ot GEM gHICH REQUIRED SUBMISSION OF A WRITTEN THESIS, INDICATE THE TITLE 6. TRADE, COMMERCIAL AND SPECIALIZED SCHOOLS 1 NAME AND ADDRESS OF SCHOOL STUDY OR SPECIALIZATION MONTHS 7. MILITARY TRAINING (FULL TIME DUTY IN SPECIALIZED SCHOOLS SUCH AS ORDNANCE, INTELLIGENCE, COMMUNICATIONS, ETC.) NAME AND ADDRESS OF SCHOOL __ STUDY OR SPECIALIZATION [From | | 70 ‘| MONTHS 005, 715, 7 Bomning,ca,| os | man ts oma | ‘Special Forces Nov 1956 8. OTHER EDUCATIONAL TRAINING NOT INDICATED ABOVE. Spe cial ‘WarfareFt Bragg” OSS and Agency ‘Schools @ | SECTION V oe FOREIGN LANGUAGE ABILITIES | COMPETENCE - IN ORDER LISTED Fs LANGUAGE R-Read, W-Write, S-Speck (List below each language in which you possess any degree EQUIV- FLUENT : ‘ALENT BUT ADEQUATE | ADEQUATE| LIMITED HOW ACQUIRED PRO- CONTACTIACADEMI of competence. Indicate your : TO FOR NATIV proficiency to Read, Write or NATIVE OBO eN. OF E LONGED (with Speak by placing a check (X) FLUENCY ioice paren c. in the appropriate box(es). . IF YOU HAVE INDICATED FLUENCY FOR A LANGUAGE HAVING SIGNIFICANT DIFFERENCES IN SPOKEN ’ANO WRITTEN FORM, EX- PLAIN YOUR COMPETENCE THEREIN. Y NA . DESCRIBE YOUR ABILITY TO DO SPECIALIZED LANGUAGE WORK INVOLVING VOCABULARIES AND TERMINOLOGY IN THE SCIEN- TIFIC, ENGINEERING, TELECOMMUNICATIONS, MILITARY, AND OTHER SPECIALIZED FIELDS. none IF YOU HAVE NOTED A PROFICIENCY IN LANGUAGE, WOULD YOU BE WILLING TO USE THIS ABILITY IN ANY POSITION FOR WHICH YOU MIGHT BE SELECTED? . =) YES (] No Lc nn ee ne ae ets eee ent ane cman, sam te et A RAI AA I HW 53294 DBocld:32399765 Page 4
SECTION VI , 1s LIST BELOW ANY FOREIGN REGIONS OR COUNTRIES IN WHICH YOU HAVE TRAVELLED OR GAINED KNOWLEDGE AS A RESULT OF RESIDENCE, STUDY OR WORK ASSIGNMENT. INDICATE TYPE OF KNOWLEDGE SUCH AS TERRAIN, HARBORS, UTILITIES, RAIL- ROADS, INDUSTRIES, POLITICAL PARTIES, ETC. . ; x DATES OF NAME OF TYPE OF DATES A REGION OR COUNTRY SPECIALIZED KNOWLEDGE RESIDENCE PLACE ‘OF STUDY RESI- DENCE russes | | ermam intelligence 196-19 Tran intelligence | | 2. INDICATE THE PURPOSE OF VISIT, RESIDENCE, OR TRAVE Military assignments EXD y SECTION VII TYPING AND STENOGRAPHIC SKILLS a, TYPING (wpm) 2. SHORTHAND (wpmv 3. SHORTHAND SYSTEM USED - CHECK (X) APPROPRIATE ITEM A A [Jerse | [srecownitine | [stenorvee | otnen Specify): 2. INDICATE OTHER BUSINESS MACHINES WITH WHICH YOU HAVE HAD OPERATING EXPERIENCE OR TRAINING (Comptometer, Mimeograph, Card Punch, Etc.). NA SECTION Vill SPECIAL QUALIFICATIONS 1. LIST ALL HOBBIES AND SPORTS IN WHICH YOU ARE ACTIVE OR HAVE ACTIVELY PARTICIPATED. INDICATE YOUR PROFICIENCY IN EACH. . Hunting - Good Fishing — Goog : Free Fall Parachuting - Good . INDICATE ANY SPECIAL QUALIFICATIONS, RESULTING FROM EXPERIENCE OR TRAINING WHICH MIGHT FIT YOU FORA PARTICULAR POSITION OR TYPE OF WORK. OSS and Agency trained Special Forces Battalion Commander 3yrs Chief Military Liaison Group, ACSI intel (FI) team Teheran Tran 2 3. EXCLUDING BUSINESS EQUIPMENT OR MACHINES WHICH YOU MAY HAVE LISTED IN ITEM 2, SECTION Vil, LIST ANY SPECIAL SKILLS YOU POSSESS RELATING TO OTHER EQUIPMENT AND MACHINES SUCH AS OPERATION OF SHORTWAVE RADIO (Indi- onre GW peed, sending and recelving),OF FSET PRESS, TURRET LATHE, SCIENTIFIC AND PROFESSIONAL DEVICES. SECTION VIII CONTINUED TO PAGE 5 53294 Docld:323992765 Page 5 . La aeeine eeneniemtnnertin meetin enti AML oF mom tga eerenensteee e sadanen ee tte can ceaeeineneemnnnnteing enane te . camp teehepee oe manent dette cheat tet Te enn et pe retemame caren
HW 53294 Bocld:323992765 Page 6 , aa ne . RARE YOU NOW OR HAVE YOU EVER BEEN A LICENSED OR CERTIFIED MEMBER OF ANY TRADE OR PROFESSION, SUCH AS PILOT, ECTRICIAN, RADIO OPERATOR, TEACHER, LAWYER, CPA, MEDICAL. TECHNICIAN, ETC.? (Ores (]No . FIRST LICENSE OR CER ICATE (Year of Issue) . 7. LATEST LICENSE OR CERTIFICATE (Year of Issue) . LIST ANY SIGNIFICANT PUBLISHED MATERIALS OF WHICH YOU ARE THE AUTHOR (Do NOT submit copies unless requested). INDICATE THE TITLE, PUBLICATION DATE, AND TYPE OF WRITING (Non-Fiction or Scientific articles, General Interest subjects, Novels, Short Stories, Etc.). . . INDICATE ANY DEVICES WHICH YOU HAVE INVENTED AND STATE WHETHER OR NOT THEY ARE PATENTED. 10. LIST PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE. e . LIST ANY PROFESSIONAL, ACADEMIC OR HONORARY ASSOCIATIONS OR SOCIETIES IN.WHICH YOU ARE NOW OR WERE FORMERLY A MEMBER. LIST ACADEMIC HONORS YOU HAVE RECEIVED. ' NOTE: (LIST LAST POSITION FIRST.) Indicate chronological history of employment for past 15 years. Account for all periods including casual employment and all periods of unemployment. Giveaddress and state what you did during periodsof unemployment, List all civilian employment by a foreign Government, regardless of dates. Incompleting item 9, “De- scription of Duties” consider your experience carefully and provide meaningful, objective statements. 1. INCLUSIVE DATES (From and To - By Mo. and Yr.) 2. NAME OF EMPLOYING FIRM OR AGENCY U.S. Army Sept 191 to pres. U.S. Army 3. ADDRESS (No., Street, City, State, Country) Washington 25 D.C. 4. KIND OF BUSINESS . S."NAME OF SUPERVISOR ; MaL1i M/Gen John Willems Lt. Colonel s11,561.lérer year | Lte Col 10. REASONS FOR LEAVING am retiring after 2lyrs 3mos 1 days service -5.- 4 ’ j j
or oad eo 6. TITLE OF JOB 1. INCLUSIVE DATES (From and To - By 3. ADDRESS(No., Street, City, State, Country) 4. KIND OF BUSINESS 6. TITLE OF JOB 9. DESCRIPTION OF DUTIES 10. REASONS FOR LEAVING 1. INCLUSIVE DATES (From and To - By Mo. and Yr.) 3. ADDRESS (No., Street, City, State, Country) "6. 2. NAME OF EMPLOYING FIRM OR AGENCY 5S. NAME OF SUPERVISOR 7. SALARY OR EARNINGS 8. CLASS. GRADE (If Federal Service) 2. NAMENOF EMPLOYING FIRM OR AGENCY 4. KIND OF BUSINESS 6. TITLE OF JOB 9. DESCRIPTION OF ‘DUTIES 10. REASONS FOR LEAVING 3. ADDRESS (No.,, Street, City, State, Country) - 4. KIND OF BUSINESS WW 53294) Docld:32399265 Page 7? 7. SALARY OR EARNINGS 8. CLASS. GRADE(If Federal Service) [so rer 5. NAME OF SUPERVISOR aw ween te ne eee ee
SECTION IX CONTINUED FROM PAGE 6 . DESCRIPTION OF DUTIES ee 2. NAME OF EMPLOYING FIRM OR AGENCY From and To - By Mo. and ¥r.) . ADORESS (No., Street. CithW. State, Country) ~ . KIND OF BUSINESS 5. NAME OF SUPERVISOR 8. CLASS. GRADE (If Federal 7. SALARY OR EARNINGS Service) . TITLE OF JOB . DESCRIPTION OF DUTIES 10. REASONS FOR LEAVING INCLUSIVE DATES (From and To - By Mo. and Yr.)! ADDRESS (No., Street, City, State, Country) . KIND OF -BUSINESS 5. NAME OF SUPERVISOR . TITLE OF JOB 7. SALARY OR EARNINGS nea) Oe (If Federal RIC C. vi . DESCRIPTION OF DUTIES 10. REASONS FOR LEAVING If PRIOR SERVICE WITH THE FEDERAL GOVERNMENT 1S NOTED ABOVE, INDI NUMBER OF YEARS CREDITABLE TOWARD U.S. CIVIL SERVICE RETIREMENT, . HAVE YOU EVER BEEN VISCHARGED OR ASKED TO RESIGN FROM ANY POSITION. HAVE YOU LEFT A POSITION UNDER CIRCUMSTANCES WHICH YOU DESIRE TO EXPLAIN? {_]Yes BYNo IF YOUR ANSWER TO EITHER: OR BOTH QUESTIONS IS "YES", GIVE DETAILS , ‘ . ec A A RR RR A HW 53294 Docld:323992765 Page @
SECTION X bo ees | rs v 1..ARE YOU REGISTERED FOR THE DRAFT UNDER 3. SELECTIVE SERVICE NO;: THE UNIVERSAL MILITARY TRAINING AND SERVICE ACT OF 1948 (As amended) SELECTIVE SERVICE CLASSIFF CATION 2 NO 4. iF DEFERRED, GIVE REASON USAR Ret Reserves FOREIGN ORGAN. OR MIL. SERVICE (Specify):s CHECK (X) AS APPROPRIATE HAVE SERVED™| "NOW SERVING -| x | 2. BRANCH OR CORPS OF ABOVE CHECKED ORGANIZATION(S) 3. DATE SEPARATED FROM EXTENDED ACTIVE DUTY (Past servicd| 4. TOTAL LENGTH OF EXTENDED ACTIVE DUTY IN U.S. ARME 5. DATE ENTERED ACTIVE DUTY =» 7. RANK, GRADE OR | PAST SERVICE RATE > - . ha 9. PRIMARY MILITARY OCCUPATIONAL SPECIALTY (Mos or Designator) AND TI 8. SERVICE, SERIAL OR FILE NUMBER (If now serving, provide cur rent number) > 10. SECONDARY MIL. OCCUPATIONAL SPECIALTY (Mos or Designator) AND TITLE Ch ief of Military Liaison Group, ARMISH/MAAG, APO 205 NY,NY 12. CHECK (X) TYPE OF SEPARATION FROM ACTIVE DUTY || HONORABLE DISCHARGE’. L | RETIREMENT FOR SERVICE RELEASE TO INACTIVE DUTY | | RETIREMENT FOR COMBAT DISABILITY | | RETIREMENT FOR AGE | | RETIREMENT FOR PHYSICAL DISABILITY | | UNDUE HAROSHIPS OTHER: . NA 1. DO YOU NOW HAVE RESERVE STATUS? 2. ARE YOU NOW A MEMBER OF THE NAT'L. GRD. OR AIR NAT’L. GRD.? . NATIONAL GUAR | COAST GUARD] | NAVY ROTC 6. DATE .OF APPOINTMENT IN CURRENT |7. EXPIRATION DATE OF CURRENT RESERVE OBLIGA- RANK 8 July '58 ; TION 1 Oct 1961 8. CHECK (X) CURRENT RESERVE CATEGORY | [READY RESERVE STAN DBY (Active) STANDBY(Inactive)| X| RETIRED 9. PRIMARY MILITARY OCCUPATIONAL SPECIALTY (Mos or Desig- | 10. SECONDARY MILITARY OCCUPATIONAL SPECIALTY (Mos or Des- nator) AND TITLE : ignator) AND TITLE NA NA 11. BRIEF DESCRIPTION OF MILITARY RESERVE DUTIES NA 3. ARE YOU NOW A MEMBER OF THE ROTC? INDICATE ROTC CATEGORY NUM- BER MARINE CORP 13. IF YOU HAVE ANSWERED “YES” TO ITEM 12, GIVE UNIT OR- AGENCY 12. ARE YOU CURRENTLY ASSIGNED OR ATTACHED Y YES AND ADDRESS TO A RESERVE, NAT'L. GUARD OR ROTC TRAIN- ING UNIT | [| NO_| > HAVE YOU A MILITARY MOBILIZATION ASSIGN- | * | YES MENT? rR [No | INDICATE TOTAL MILITARY SERVICE FOR LONGEVITY PURPOSES INCLUD- ING ACTIVE AND INACTIVE DUTY + WW 53294 Docld: 323992765 Page 9 . .. ett ema,
eo” [SECTION x! “FINANCIAL STATUS. » At neers cede og tent 1.,ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY? Ves . [Ino 2. 1F YOUR ANSWER 1S “NO” TO THE ABOVE, STATE SOURCES OF OTHER 1 haga " Not Applicable 4 thor 3. BANKING INSTITUTIONS witty WHIgH YOU HAVE ACCOUNTS . NAME OF INSTITUTION - { , . ADDRESS (City, State, Country) The Riggs Nat'l Bank, Linchln Br. j|-+| 1°th & H Street, N.W. Washington, D.C. ae tg r ; et % 4. HAVE YOU EVER BEEN IN, OR PETITIONED FOR, BANKRUPT Gy™ a [EES YES F]No , A 5. IF YOUR ANSWER IS "“YES’’ TO THE ABOVE, GIVE. PARTICUIJARS,- INCLUDING COURT AND DATE(S) . sone “ on . . . 2 TRS ates ae it oe 7 6. GIVE THREE CREDIT “REFERENCES IN THE UNITED STATES é ee 3 - ADDRESS (No., Street, City; State) mo i NAME The First City Bank & Trust“. The Guaranpy State Bank.” 7. DO YOU RECEIVE AN ANNUITY FROM THE U/ITED STATES OR DISTRICT OF COLUMBIA GOVERNMENT UNDER ANY RETIREMENT . ‘ ACT, PENSION, OR COMPENSATION FOR MILITARY OR NAVAL SERVICE? ! (_j ves X Jno 8. IF YOUR ANSWER IS ‘‘YES’’ TO THE ABOVE QUESTION, GIVE COMPLETE DETAILS . 9. DO YOU HAVE ANY FINANCIAL INTEREST IN, OR OFFICIAL CONNECTIONS WITH NON-U.S. CORPORATIONS OR BUSINESSES; OR IN t OR WITH U.S. CORPORATIONS OR BUSINESSES HAVING SUBSTANTIAL FOREIGN INTERESTS? : Cc YES tes ra NO (Hf answer “YES", furnish details on separate sheet.) : xy SECTION XIIl-- |” . “MARITAL STATUS“ .° 1. PRESENT STATUS (Single, Married, Widowed, Separated, Divorced, or Annulled) SPECIFY: MARRIED 2.STATE DATE, PLACE, AND REASON FOR ALL SEPARATIONS, DIVORCES OR ANNULMENTS : . Divorced from Monique Pierre Veber, 23 December 19):7;Paris, France. ‘Divorce by mutual agreement. Divorced from Carmen Gil 26 Mar? Wyandotte County, Kansas WIFE, HUSBAND If you have been married more than once - including annulments - use a separate sheet for former wife or OR FIANCE: husband giving data required below for all previous marriages. If marriage contemplated, fill in appropriate ‘ information for fiance. ~ (First) (Middle) . (Maiden) (Last), ee nee CONETA STATE ANY OTHER NAMES EVER USED INDICATE CIRCUMSTANCES (Including length of time) UNDER WHICH ANY OF THESE NAMES WERE’ USED. IF LEGAL CHANGE GIVE PARTICULARS NA (Where and by what authority). USE EXTRA SPACE PROVIDED ON PAGE 16 i : OF THIS FORM TO RECORD THIS INFORMATION. . 5. DATE OF MARRIAGE | &- PLACE OF MARRIAGE (City, State, Country) ; ' 7. HIS (OR HER) ADDRE BEFORE MARRIAGE i rue Docteur Charcot, Champigny B. LIVING 9, DATE OF DEATH ; . NA a 11. CURRENT ADORESS (Give last address, if deceased) . . 50 11 Hanes Street, McLean, Virginia 12. DATE OF BIRTH , . 13. PLACE OF BIRTH (City, State, Country) h Sept 1929 Vinh, Vietnam SECTION XII CONTINUED TO PAGE 10 , s -9- ee ee ree en te en eee eet eee “pete een en erneent Ae atte Bete AT 2A TT COG ae neta ene ne pe en eee lh eet armen ee sete are someting toe MO some WW 53294 Docld: 323992765 Page 10
~10- SECTION XII CONTINUED FROM PAGE 9 ee. 2 ita. IF BORN OUTSIDE U.S. - DATE OF ENTRY ‘ 23 December 1956 16. FORMER CITIZENSHIP(S) Countryfies)7 French 19. OCCUPATION h ousewife 15. PLACE OF ENTRY New York City, New York 17. DATE U.S. CITIZENSHIP | 18. WHERE ACQUIRED (City, State, Country) “Th 'Saly 1959 | UeS. Dist. Combb for Dist of Col. 20. PRESENT EMPLOYER (Also give former employer, or if spouse deceased or unemployed give last two employers) none 21. EMPLOYER’S OR BUSINESS ADDRESS (No., Street, City, State, Country) e 2. NUMBER OF CHILDREN (Including ste children and adopted children) WHO AR UNMARRIED, UNDER 21 YRS. OF AGE AND NOT SEL F-SUPPORTING. e FORMER CITIZENSHIP(S) /Country(ies)7 HW 53294 Bocld:323992765 Page 11 16, e i Tet Steen 3. NUMBER ‘OF, “OTHER® DEPENDENTS (Including spouse, parenta,- -etep-parents,. sister, etc.) WHO DEPEND ON YOU FOR'‘AT LEAST 50% OF THEIR SUPPORT, OR CHILDREN-OVER 28 YRS. OF AGE WHO ARE NOT SEL FISUPRORTING: ists x : ee eas (Including length of time) UNDER WHICH HE HAS veo BNAMES. IF LEGAL CHANGE, GIVE PARTICULARS (Where USE EXTRA SPACE PROVIDED ON PAGE 16 OF THIS tan RO THIS INFORMATION. ACQUIRED GREE ERY - AS : ‘ PRESENT EM bene ee et ne wae Nee aneetieenetnnete ae Ee een
: is € STATE OTHER NAMES SHE HAS USED EVER. USED THESE NAMES: IF LEGAL CHANGE, GIVE PARTICULARS (Where Estelle Leontine Elin (maiden) and by what authority). USE EXTRA SPACE PROVIDED ON PAGE 16 OF THIS | FORM TO RECORD THIS INFORMATION. DATE OF BIRTH wend 3 9. CITIZENSHIP 6June~1893 7 i . U.S. iF BORN OUTSIDE U.S.- DATE OF ENTRY 11. PLACE OF ENTRY ; New York City, New FORMER CITIZENSHIP(S) Country(ies)7 .-- 13. DATE U. S..CITIZENSHIP | 14, WHERE ACQUIRED (City, State; Country) French 10 Novenb vember 1959 Dist. Court, _San Francisco, Cale OCCUPATION * : . none | BRANCH OF SERVICE oars 20.°- COUNTRY DETAILS OF OTHER GOVERNMENT SERVICE, U.S. OR FOREIGN NA e SECTION XVI 7 BROTHERS AND SISTERS (Including Half-, Step- and Adopted Brothers and Sisters) 1. FULL NAME (Last-First-Middle) [2. RELATIONSHIP 3. CITIZENSHIP (Country) Conein, Maurice Rene . Brother French 4. CURRENT ADDRESS (Now, Street, City, Zone, State, Country) - 3. LIVING uninowmn Champigny sur Marne, Seine, France mo Tre Tet 1. FULL NAME (Last-First-Middle) RELATIONSHIP 3. CITIZENSHIP (Country) ene ES Se T ADDRESS (No., Street, City, Zone, State, Country) . FULL.NAME (Laet-First-Middle) - RELATIONSHIP 3. CITIZENSHIP (Country) qeerpannananee ? WEN ape mmene 4. CURRENT ADDRESS (No., Street, City, Zone, State, Country) FULL NAME (Last-First-Middle) RELATIONSHIP 3. CITIZENSHIP (Country) | 4. CURRENT ADDRESS (No., Street, City, Zone, mae an : 5. LIVING ~, {Tres [ [xo . FULL NAME (Last-F irst-Middle) RELATIONSHIP 3. CITIZENSHIP (Country) | 4 ‘7 | ro. i | ' } t { 3 a 4. CURRENT ADDRESS (No., Street, City, Zone, State, Country) . 3. LIVING [ves | Jno | . FULL NAME (Last-First-Middie) we arwee 3. CITIZENSHIP (Country) 4. CURRENT ADDRESS (No., Street, City, Zone, State, Country) 5. LIVING © cae re oe [Tres [Tre | . FULL NAME (Last-First-Middle) RELATIONSHIP , SX CITIZENSHIP (Country) 4. CURRENT ADDRESS (No., Street, City, Zone, State, Country) — > FULL NAME (Last-First-Middle) » RELATIONSHIP 4. CURRENT ADDRESS (No., Street, City, Zone, State, Country) -ll- HW 53294) Bocld:323992765 Page 12
SECTION XV.IT : FATHER: IN-LAW : . - 1, FULL NAME (Last-First-Middle) LIVING 3. DATE OF DEATH 4. CAUSE OF DEATH ( ere pe STATE OTHER NAMES HE HAS USED . INDICATE CIRCUMSTANCES (Including length of time) UNDER WHICH HE HAS . EVER USED THESE NAMES. 1F LEGAL CHANGE, GIVE PARTICULARS (Where ~ unknown : and by what authority). USE EXTRA SPACE PROVIDED ON PAGE 16 OF THIS ' FORM TO RECORD THIS INFORMATION. CURRENT OR LAST ADDRESS (No., Street, City, State, Country) Noumea, New Caledonia DATE OF BIRTH 8, PLACE OF BIRTH (City, State, Country) a CITIZENSHIP Noumea, New Caledonia | | | | } IF BORN OUTSIDE U.S.- DATE OF ENTRY 1f. PLACE OF ENTRY NA FORMER CITIZENSHIP(S) {Country(ies)/ 13, DATE U.S. CITIZENSHIP : : ACQUIRED ek cancer INDICATE CIRCUMSTANCES (Including Tengih of time) UNDER WHICH SHE HAS | EVER USED THESE NAMES. IF LEGAL CHANGE, GIVE PARTICULARS (Where and by what authority). USE EXTRA SPACE PROVIDED ON PAGE 16 OF THIS FORM TO RECORD THIS INFORMATION. 9. CITIZENSHIP ' FORMER CITIZENSHIP(S) /Country(ies)7 ° | 13. DATE U.S. CITIZENSHIP 14. WHERE ACQUIRED (City, State, Country) . ACQUIRED OCCUPATION : " ~ | 16, PRESENT EMPLOYER (Give last employer, if Mothenin-Law is deceased or unemployed) SECTION XIX. RELATIVES BY BLOOD, MARRIAGE OR ADOPTION WHO EITHER (1) LIVE ABROAD, j (2) ARE NOT U.S. CITIZENS OR (3) WORK FOR A FOREIGN GOVERNMENT ; 1. FULL NAME (Last-First-Middle) 2. RELATIONSHIP CONEIN, Maurice Rene . brother . 4. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES . 5. EMPLOYED BY Champigny sur Marne, Seine France , unknown 6. CITIZENSHIP (Country) 7, FREQUENCY OF CONTACT 8. DATE OF LAST CONTACT 16 Sept 61 BROCHOT Joh n James Jones f ther in law ae | 4, ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES | 5. EMPLOYED ay Noumea, New Caledonia set enployed AW 53294 DoclId:323992765 Page 13