‘ i a tiScation at waz end of this questionnaire befnre enteriay She reespere § . ments raust D+ completed. VF the answer is “Mone,” 30 state. Do net Payee ‘ BOL Aereia art auoicet to veriication. YF more space is needed, use the Wemarks gn 2 : c a is for ofacial use only aad with be maaintatacs in confidence. i Bo: The jaformation aterza hereo ca eee enema nid a8 ONT ee | een, | | | een oe | | | ) bees any Gent 5 ae 1 —f | 75 { HAE AWD ADDRESS ; i : ; ad > Gecial, grararnal, profesional, of&. ; . Ly 7 . ne = naeoeernnnce cot rem A inmorican Lesion, post 139 SOCTAL _ pivd, Arlington, Va. mariocan Tlaeion ecw 52? L Pore on, Virgi nia_| ofan? UN SAMTATIONS A ad AWY COMMLNIST OF: 22 YOU HOW CA HAYE (OU EVER CELA A MERCER OF THE COBHUNIST PARTY U5. A, 08 — z VOU How OR Nn oo an FASEIST — yOu tow OF Pave YOU ZVER BEEN A MEAS! FA FASCIST ORGAMIZATICA? . —_—_——— nee —_. FET nN QNO0H OF PERTONS VHILN ADPOCATES THE ae rer nes cy ————T MBER CF ANY ORGNAIZAT IO, ASSOCIATION MOVEIENT, GROUP Cn 6 BT, O8 WHICH HAS ADOPTED TRE POLICY CF AL NVGCATING O UNITED STATES, GF Wopck 5 = yOu HOY! OR HAVE YOU EVER BREA aii JERTMAON CF QUA CONSTITUTESAAL FORM CF GOYE! On VIGLESCE TO OEY OTHER PEPSONS THEIR RIGHTS UADER THE COASTITUTION OF THE THE UNITED STATES OY URDOMSTITUTIOAAL FEAST . ane YGU HOCH A ANE YOU EVER LEEA AFFILIATES GR ASSOUIATEO VITM ANY ORGATHTAT AL Ca ENPLOVEST i . ( wwvo You MNcHY CRS — : SOCATIaNG VATH, OF HAYE VOU AACOCIATIO WITH ABY JEENYIDBALS, PACLUGING RELATIVES, F ANY OF THE CRGAAIL JAS ICSNTIFIED AZOVET —— a a OH CF THE TYPE DESCMBLO ARIVE: CORTMAYTC: x FTO HEM OR ART OF THEIR ee u HAVE YOU EVER ENGAGED 14 AMY GF THE FOLOVENG ACTIVITIES OF AMY CRGANIZAT! PARTICIR ATION 1A Att ORGANIZATIONAL, SOCIAL, OA OTHER ACTIVITIES CF SAIO ONGAMIZAT ONS OR CF A REPAREO, REPRCDUCED, OF PUBLISHED, DY T c3vauT et OF AMY WRECTES, PRINTEO, OR OTHER 4ATTER. P AGENTS GR INSTAUHESTALIOS SS ee enn nal SETAREO STATEMENT. WF ASHORIATEO ITA ANY OF THE SG AMILAT IONS, SPLGIFY HATURE i CLUDE CATES, PLACES, AND CREDET! aig taveH OR FORNERLY HELO, IF ASEOCIATYRIS HAZE IF (NDIVIDUALS AMO THE ORDAPIATCHE LIATEO. = IACUMSTAMCES. ATTACH ADDIT™ HAL SHEETS Foe A FULL ICE OR POSITCA HELD, ALSO I UNTION WITH EACH, ISCLUDING Ore WIERS OF THE ABOVE CRGANIZAT ICES. THEM LIST TH zc Tu Mion THEY WIESE OR ARE AFP oT TED, WIOKTEO Cx SU AQAAT CH. O28 HAVE yOu EVER ELEM OROE SIT DAIL OA COLLATERAL jolations for which a fire or forfisiturs A 915, oF fron trae draped}! MATURE OF THE GFFZASE CR SILLATICN, THE HAVE AMD LOCATICN OF THE COUAT C2 PLACE OF HEAR INCLUDE ALL COURT Fhe : ILE UY DILITAAY Serva € AALTY SPUGED C FOTO DF fealhie ¥ Los THE DATE, THE OF EACH CASE, NW 55923 DoGId: 32255104 _Pag et ete as See cee
e eek tee ete cme enema tere te ete ate Rene eA en aR Aer ht Hi eo RARE eR AR A RRR at SNR ne tras ele te on tae U2 Aint atm Benen SAR tn ne ee a nan ts Aner Pa net oe 9 a nares MRS. RF ADT SEAR RIC OE EEE TUN CAT at mete a Pea cate ot tee are tmnt ren net tem Acne ttt ae te tn A ret ttt tt tat errant never Th 400 TRIAS ABY ERCIODNTS ft YOUR LIST HOY BeeTORTO WERIN WHA BAY REPLOCT URN YOUR LOYALTY TO THE URED STATES OR UFOX VOU SUlTACILITY TO Result * THE DUTIES WHICH YOU MAY 8£ CALLEO URKH TO TARE Of} WHICH KIGHT REGUIRE FURTHER EXPLANATION? gO yes ti ko tev ves.” GIVE CETAILS ‘ > TEM HIS "SECURET. CLEARANCES HELD" ie “BERT? CERARANCE: INVESTIGATIVE AGENCY: DATE. COMPI 2 U.S An AMY  WSTCRYPro TTC —— BEBROX MARTI 1562 DIO NDY NAVY . 5S. S.2. DIO NDW oS 05 MARCH 1965 7 oe FLLE #1313-1C NIPSSA NAW =o T.S. S.T. | BELIEVED [0 BE N.I.S.. APPROX JUNE 1965 NEPSSA/HOSIC NAVY T.S. S.0. BELIEVED TO BE N.I.S. APPROX JUNE. 1970 4 (UPDATE). Hh | | a DOB/EOB PRESENT ADDRESS U.S. CITIZEN | 4 35 October 1933 403 Hornel Avenue "YES" (Ona na, Texas. Baltimore, 2h, Maryland. 21224 TEM #14 "CREDIT R REFERENCES VIRGINTA MORTGAGE AND INVESTMENT CO INC.... «ACCOUNT NUNBER 01432 70 | VIRGINIA NATIONAL BANK... 2.0.00. e eee eee ee ee ACCOUNT NUYRER 1001578 v- ee 1 CERTIFY mm AT THE ENTRIES RADE BY KE ABOVE ARE TRUE COME LETE, AKD CORRECT TO THE EST OF KY KNOY HLEDSE ARO KELIFE AND ARE EOS GOGO FAITH. TUN ISTAHD THAT A KHONG AND WALLFUL FALSE STATEMENT ON THIS FORK CAN BE PUNISHEO S&S ae FINE OR [MPSISONHMENT OR: sont (Se0 U.S. Code, title lu, esctiaa [G0i ) . “7 : ale ace oe Rett 8 COMPLETING] Wok Monta (f Vine A CL? i ff YO Bs CO RAD CGMPLETED BY AUTHGRITY RE OURSTING INVESTIGATION EE OF CLASSIFIED KATTER (fojs caveat, eeurel, ofc.) 10 WHICH APPLICANT WILL REQUIRE RC a ———
v ERRON FING RRPINTE ST ?, DUMFRIES ,VA 22026 $27 (8-59) s1H orar-732 LAST MAME . . FIRST NAHE CONTRIBUTOR & ADDRESS COMPA CO} . ¥ DOD NAC CENTER . NAY! by NPE LEGS NCE MIODLE NANS Post Office Box 4 ~ CORE 4AND, 2NOL Fort Holabird, #id. 21219 ELSENHOMER AVENUE ALIA. tal TAXING FINGERPRINTS ‘ i q Ws a fe 7 YP OR pariy ALL SEQUESTED QUZSTED DATA 1. RiGHy. TRUMS : 2. Pt NW 55993 DocId:32255104” SIDE FOR FURTHER iNSTRUCTIONS) GHT INDEX Page. Bh “send NUMSER (LEAVE THIS SP. DATE FINGEAPRIN TH , . - a ee os 15 APR 1975 cus PLACE OF MIATH ; PALL RIVED CITIZENSHIP / REF. or U.S. 3 RIGHT MIDDLE JFK Act 6 (3) ANDRIA,VA.2233 1 — i ee te Se em Ek tate BLANK 2 at aa NP Bran Em Reet man ne nem 5. RIGHT LITTLE 4 RIGHT elaG CARROLL «IR. | |
LEAVE THIS SPACE BLANK HONATURE OF PERS SON FINGERPRINTED av FORM53 10-2 {REV. FES) (Supersedes G! OT BGs HORARD ) SP DUNE HGOMATURE Cr OF FI aA TAKING FINGEREAINTS a Boh rib gy rype ALL REQUESTED Sata (SEE REVZEKSE SIDE FOR FORTHER V. RIGHT ‘(HUMS ‘MW 55993 DocId: 32255104: SVR 22026. Pd ee “| CONTRIBUTOR & ADDRESS GLYN? LAST NAME DOD NAC CENTER Post Office Box 4 Fort Holabird, Hd. 21219 - NUMBER la#STRUCTIONS) 2. RIGHT INDEX Page 9° DATE FINGERPRINTEO “ 15. APR 1975. PLACE OF BiATH FALL REVER, MASS. CITIZENSHIP US 3% RIGHT MIDDLE JFK Act 6 (3) FIRST NAME ve tye ee ee ent ret nates oe VAV+32-327 (6-59)) 5/4 0197-732-3 cL RE > “COMPANY & COMMAS NAVAL. ING CARROLL nian COMMAND , Ole ETS JHOWER AVENUE ASS Fee + eh et Ne ty 4 RIGHT RINGS Bae mye pets nge = MIDDLE NAME DATE OF DIATR 05 MARCH 19h0 EYES HAZET, Tarn! 3S. RIGHT LITTLE
Nw 35923 Doold: 32255104 HE EADQUARTERS UNITED STATES ARMY SECURITY AGENCY TRAINING CENTER & SCHOOL Massachusetts Fort Devens, SPECIAL ORDERS EXTRACT NUMBER 135 , 15 TC 241. Fol reassignment dir. . TDN. ~1363 P1513 § p79? _. FRISBY, CLARENCE R RAL5659275 PEG E3 ~Asg to: 303rd USASA Bn, Camp Wolters, Texas, ae - Rept Date: 7 Sep 62 PPSC: Bo | PCS (MDC): AD Ng Depn;l — oes ADC: 3 yrs Last FST & Tvl Sta: 2 BRED: 11 Dec 61 7 DROS; NONE ETS; Dec 64 Oe | DMOS;: 058.10 | ~ Ly Data: DDALVAHP~ NONE FSAC; 6 “EDCSA; 11 Sep 62 Auth: Sety Clne: Interim TS & Crypto Sp Instr: TO will detm & furn nec Page 10 WP: 058. 1G CoA “USASATR + 322) this sta. Grad date: 22 Aug 6 ct TR & AMT fr this sta to Camp Wdlters, . Texas only. eo te amas we me 27 bug | 1962 4 Sep 62] 2132010 o1- 1361 Aloe CUBASA, Aug piol- “10 .Govt tvl fr N Sta to S Sta or Logan Airport Boston, Mass is auth. _— . GINCLEY, KENNETH E RAI3750222 PVT no 058. 1G Co B USASATR an (32) this ‘sta. Asg to: 303x -USASA Bn, Camp Wosters. fovesy ~ TLcnetp aaah oe Rept Date: 7 |Sep 62 ca PPSC: A. o PCS (MDC); AD {°° Ne Dapn: L Apc: 3 yrs i. Last FST . Tvl Sta: Z BPED: 22 Dec 61 i DROS; NONE ETS: Dec 64 |, DMOS : 038. 10 | "Ly Data: DOAN yan HOE “i -PSAC: 6 EDCSA: 11 Sep B2 7 i Auth: Aloc CUSASA, Sug D10L~ 10 Scty Clnc:; Firpl TS & Cx ypto f Grad date: 22 Aug’62. a Sp Instr: TO whll detm & furn nec TR &i AMT fr this sta to Camp Wolters, Texas only. ae Govt Tyi}fr N Sta to S Sta or Log fa Airport Boston » Mass is auth. ‘GLYNN, PETER $ Jr RALL39 3 OF8.10 Co E USASATR (9322) this sta. “KGa to: Suotd) USASA En, rs, Texas. | n Rept Date: 7 spo 62 . : fd . Ppsc:4 pcs (mpc): A9 | 7 oS Nr Depn: ADC: 3 yre {t+ Last. FST & Tvl Stat: Po, | BPED; 18Sep6l rp DROS: NONE ann a ETS; Sep 64 ; DMOS: 058.10 | SO Iv Data: DDALVAHP- NONE FSAC: N EpDCSA; Li Sep 92 Auth: Aloc CUSASA | ‘Aug ‘D1Ol- 10 Final TS & Crypto ; rad date: 22 Aug 62 soy Clne: to. will datm ve furn nec TR : ANT & ‘this sta. to Aug 62 veers, Texas onty. | \. SP nse t Tyl fr N Sts te S Sta or Le f.an Airsort Boston, Mass is auth. : ENEL-OSURE (a) : | Hemme ome Eee Sect ae ne mete ee net tn semen emma