404-10175-10179 t . o- ; - ~ + . 7 CLACEF CATON SECRET PROCESSING ‘ acon fafa ACTOR FusreD BG THEA RG AEQUIAED - 1 fe Pi AIEED | tates aaTeas tase. 1 C8% JOE IROL KING REFERENCE: A. HMMW “11321, 13 Feb 1963 B. HMMA~20931, 22 Mar 1963 1, Transmitted under separate cover truename attachments are the following forms to complete Headquarters’ records on subject: a. Personal History Statement b. Personal history S.te..cut (igpontiz c. Report of Medical History bent ed 2. Subject was originally recruited as a cutout for the LIHUFE/2 organization, However, his actual duties for KUBARK entail far more than ' contact and communication with LIHUFF/2. He is an outside agent. ‘in ‘addition to acting as the contact between the Mexico Station and the LIHUFF/2 ‘Institute, LIMNUFF/1 is responsible for organizing and directing the KUWOLF student groups in the LINUFF/2 project; printing and distributing of p-opaganda; planning and initiating student harrassn.ent activities, Since LinUrE, ifs duties are those of an outside agent, sis salary was established to reir-burse him for the amount of tince it is necessary for him to spend on LIHUFF activities. In this re teat the sum of excessive amount. Headquarters is sequested te process a contract far wide rae. “ subject in this amount. oc 3. Subject's social security number ig | ‘ Shee L ack Ad Enclosures: as stated above (UNDER SEPARATF. COVER) . s A 2 Tare CHOPAIOSD Distribution: : : ! o WH, w/encle eer od Wa 29 Apr, 63 30 Apr 63 » zal £04993 a2 rr . MRRP AOE tm te rertnuseenNEI ange ne ye
14-00000 Ae emi a POTEET BN pete one . 7 SECRET Bf. ELL LBA dh £ ABE Bah §F SOCIAL SECURITY &O. 1S NOT AVAILABLE. SAVE FORM 40, S55. “APPLIC2TION FOR SOCHAL SECURITY ACCO.RTS,* COMPLETED aS ? PROVIDED 46 DETAILED PROCEDURES. ' [e)-4 : 20. ADCRESS OF RECIRG (Fe Y.$.3 22. aDDRiSs (Foralgn none : Kexioo city, bextoo BESFRTE'TINN: SIGNED ORIG. AND COPY ~ TO FINAVCE: COPY « TO CFNTPAL COVER: COPY - TO SILE sare . SECRET : ssa a Oe aol B3iga cvsorera reavecus anevesns. He ce wee! a ¢
14-00000 i 4 j . OO NOT WEE THIS SPACE THIS CATE (#118 in} # PERSONAL HISTORY STATEMENT INSTRUCTIONS 1. Answer all questions completely or check appropriate box. If question is aot applicable, write “NA”. Write “Un- known® only if you do not know the answer and it cannot be obtained from personal records. Use blank space at end of form for extea details on any question for which you have insufficient space. 2. Type, print or write carefully; legible or sacomplete forms will not receive consideration. 3. Consider your answers carefully. Your signature at the ead of this form will certify to theirs correctness. Careful completica af all applicable questions #11] permit review of your qualifi : ations to the best advantage. SECTION 8 _ GENERAL PERSONAL AND PHYSICAL DATA 1. FULL NAME “Loal-Fieet-Ahiddla; 7: uT §. wEIGRT 6'3" 185 10 SCARS {Type and Location) None 18. OTHER CASTINGUSHING PHYSICAL FEATURES 5 {?. COLGR OF HAIR 1@. TYPE COMPLEXION Brown iBrow: Light | Med, ROD of Constey) 13. PERMANENT AD ORESS C¥o., Street, Csty, Zone, Seate ang i Country) AND PHONE NO. : (a) ! 3 . Same os (12)- . y a TYR Mexico Phone 20-77- Os : 14, CURRENT PRONE NO. 1S. OFFIGE PHOWE NO. B EXT. 16. LEGAL RESICENCE (Stale, Temilecy oe Country) 20-77-47 OX 5-96-53 4 Ok i Mexico 17. NICKNAMES (18. OTHER NAWES YOU HAVE USED er onenker ee wh est ste — re a NCES ‘inchsling Length of Tara) UNDER BHICH YOU HAVE EVER USED THESE wawes. " | ~ through college : E Used to date CRANGE. GIVE PARTICULAR O : . ‘ . SECTION Hl POSITION DATA 3 & 1. INDICATE THE TYPE OF BORK OR POSITION FOP @riCH YOU ARE APPLYING ® 2. INDICATE THE LOWEST ANNUAL EMTRANCE SALARY YOU WILE * al OATE AVAILASLE FOR EMPLOVMENT ACCEPT (P-uz will not be conerdersd for any powsteon with a lower entrance salary}, Me ae fh te ae ceetenes ee adhe Mt atten & INDICATE YOUR WILLINGNESS TO TRAVEL foccasiouaucy iemequentey H ‘SONSTAMTL Y T” Jornen: t & INDICATE YOUR WILLINGNESS TO ACCEPT ASSIGHMMENT IN THE FOLLOWING LOCATIONS (Check x) ooch item applicabten * ere a ncn WASEINGTON &.¢. PANT OMERE 1M U8. TERTAIN LOCATIONS ONL v (Specdpi: OUIMNDE CONTINENTAL Uv & i 6. IMGICATE @HAT RESERVATIONS YOU GOULD PLACE ON ASSIGNMENTS OUTSIDE THE BASHINGTON. 0.C. AREA. wll BBA on | FORM a A 14 ase 444 use emevious enirion. ate : Leta yr c0 Ahead Oo: cTERI ORBITS EPEC ete cat beh LORRI, Flea ab Ae eMedehth es PNY +49 Min hin Hide seat bets Nimininlenediceet th hive Ab he Aes lachts EGR by ant at AN Es tical Rett Bhd Tals ~ ot nendadtarmbeet tw at 4S Se een ©
-2. - .@ {SECTION It CITIZENSHIP : @ i, BATE OF Bates 2 PLALE OF Bim Yee ec a late, Counters ; 8s PRESET CATIZENSMIP (Coumary) oe Meco, U.S.A. = ——— : 8, CsTiZEMSese ACQUIRED BY 5 erty WAT UR ALS i &. NATURALIZATION CERTIFICATE tac3. 7. COURT t$ivinG MATUAALIZATION CERTIFICATE 18, SSUED aT (Coty, State, Countess . _ NLA : 9. HAVE YOU HELO PREVIOUS NATIONALITY 10. (F VES. GIVE MAME OF COUNTRY i Loves [xine NLA. 8%, GIVE PARTICULARS COMCERNIMG PREVIOUS WATIONALET ¥ NLA, &: 12. HAVE YOU TAKEN STEPS TO CHANGE {__lvee | 3. Give PaRTicuLans ‘ Lo PRESENT CITIZENSHIP x iol NA 14. 1F YOU HAVE APPLIED FO® U.S. CITIZENSHIO, WHAT 15 PRESENT STATUS OF YOUR APPLICATION (Firat Papers, EtcJ® . : . _ NA. : 1%. DATE OF ARRIVAL IN US. 36. PORT OF ENTRY 17. ON PASSPORT OF WHAT COUNTRY 1916 El Paso, Texas Unknown $6. LAST U.S. VISA (No, Typa, Place of Ieaus) | 19. DATE ViSa ISSUEO A vee. : @ | SECTION Iv . : EDUCATION @ : : 1. CHECE (KX) HIGHEST LEVEL OF EDUCATION ATTAINED - | LESS Tate HIGH SCHOOL SIASUATE i H OVER Tas VELRS OF COLLESE-. wo SEGPEE Tae VEERG CMLLEGE OS Lees t | saagreess NEgarEe i AME THRs NEsvee * 2. ELEMENTARY SCHOOL . = Coton mie ce Sn ha 4 i : oe | ee an = | . iru TERED TE EE Se a“ a GHAD UATE . . 3. HIGH SCHOOL 1. MAME OF HiGm SCHOOL 2. ADORESS (cerry, State, Country) & [o r * Quate : 1930-1934 - Kives t NO 1. NAME OF HIGH SCHOGK 2. ADORESS .Crty, State, Coumtry$ : a. DATES ATTENDED (Feoa-andTas 4 GRASVATE ves { [xo 4. COLLEGE O@ UMIVERSITY STUDY $UBIECT CATES ATTENDED | p seu ore NAME AKD LOCATION OF COLLEGE OR UNIVERSITY — Cee Ree nOURS MASON | NOR emce BT) {Spocetw) ok ange Antal” ey 7 cology Hugb. 34 | 39 cheloy 1939 | Sem- ! SECTION IV CONTINUED TO P&GE ¥ Re ge ce Lea TT nd .* ~ ea ores ee . ! ; . i { ° . . a, * ™, ne rece ee cnynts ae sacri Veto tain al out dm ’
14-00000 © cme act acme ne te « ° . ) | eee; . SECTION [V CCHTINUED FROW PAGE 2? SF A GRADUATE SEGPLE HAS BEER NOTED tn MG ww, OF TRE THESIS END BALEPLY DES er ree HAT EM 4 mosices REQUIRED SUBMISSION OF A WRITTEN THESIS, @ENCATE THE TITLE NVA ‘ @ e Pa & TRADE, COMMERCIAL AND SPECIALIZED SCHOOLS STUDY GR SPECIALIZATION 7, MILITARY TRAIMING (FULL Time OUTY lel SPECIALIZED SCHOOLS SUCH AS ORDNANCE, PMT ELL IGENCE, aman abae ETC) MAME AND ADDRESS OF SCHOOL i STvoY Cr SPECIALIZATION ? Faow MOHTHS Cav. School - Bas ~ Basic | Troop Dury rare Et “s ey. Kansas_—__—-Horse. Mechanized . Ve ey. ~ vance Command Gener Kah G-2- CRCS 1943 | 3 & OTHER EOUCATIONAL TRAINING ROT INDICATED ABGVE. War Dept. Mis-X - Intelligence Fort Hunt, Washington, D.C, 1943 - 6 monzhs stn ak stamens SECTION ¥ FOREIGN LANGUAGE ABILITIES . @ COMPETENCE - IM ORDER LISTED : : a. LANGUAGE R-Reed, W-Wene, $-Speck HOw ACQUIRED ? , * (List delow each langue se im - . . which pou possess any degree equiv. FLUENT t of competence. Indicate rou ALENT losvious t eee apesuare uoee SAazIVE PRO CONTACT: Ca DE Mid proftetoncs to Read, Werete or NATIVE FOneian aeSseaRceH TRAVER LEDGE LongeD : suupy Speck by placeng @ check (X) FLUENCY j _ COUNTRY | woeNce i vere fevele) . 4 in the appecpreate Saxte ss. R : r H : Rowes Spanish - 2. 1F YOU WAVE CHECKED “ACADEME STUDY"? UNDER "ROW ACQUIRED, INTHCATE LENGTH AMD INTENSIY EWESS OF suo. 4 years high school S$. 1F YOU MAE centres DB FLYUENTT FOR A LANGUAGE MAVIND GIGMIFIC ART OFF FERENCES ts SPOKEN AND BRITTEN Pore, €k- PRAIM TOUR COVPETENCE THERE Goa, NLA. a . TFC, CMGINE CANS, TELE COMMUNICATIONS, MILITARY, AND OTHER FPECBLIZED CIEL SS. Business terminology - write. ~ speak - read & translate, Soclo-Economics - write ~ speak - read & translate, 3. 1” YOU HAVE NOTED & PROFICIENC T 1G LaNGuage, @OVLO ve vou BE wiems TS vse ¥ ees astuity 1M ANY POG TeOee FOR weae oe Fou WEG? BE SELECTED? A j ; “ke ves f ' Fi 4 4 oe 4. vEscmiBE “youa ABLLITY TO DO SPECIALIZED LANGUAGE BORK INVOLVING VOCABULARIES ang TERMINOLOGY oe " SC0E t i i 30 wo * . 1 . re. Sree Prat Se Te Tae oa, a aaa + anne ntti tm tee > Meera GR i +
14-00000 ~@. @ | SECTION VI GEOGRAPHIC AREA KNOWLEOGE AND FOREIGN TRAVEL . e - OF LOW ANY FOREIG® FEGIONS OR COUMTH.ES Im HICH YOU HAVE TRAVELLED OR GAIMED (hGWLEOGE AS A RESULT OF , ResigeMee, STUBY OR ITN ASSIGMMENT, (VOISCATE TYPE oF TMOWLEOGE SUCH AS TERRAIN, MARASSS, VTILITIES, RAIL ROADS, INDUSTRIES, POLSTICAL PARTIES, ETC. ; . ~ i KNCO@LE & R ¥ ] cares oF DGE ACOVIRED 6B { MAME OF TYPE OF : {GATES AND : # RESIDENCE : . | work REGION OR COUNTAY { SPECIALIZED KNOWLEDGE ; Oe TRAVEL | PLACE OF STUDY RES TRave. stuor! Assigns ’ i | i x adusirial = Bus, 7 1949= Mexicn - Socio: Economia Present CNA Xx |x ‘x |x Poti iPresent oN. i { ! : ! =i _ (2 Business _ | PPanania srrain- RR. 11945-1949 | NLA, i X x i 1 ; i i H China Ferrain. ditions 1943-1945: N.A. | | —X x | entral Amer.'tocnt Conditions 1946-Present NA, {| | x : & GMOICATE THE PURPOSE OF wisit, RESIDENCE OR TRAVEL 1 EACH OF THE REGIOnwS OR COUNTRIES LISTED ASOVE. ‘ Mexico - Business - Work Assigament ” “ ¢° | [panama - Business - Work Assigameat i 2 ; China - Army, 3, UNITED STATES PASSPCART MUMBER AND EXMAATION DATE 8F ISSUES. OS [| | Expired August 20, 1962 ‘@ GN Y TYPING AND STENOGRAPHIC SKILLS @ : 1. TYPING (wpm) . 2. SHORTHASO (wpey | 3. SHORTHAND SYSTEM USED - CPECK IX) APPROPRIATE IT Esa , ; nx Unknown i No jcaeca | IsPeeowminims | ISTENOTYPE | ! OTHER (Ssecrfys: : 4. INDICATE OTMER GUSINESS WACHINES BITH BWHICK TOU MAVE MAD OPERATING EXPERIENCE OR TRAINING (Compiometer, Miaeogmph, Card Punch, Ere.4. . eet nave : . None.-; ar, ae i eee ca , :8 SECTION Vili : SPECIAL QUALIFICATIONS ad ‘ { i. LIST ALL ACBSIES AMD SPSATS Iv WHICH YOU ARE ACY WF A@ seYE ACTIYEL Y OA STICI@ATEP, IMME LTS YOUR PROFISIONSY ~ ; EaCH. : . . | | jor Athletics - Good ; a ee 3 ope Ban + i. | Riding Horsebacx - Good . . : ; Horse shoes - Good ; - : i < “, ¢ . wes - = ‘ ; Gardening - Fair ‘ # roe wt ~ . ~ : ' Brldge ~ Fair ; 4 2. INDICATE ANY SPECIAL OUBLIFICATIONS RESULTING FROM EXPERIENCE OR TRAINING BHICH MIGHT FIT YOU FOR a . 3 PARTICULAR POSITION OR TUPE OF BORK. i . . 7 i i . ; > e * a) i * 8. CXELUDING BUSINESS EQLAPUENT OR MAL CINES BrICM YOU MAY MAVE LISTED IN ITEM 2, SECTION Yi?, LIST ANY SPECIAL . 4 SRLS YOU POSSESS RELATING TO OTHER EQuICMENT AND WACHINES SUCH AS OPERATION OF SHORTWAVE RAM fadi= . . cate CP speed, sendmg and rocerverg),OF FSET PRESS, TURRET LATME SCIENTIFIC AND PROPESSIONAL DEVICES. . u : t 3 ae 3 i at ' “3 5 . ‘ : ‘ B ee ar peo anae apaee Paone apa, Sa as en Oa F4 SECTION VIHECTIACED TO PAGE & : ; . 6 ee TE TO PACE aw : - PP id nett eet eS eee Scene . * meneenarene moet Sharm tn enews RET RO mee ee
86 NIRS ARRIGO ES ORAS UY ny oA ege sti Maha act BORE ee me oe oan ne eee emer + is a - - - “eee SSE E . SECTION VUE CONTINUED FROY PAGE 4 4. ARE (Ou NOW OR HAVE FOU EYER BEEX 4 LICENSED OF CERTIPFIEG MEMSES OF AMY TRADE OR PROFESSION, Ssuce as PILOT, ELECTRICIAN, RADIO CPERATOR, TEACMER, LAWYER, CPA, MEDICA. TEC ae cian, ETC.F ~— . : (ores kno S$. 1F YOU HAVE ANSWERED "YES" TO ABSVE. INDICATE KINO OF LICENSE AND STATE (6SUING LICENSE (Provide Locense Regisisy Humber, if known. . - | NA. 6. FIRST LICENSE OR CERTIFICATE (Year cf Lesere) 7 LATEST LICENSE OR CERTIFICATE (Year af leave) NLA, N.A. 6. LIST ANY SIGNIFICANT ®UBLISHED 4 TE S145 OF WHICH YOU ARE THE AUTMC® (Do NOT eubmir capies avers requested), INDICATE yHe TITLE. PUBLICATION DATE, AWG TYPE OF WRITING (NorrF iction or Scoentetse articles, Géinezal Interest aubjects, Novels, Share ferios, Ere.). NA. @. INDICATE ANY DEVICES Which VOU HAVE INVENTED AND STATE WHETHER OM NOT TREY ARE PATENTEO. ~ NA. - $0, LIST PUBLIC TPTAKING BUM Bipmt te Gee eTiMAE CY OTST re Throughout College and business career, $4. LIST ANY PROFESSIGNAL. ACADEME OF “ONORAARY ASSOCIATIONS OR SOCIETIES IN WHITH YOU ARE NOW OR WERE FORMERLY & MEMBER. LIST ACADEMIC HONORS YOU AAVE RECEIVED. . . Alpha Zeta - Honorary Bob Cats Scabbard & Blade SECTION §X EMPLOYMENT HISTORY NOTE: (LIST LAST POSITION FIRST.) indicate chronological history of employment for past 1§ years. Account for all perioda including casual employment and aif perrods of unemployment. Give address and state what you did during periods of ememployment. List all csvilian exstoyment by a foce:gn Govemment, regardiess of dates. Incampleting stem 9, “De scription of Duties consider your expenence carefully and provide mearmgtful, objective statements, O¢ soe, GRADE! Paderal Service) UO. -ss°-annum . i Coordinate committee work, ‘ . ¢ 20. REABIND FOR LEAVING q N.A. i i : & o @ Sid tems. we yes er tet ae wee ae 2a!
14-00000 + i Namur eee sapalle wn een sead Sidmeamamevents settee Gnacrtanetea Bae RUlaredh 5 RGR naa ING CRETE TN Eo Lae BOMBA Be ee oor ne te meat ate Bh ye thc Neth ee ap AES, cual Beds w~RIDTION IS DONTINGCED FROW PAGE § 12 BMCAUSIVE DATES (Fromand Ts Gr ho and ¥ry Z Ea Batak t Sept 1949 - Dec, 31, 1962 Pp 13 ADDRESS (he, Strwet, Caty, State, Covrsty? 4 rria Te KIND OF BUS SESS "§. WAME OF SUPERVISOR Lo. $ 18. CLASS. GRADE Podecal Services -eesneennfentntyosnnnttnnananesrecnmaacd “#12, 000 -re* year SH SESERIF TION CF SUES — ‘Direction of manufacturing concentrates, Marketing, Advertising. ‘Development of sales, Franchising. Mexico and C. America, Supervision of all franchised b& 13 REASONS FOR LEA ENG Transfer to States ~ Preffered M2xico, ' i ' 1. IMCLUSIVE DATES (Fram end To - By sta amd Yr) 2. MAME OF EMPLOYING FIRM OR AGE 06M ‘Dec, 1946 - Sepr. 1949 | | i INO GE Ss ihee Ss a. MAME wt SUPEAY . OK ‘ ng & Sales Board Directo 6 TITLE OF see . = } 7. SALARY CR EARNINGS 8. CLASS. GRADE (CH! Federal Service) 3 $19,000, |ree year: 9. DESCRIP TiOm OF NUTIES i Direct ton of Company. 18. REASONS FOR LEAWING | {Unfavorable climatic condirions, j 2 MAME CE EMPLOYING FIRM OR AGEKCY &. NAWE OF SUPERVISOR ' 6. TITLE GF JOB 7.$4LA8Y OR EARNINGS |8- CLASS. GRADE UIT Federal Sarvica) J S$. SESCHIP TION OF DUTIES H 1G. REASONS FOR LEA WING 4 I i i ’ i 1. INCLUSIVE DATES (From and Te - Br Ma and Yr} 2. MAVE OF EMPLOVING FIRM OR AGENCY ? 3. ADDRESS (Xo., Street, City. Seate, Cocmerys , & RIND OF Business &. MAWE OF SUPER YISOR t @ TITLE OF JOB : ? ¢aLaee Om Gannings§ |6. CLass. Grand (si Fedaral Seevien) | $ 7ER i a entanrennnnente manmnninan SECTION IX CONTIACED TO PAGE 7 - - pew <=
eT ee ee i 2 ee i Oe SS . tee 9 CESCRIP TION OF DUTIES 16 REASON FOR LE AY ING 1. INCLUSIVE DATES (Foun and To- By Mo and Ye.) En RARE OF EMPLOYING FIRM CA AGescy 3. ADDRESS (No . Ssowet Coty, Stato, Coemury} 4. KiNG OF BUSINESS }3. RAME OF SUPER VISOR 7. GALAQY OW Eanes Ae CLASS. G&aDE (Uf Federal j Serwscas &@ TITLE OF 30D | 6 ! pee 9. CESERIPTION OF DUTIES $0. REASONS FOR LE AW ING Qt. MCLUSIVE OATES (Fee end Yo- Be Ma end Ye } Z RANE OF EWFLOVING FIR OF ECEMTY 3B ADORESS (No . Street. Cay, State, Camry} 4. KiNG OF BUSINESS _ S$. mae OF SUPE RY SOR . i 4 6. TITLE OF . OB %. SALARY GR EARNINGS ,8. CLASS. GRADE i Federal Seevice) F $ 1PER %. DESCRIPTION OF DUTIES wear {6 REASONS FOR LEA YING @. Ff PRIOR SERVICE BITH THE FEDERAL GOVERNMENT 1S NOTED ABOVE, INSICATE THE HUMBER OF YEARS CRECITABLE TOPAS U.S. ClViL SERVICE RETIREMENT, IF NOUN. 8. HAVE YOU EVER SEEN DISCHARGED CR ASKED TO RESIGN FRO ANY POSITION. Tv Pes HAVE TOU LEFT A POSITION UNDER CIRCUMSTANCES WHIEM 'OU DESINE TO ExPLAIN? [res (ejno iF YOUR ANSWER (O ETHER OR BOTH QUESTIONS I$ “YES, GIVE DETAILS ” wee
14-00000 temee tURBALS eare hese thannitreltiront thy eemattonts ecmarenatin endian tytientsttserrereeperttttrtntrtstteteessenstrseetenat ane ts tne AERA eh one ASTER SRO SAE Eno frites ARES So ht Aa aati mal ate Qeteer teense < 4 abet SECTION X MILITARY SERVICE i CURREKT bearT status = NLA, es wanna eg ee ow eee eee oe {ARE YOU SEGISTEFED FOR THE CPAFT UNDER VES) 2. SELESTIVE SERVICE Cisigeeh | 3. SELECTIVE SERVICE BO. TRE UMIVERSAL MILITARY FRAinNISG AND CATS : SERVICE ACT OF 1$88 (Ae amended Lite] 1 4. if COEF ERRED, Give REASON ne es et. S$ LOCAL GRAFT eoaan ws. AR SESIGNATION AND ADDRESS 2, MLITARY SERVICE RECORD 1 CURRENT AwD/GR PAST CPZANIZATIONAL MEWS ESZHIP Cee peepee nee te Se A | amine - air COALY WERCHANT. MAT ICWAL AIR NATL) FIPEIGH ORGAN. OF GL. wavy | cones ' gonce | Guasn wamine 1 Guaea i Guano | AVICE Specitys: | CHECK (XPAS j appropriare | ARMY 1 } i aa HAVE SERVED an, 1941 0 ' CURRENT SERVICE 8. SEAWICE. SERIAL Of FILE NUMBER Fit wcaee serving. Provicte <zgpe rent tua mn ns $. Pasar BEL : PAST SERVICE 7 TRENT SERVIC SPECIALTY (Moe or Deeignator) AND TITLE MIS . . NOW SERVING o! i : . 2. BRANCH OF CORPS OF ABOVE CHECKED ORGANIZATION(SI avalry = MIS 3. DATE SEPARATED FROM EXTENDED ACTIVE DUTY (Past serricg, 6. TOTAL LENGTH OF EXTENDED ACTIVE OUTY IN: U.S. ARMED t FORCES (Peat and carrent ee serene 6-46 i years , 5. SATE ENVERES | PAST SERVICE 1 CURRENT SERWICE .& FOTAL LENGT a OF ACTIVE BUY Y IM FOREIGN MILITARY Ga ACTIVE DUTY age) H . GANIZATION i 1a HA, GRAD pare 2 i #8. SECONDARY MIL. OCCUPATIONAL 1 PAST SERVICE , CURRENT SERVICE - j SPECIALTY (Moe or Deatgnetor) AWD 1 py pn. z . - Sod 7 owe eat - : 48, eRier DESCRIPTION OF MILITARY DUTIES (indicate etether applicable ta peet or current services Past. Troop duty - troop and squadron ~- horse and mechanized cavalry, 2. CHESK (X] TYPE OF SEPARATION FROM ACTIVE SUTY | HONGRABLE DISCHARGE ‘XK 'metinement ror service 4 USOUE HA s SHIPS . } @ELEASE TO INACTIVE DUTY ly ; RETIREMENT FOR COMBAT D'SA BILITY i STRER: . . t RETIREMENT FOR AGE t , RETIREMENT FOR PuYSical MsaBiLitTy q 13. CHECK (X) COMPONENT IN WHICH YOU SESVES RESERVE (CIncfinimg the National and Air Natronal Guard} xX SréGa finclucdeng 453} AU 3. MILITARY RESERVE, NATIONAL GUARD AND ROTC STATUS (| REGULAR 1. 50 YOU NOW HAV 12. ARE vou Ncw 4 mew ete ives 3. a3 YSU NOW & t ; RESERVE STATLST XO ix ives ! eee Oe eo on ate Rae, a ETE TSE NR A EMBER OF) | ves ino . GRO? x Nd : ‘ X | « 4 UF YOU HAVE ANSWERED °YES*® TO HES 1,2 GR 3 ABOVE, CHECK COmPCHENT MEMBERSHE BELOW | Sanat] ARINE CORPS "RATIONAL GUARG COAST GUAPEX TwMaVY aaTe VINDICATE ROTC CATEGORY mime ise aesene cient DO | RAvy ain force | ‘arm NAT*L.GUARD aRwy ROTE | {aim FOacE Rot OFF S CURREME-R RADE OR 6 DATE OF APPOINTMENT im CURRENT |7. EXPIRATICH DATE OF CURSENT RESERVE OBUIGH& 8. CHEC cere a we CATEGORY aeapy RESERVE STANDBY (Actes X [ST stanbermecral | RETIRED 3. PRIMARY MILITARY OCCUPATIONAL SPECIALTY (Moe ov Deeige (10. SECONDARY MILITAGY OCCUPATIONAL SPECIALTY (Mee ov Dee eater) AMD TITLE igratoe) AMD TITLE if , <nown : : 45, BRIEF DESCRIPTION OF MILITARY RESERVE DUTIES N.A. eee 12. ARE YOU CURRENTLY ASSIGNED OR ATTACHED $2. 1F YOU MAVE AMNSHERED "VES" TO ITEn 12, GIVE UNIT O8 AGENCY 0S une RATE. GUARD OF ROTC TRAIN: ? AND ASORESS : 8g : 18. If VOU MAVE ANSWERED ves"? TO ITEM 14, Give UNIT OR AGENCY went? AND ADORESS . ‘ {%. HEAL ARE YOUR SERVICE RECORDS KECTE FOR LONGEVITY PURPCSES INCL UI 16. INDICATE TOTAL MILITARY whet sel ° VvEARS fox8, * 1G ACTIVE AND INACTIVE OUTY Unknown Military Intelligence - War Dept. Assigned CBI (MIS-X) : ; { i & %
Drew ener eee ae Oe EY 2 eee anet Ra RABE A Res Heart sate 1 8: Maes oath AES Or rteks. TAM RA" LS eens om TA A S WIRE A La ARI, ew cates a sapien: sat Ha vat {o SECTION Xf ( FINANCIAL STATUS + &RE VOU ENTIRELY DEPENDENT Se YOLR SALARY? 2. OF YOUR ANS@ER If °° NO TO THE A2OVE. STATE SOUPCES OF OT HES twrSwEe Investments, ' 3 SAMKING INSTITUTIONS WITH RMICM YOU HAVE ACCOUNTS MAME BO INSTIT.. VIO Falls Church Bank Falls Church, Virginia Banco Nacional de Mexico . Mexico, DF 4, WAVE YOU EVER GEEW IM, OF PETITIONED FOR. BANKRUPTCY. ~ ves a) $. 1F YOUR ANSWER 1S “VES TO THE ABOVE, GIVE PARTICULARS, INCLUD 5G COURT AND DATE!S: aDDRess (Cery, Sate, Country) . H & GIVE THREE CRECIT REFERENCES J THE UNITED STATES AME H ; El Paso, Texas - BO YOU RECEIVE AW ANNUITY FRO THE UNITED STATES OR DISTRICT CE COLUMBIA GOVERNWENT UNDER ACT, PEMSION, OR COMPENSATION FOR MILITARY OR NAVAL SERVICE? wa YES NS {Tf anewes “YES, Gueiah details on sepasare sheet.) XT ves i! #0 SECTION Xil MARITAL STATES 3. PRESENT STATUS (Sivgle, Marned, Gricowed, Seperated, Divarced, of Aramiied SPECIFY: ; rriecd 2. STATE OATE, PLACE, AND REASSS FOR ALL SEPARATIONS, DIVORCES CH ANNULMENTS ADDRESS 'Ne.. Server, Cary, Semee) WIFE, HUSRAND If you have been married were than once - including amnulments - use a separate sheet for former wife of _ OR FIANCE: & DATE OF MARL, ~ aki < < a ms Dec. 23,1938 : $. HIS 1G HER) ADORESS BEF si U.S.A. 9. CAUSE OF DEATH rs we " cy | ves an [ wo | S If DMEREMY AOUOE SS Misre leat ettre ae. sf econ eeutl, busband giving data required below for all previous marriages. UW carriage contemplated, fill in - - information for fiance. Nie Oo... i VB. CITIZEwSouP [fexas, U.S.A. _ U.S.A ooo SECTION XU CONTIAUED TO PAGE 10 : eg a 2 ' : i Bs : appropriate i j 4 4 4 i EX1CO j hy SR eres ion
14-00000 _ SECTION Til CONTINUED FROW PAGE v 14. F BORN OUTSIDE U-S.- DATE f° EWTRY IS BLACE OF ENTS? NA. 86. FOOMER CITIZEN SHIPTS) 1%. BATE U.S u. so CHriZE sear i 18. @HEGE ACQUIRED (Catp. Stace, Comten LComerytiesy? r wR s , “RA i NA. 19. OCCUPATION , 23. PRESENT EVOLSYER (Alea gave fcener employer. oe Hf apanene deceased os 1 | amemplayed gore Leet twa employers : Housewtfe . IN : at. € EMPLOYER'S § OR B BUSINESS ADDRESS (No. Seeeet Cary. Seate, Counteyy NLA : ; 22. DATES OF MILITARY SERVICE (From and te - Sy Mo and Vr} eticca GF SERVICE 24, COURTRY WITH WHICH MILITARY SERVICE AFFILIATED . . N ‘ : : a5. DETAILS GF OTHER GOVERNMENT SERVICE, U.S. GH FOREIGN , —_ , BN.A, @ [SECTION XHE CHILDREN AND OTHER DEPENDENTS 8, PROVIDE THE FOLLOWING InFOOMATION FOR ALL CHILDREN AND DEPENDENTS Bane. } PEL ATIONSHP . eiverenaep | ADDRESS i ~ [Navy OCS |_Son U.S.A, Newport, R,I niv. of N. Mex. Daushter | uwicia aa. ae te we masts eb kar scl, ste UF eo U.S.A Mexico DF aati \ i « “ t ‘3 r £ 3. MUMBER Or VTHER DEPENDENTS (inchuding epow i 2. NUMBER OF Gis ML As oS de Bhd berg ae i Parente, stepparents, rater, ete.) BHO OEPENt On on i VHRAQRIED. UNDER 21 YQ. OF ASE, | 4 | cou been cwee at sag Ge EES ARE HO 5 AND NOT SEL F-SUPPORT ING. H Sei egee oa Tine. i Se we 7 @ PSECTION xi¥ FATHER (Give same information. tor Stepiather and or Gusriion on = sepatale sheet § — 2. Living | TS. DATE OF SEATH 16. CAUSE OF DEATH : Yass i “X[so0 | Feb, 19592 Pneumonia % wees, of deceasec (Xo. reat City, “Stace, Conmery) 2% = : - CATE OF BINTH j? PLACE OF B:RTH (City, State, Country) B. Cryrivessaie . 1864 i Germany U.S. : 9.18 GORN OUTSIDE US.- DATE OF ENTRY 10. PLACE OF EXTRY if 4 4 a 4 x | Unknown . Unknowa & : Th Foauea cn CITIZENSMIFIS) +2. DATE U.S, CITIZENSHIF WHERE ACQUIfED Se camer y) , Pa German 9-45-35 Arizona $4, OCCUPATION 1S. PRESENT EMPLOVEA mpd yet) Owner, Sheermeral Shop N.A. 16, EUPLOVER'S BUSINESS #OORESS OF FATHER'S BUSINESS ADORESS 1% SELF-EMPLOVED. [tO ICE (From-and-To) | 18. aRamcH OF SERVICE Pas orm f 19, COUMTAY N.A. A, NLA 20. CE VALS OF GTHER GOVERNMEMT SERWICE, U.S. OR FOREIGN . N.A, a ere ae wha adhd, STR ae BNC bet ae rare aah, x) %)
14-00000 » 8 em genttentee Hose te gore ean OEET I AEN MIE, Co ie nee Ne cet oe ae -_ . ata “Ak FOS Near ome" eeredamemnecenparEh A ome vate dae mmamrennnemanenemne ae ine bee mpaetiine Anta aati 6 AE onal te oBid BF MOM mene ede Or math AOCRETORRCOREEN ne PREECE ee eee ee ee mee eee keene enmtitme  ne ceteee aera me oe oo. - - SECTION KV MOTHER (Give same wicrratica lor Stepmetiar on separate sheets A: %] ” h. LbvING 2 SATE OF DEATH 4. CAUSE CO DEATH [vis [ho b..195] _, Paeumonia RESS, IF OECEASES fNo., Stevat, Cary, State, Country) 4 TRETE OF BIRTH — a (Coty. Stare, Country) \& CUTZ Caeser? 1874 Mexico, D.F. LU.S.4, $. of BORN OUTSIDE U.S.- DAT 140, PLACE OF ENTAY Unknown | Et Paso, Texa: 1S. @MERE ACQUIRED (Coty, State, Coumtry? ‘Bisbee, Arizona _ YER (Gave ieee exployer, if Mother 14 deceased oF aerrnergdoyed> if. FORMER CrriZemseiPist 12. OATE U.S. CITIZEN SeatP KComenierl vA svican 14. OCCUPATION 16. EMPLOYER'S QUSINESS ALORESS OR MOTHER'S BUSINESS ADORESS IF SELF EMPLOYED NLA. 17. DATES OF MILITARY SERVICE (F rom-and-Ta) 8. S@anctn OF SERVICE 12. COumTRY $ 2G. DETAILS OF OTMER GOVERNMENT SERVICE, U.S. OR FOREIGN NLA. SECTION X¥i SROTVHERS AND SISTERS (fraciuding Half-, Step aexd Adopted Brothers and Sisters) | 8 PUL mame (LagsF seet-M states ~ sue a, RELAT IOr SeasP an Caled Ew sete 4 Consuteyy , Mrs, Sister . S. Living 6. AGE Mw TYES * 5. rT: 2 RELATIONSHIP ‘3. CITIZENS e3tP (Comery) 2 airs _____! Sister. US , 4. CUR 4 o is Stata, Caumery? : S. Living _ 6. AGE NLA. : ves X two] 2 RELATIONSHIP 12. CHTIZES sett *Counceys Sister -U.S... 0 o Lane, State, Country) S. Living 6. AGE ix ives 7 Tse | 52 TY ACDRESS (No., Street, C: | . 1 (9 eS FLL PAN E + Lester wateMaddies 2. RELATIONSHIP 83. CiTiZemSiiP (Coumery; «Mr OG ist i & CUAPERT ADSRESS (No Sires, City, Zone, Stace, Coxmery) S. Laws €. AGE st ~ F yo (2 res : NO c=4 r 0 er REL ATIONSHIP 3. CIT ILE MSP (Counerys ms : ie : O& i if 7s oe Street, City, Zone, Stare, Coumtey? Fy S$. GIYIEG 6. AGE Los Angeles Area (Address Unknown tyes fae | 5 jf. FUks MAME (laa eK erateldeddics 2 RELATIONSHIP 3B. CATIZEN Sotth fOoumery) (4) er___|_US, cece wrorewer hs OS ree Fa State, Country) BS. Lawes 6. AGE | ves X | 80 j 1. FUL& NAME fLaateF seat-Sfeekdies Z RELATIONSHIP B. CITC ENS 008F (Country) &. CURRENT ADDRESS (Na, Sareee, City, Zone, Stara, Country} S. Living &. AGE { ves ¢ i MO 1. PULE MAME (Last-F teatBiddle) & RELATIONSHIP 3. CUP ES Emr? *Countey) 4, CUARENT ADDRESS (Neo. Street, City, Zone, Stata, Country) BS. LEvene 6. ace — i ¥vES wo [- PULE NAME (LecteF tratM adie: : 2. MEL ATIONSHIP B. CATIT Cm Seech (Conmeiey> ae ———— ‘ & GURREMT ADORESS (No., Stover, Clty, Lone, State, Cauntey) . Livisss @. AGE wes ere { oft. j 4 Wh Bai divente Senchiamanieca dt nee
14-00000 eben ‘ 't elZe- @ FATHER-IM-Lag @ 3. CATE OF DEATH TAUSE OF DEATH 1944 Stroke . @. DATE OF 2.97% 7, PLACE OF BtRT oH (Cty, Stare, Couenrr> ( CITIZENSHIP : Unknown Rome, Georgia i 9. 1F GORN OUTSTE U.S. - DATE OF ENTRY 16. PLACE.OF EmTRY H ; NA. N.A. : fh, FORMER CITEZE mse PES) 12, GATE U.S. CITIZENS ACIUIREO | 3. HERE AT QUINED (Cuty, Tate, Country} : LCouury (ies? ' . : iS N_A . | $$. PROF aT CuPLOVER {Give laser employer, if Fatherun-Law ta deceased or memployed? ‘ . Ld MOTHER-IN-LA® @ : 3. DATE OF DEATH ®, CAUSE OF DEATH . 1918 Flu . 0 a re: . 6. DATE OF BiRTa 7. PLACE OF B1QTH (City, State, Coumepy i? $.1€ BORM OUTSITE U.S. - DATE OF ENTRY 20. PLACE OF ESTRY e NLA NA. ; tt. FORMER CITIZENS HIMIS) 42. GATE US. CITIZENSHIP ACQUIRED [13.WHEPE ACQUIRED (Cay, State, Countsy) 4 LCounrery fies? NI nT & ae. * “4 ty " @ [section xix RELATIVES BY BLOOD. MARRIAGE OR ADGPTION WHO EITHER (1) LIVE ASROAD, @ ot " (2) ARE MOT U.S. CITIZENS OR (3) WORE FOR A FOREIGN GOVERNMENT NA. . i { 6. CITIZERSHIP (Country) 7. FREQUENCY OF CONTACT é $, FULL NAME (Last-Firat-pfeddle) 2. RELATIONSHIP ' ed - : . 5, 4. ADORESS OR COUNTRY IN BHICH RELATIVE RESIDES §. EMPLOYED BY 2 4 & CITIZENS HIF {Countey} 4%. FREQUENCY oF COMTALT 2 y 4. ADDRESS OF COUNTRY IN WHICH RELATIVE RESIDES $. EMPLOYED BY « 4 6. CITIZENSHIP (Country) 9. FREQUENCY OF CONTACT 6, OATE OF LAST CONTACT. | 1. FULL MAWE (LaateF wratMiddie) 2, RELATIONSHIP pe 4 3 4 ADDRESS OR COUNTRY IM WHICH RELATIVE RESDES $8. EMPLOYED BY 4 , . % 6. CATOZENSMIE iCountry) %. FREQUENCY OF CONTACT 6. DATE OF LAST CONTACT : 1, PULL NAME (LacteFirst-tgiddie) 2. RELATIONSHIP aan , 4 4 ADORESS OR COUNTAY 100 MICH RELATIVE RESIDES @. EMPLOYED BY va *s . . SFCTION X1% COATINLED TO PAGE £3 B ° ~, . og wate prmepge monroe «
14-00000 TOR MPO Cp BU RyE EMSS OCC, OL nieatattmdelnrrabmnan to cuaRinettintal nc aepieNNt te = w ace Ae re Se cette ener & SPECIAL REMARKS, IF ANY, COMCERHING REL AT WES ROTED iu SECTION KIM ABOVE Any relatives I might have in Mexico or Germany are unknown, _ RELATIVES BY BLOOD, MARRIAGE OR ADOPTION WHO ARE Ih THE MILITARY OR CIVIL e@ ® SECTION XX SERVICE OF THE UNITED STATES ERT AAO ROTO TE ttt as ctrntetnae SUCRN Eehs  etresnseni, hee Pe reaaik < Pa PRL in tH PR AARON Ii, i. MAME (Leote? ivet-Agsddia) 2, REL AT COmsoeer 3. AGE +4. CITIZENSHIP $. ADORESS (We., Sreoet, Crey, Seate, Coumtry) & TYPE AND LOCATION OF SERVICE (1? ieower) 1. MAME (Lato? retMiddieg {$. ADORESS O¥a, Street, Coty, State, Country) 1. NAME (Lant-P sratiiddie) 8. ADDRESS (Meg Seeeet, City, State, Country) SECTION XX1 _____REFERENCES. ACQUAINTANCES, AND NEIGHBORS oe a 3. wthT FIVE CHARACTER REFEALSIES. NOY RELATSVES, IN TRE U.8.. am AKOW YOU INTIMATELY ARE BUSINESS ADDRESS \ RESIDENCE ADDRESS {(Xo., Seeeet, Cate and State} 4. LV ce GLEBE comb ALN BERLE aR LBLL 2, jum>us, Ceorcia Lae F tgat -SMiddte) Paoenix, Arizona i fhimail oc.ence i 2. LIST Fivé PEASONS IN THE U.S. WHO K4Sw YOU SOCIALLY - NOT SELATIVES. SUPE RYISGes OT EMPLOYERS SAME : BUSINESS AONRESS A SEsinence ADORESS ( Last-F erat-Mrddie) i (No , Siveet, Cty and State) fo | Miamt, Florida | New Caandn, Conn HBORE AT YOUR MOST RECENT NORMAL RESIDENCE IN THE U.S. Riverside, California CaeE i BUSINESS ADDRESS | RESIDENCE AQDRESS (Laat-F wet-Meddie) (Ne., Street, Caty and Stete} LE Serre CIEE OK kdl ttre SI ee 2 a ee ae dae ee Lek ener eee eh te te Re em em Saree Re | | | i ~ ete Uh ABN Us p= wste oi ee eenehtttoe wk ee fas ene At ae ft pent otaaet es ae ' aves Reb iin Trev me 8
14-00000 by in ena cities Bane earn yao a Hg ak Ba DAM Rte Sala Rereentered meaoeaient a aneneinee eteOniet tad wet atone the BY eat _ «he SECTION KXit CLUBS, SOCIETIES, AND OTHER ORGANIZATIONS NOTE: List canes ad addresses of ali clubs, societies, professional societies. employee groups or organizations of any kind fineiude membership in, or aupport of, any organization having headquarters or branch in a foreign country) to which you belong of have belonged. : repro npr rr . MAME AND CHAPTER SECTION XXiti . RESIDENCES FOR THE PAST 15 YEARS Ale ices: LAST Red cEWCE FIRST : mE S USE OAY {Nurber, Street, City, State, Coumtey) FROM oO Pt hu Mexico, D.F., Mexico 1949 1952. Mexico, D, F., Mexico 690 ; ae ee NON Aiea Fate Se F + wena WS Yee (oO 1946 1949 oe pn sence pris Dhobis  tatinie d |
* Dmnnew cee 2B OLA steel hates tat ree me tna ee rs woh vray tata, ts ret ern cgrenmanpnectncnininns abtiecened Cie STRESSES SN FREE ery etopusateme tpacer See ae eee SECTION XXIV ADOITIONAL INFORMATION 41.20 PEVEN ADVOCATES OF ARE YOU Soe OR HAVE YOU EVE? BEEN A MEVEER OF; YOU anv & BEEN ASSOCIATED WTNH &8~ FZWITICAL PAETY iSSIVIDUAL OR OP GAN - OR HAVE YG 6 EaACMES Ure Cvt i nkOw OF Ted SovERNMENT GF THE uWiTED STATES B° FOSCE wie v MOSNSTITUTIONAL WEEKS GR EZETL BY FORCE OF J CLENCE TO CEMY PERSONS THEIR BIGRT STsTuTiON OF TrE UNITED STATES" 2. 1F YOU HAVE ANSWERED “VES* 70 THE AGOVE CUESTION EXPLAam 3. OO YOU USE OR HAVE YOU EVER USED INTOXICANTS? ino 7 ” [ees [sf $0. 70 wHat Extent? ara Moderate 6 &F $0, TO WHAT EXTENT? $. 00 YOU USE OR HAVE You = __! YES EVER USED WAACOTICS? Xi ao HAVE VOU EVER BEEN A MEWRES OF, OR SUPPORTED. OF HAD ANY CONNECTIONS BIT a A FOREIGN INTELLIGENCE ORGAN. IZATION OA ITS ACTIVITIES? ~ {ves iiso IF ANSWER 15 “VES", GIVE COMPLETE DETAILS. ' f LIST BELOW THE MAMES OF GOVERNMENT DEPARTMENTS, AGENCIES OR OFFICES TO @HICH YOU HAVE APPLIED FOR EM PLOYMENT SINCE 1940 tf TO YOUR K AGENCY AND INVESTIGATION. AVE CONDUCTED AM INVESTIGATION OF VOU, INDICATE THE NAME OF THE ROTE SPECIAL! If your cnswer is *VES* te the foilowing Questions 10, 11 oc 12, provide the Infosmetion requested far each INSTRUCTIONS | question on @ seperate, signed sheet and attach the sheet to this form in o sealed envelope. 1. HAVE YOu, OR TO YOUR KNOWL ZOGE MAS YOUR SPOUSE. EVER BEEN OETAINED. ARRESTED, INDICTEO OR CON- MISTER OF AMY VIOLATION OF THE LAW OTHER THAN A WINCR TRAFFIC VIOLATION IN THE UNITED STATES OF iF $0, STATE NAME OF COURT, CITY, STATE, COUNTRY, DATE, NATURE OF OFFENSE AND DISPOSITION OF CASE if ACCORDANCE WITH THE SPECIAL INSTRUCTION ADOVE. HAVE YOU EVER BEEN ARRESTED. COURT MARTIALED OR OTHERWISE PUNISHED UNDER MILITARY Lag on REG ULATION? {Ff $0, DESCRIBE -“CIDENTIS) AWD PROVIDE DATE(S) OF OCCURRENCE OM SEPARATE SMEET IN AG CORDANCE WITH SPECIAL INSTRUCTIONS ABOVE. . 42. ARE THERE ANY UNFAVORABLE INCIDENTS IN YOUR LIFE, HOT MENTIONED ABOVE, WHICH MAY BE DISCOVERED [res IN SUBSEQUENT INVESTIGATION. WHETHER YCU WERE DIRECTLY INVOLVED OR NOT, SWICK MIGHT REQUIRE EX- PLANATION? IF $0, DESCRIBE INCIDENTIS! AND PROVIDE DATE(S! OF OCCURRENCE ON SEPARATE SHEET in AC CORDANCE WITH SPECIAL INSTRUCTIONS ABOVE. ino | SECTION KXV PERSON TO BE NOTIFIED IN CASE OF EMERGENCY $. RAME 2. RELATIONSSIP Mrs Wife i@. OR HONE HO. (Q -77-47 \ any i ei * ‘o fe 2 > ORS. BUSINESS PHONE NO. & xr. . j (35-96-53] O€. EMERGENCY. al a aviv tl pouae, Wood. ‘athec) MAY ALSO BE NOTIFIED. iF SUCH NOTIFICATION S$ NOT GESIAA TE. G . i Mr or Mr OS, {Ss i ' i : t -_ Ld . we ded arate: . » ern erent Hy i ° med nbtiinl nha tines ote _
eG. SUL! Utd, Ae Radten. erBvemndetnan mevmemeemmemitrre eomegimomaniiets neers So iee — MOabenate semi Sab e+ ie ‘ “Bis? » od tat Hy AF nt tat tae heat tye : we sSitties Tela, De tbred t200eds i any et we «4G. SECTION FF vi CERTIF iC aT iOe6 YCU ARE INFORMED THAT THE CORRECTNESS OF sery STATEMENT ADE IN THIS 4FPLICATION WILL BE INSESTIGATED, 4 { hove read ond understand the instructions. | Cartify that the foregoing answers ore true and cosrect fo the best of my knowleoge and belief. i agree that ony misstatement or or:sema as to material fact will const tute graunds for immedrate dismisses! or reyection of "7, cpplication. § also understand thar any false stctement made heree moy be punishable by few (U5. Cade, Title 18, tian 1000), %. DATE GF UGNATURES 3. SIGNED AY (City and States .* . In : j AK 9 NOTE: Use tae tollowmg space for extra details. Reference each continued item by tion Ang tem number to which relates. Sign pour name at the end of the added maternal. Hf addatenusl spece is required as tra pages the same size ag thiag page and sign each euch page. . ection XI - (9) - Shares in Ron Castillo S.A. - Mexico, D.F. , . Shares in Telefonos de Mexico, S.A. . Section XX1 (3) Oaly neighbors - remaining in area. Og & MVTSASTAT PMAtIOG STKE 1HES O~ATOTE . @ © . so cant fe Sine we B BO weet i e t poy he Re Meret wae eae ;
14-00000 FOR" 444d ose ragvious mprnoss -1- . . . i ‘ i i PERSONAL HISTORY STATEMENT — (Appendix I) ; i Listed beiow are names of erganizations identified by the Attorney General, under his responsibility pursuant to Executjve Order 10450, dated 27 April 1953, to Est the names of tach foreign or domestic organization, association, movement, grorp or combination of persons waich he designates as Totalitarien, Fascist, Communist, or subversive, oc as hat: ag adopted or having shown # policy of advocatiz y or approving the commission of acts of force or vio- lence to deny ethers their rights under the Constitution of the United States, or as seeking to alter the form of government of the United States by unconstitutional means. Each aprdecant or employee and spouse (if any) must review the following list of organizations for certification purposes, and aign on the last page. abrsham Lincis Brigade Berton Gcheot for Margiat Studies, Boston, Massachusetts 4braham Lincas School, Chicago, Kites Dridgee-Hobertaon-fchimids Defense Committee Section Comminae to Free Spain Now Bulgarian American People’s League of the United Btates of Alabama Peopie's Educational Association (ese Ccmmmunist Politi- Amery eal Associatian) American Assuustion for Reconstractien im Yugoslavia, Loc. Caifornia Emergency Defense Committee American Brand of the Pederation ef Greek Maritime Unions American Chriscea Nationalist Party CacZornia Labor School, Ine. 221 Divisadero Street, Sen Prancisco, Americsn Commctee for European Workers’ Ballet (see Socialist corns Dera an eo Onn eteres Baw Moet, a te B Commds tvelctl of Amerfaan omen of Croatian Descent, alse American Commetes it Spanish Prootan | known as Central Counc] of American Croatian Women, Ne- - : teen Councli of Croatian Ween amerkan Commcces for the Settiement of Jews tn Birobidien, Ine. a co for Yugosisy Petief, Central dapaneee Association (Belzoku Chue Nipponjin Kal) American Coummc-tee to Survey Labor Conditions in Europe Japenese of Bou . Cesteai Organization of the German-Americeas National Alliance american Count for e Democratic Greece, formerly known as the Leus Greek Americe: Council; Greek American Committee for Na- (Lauterbe-Amerikaniache Einheltatront) ttonal Caicy Cervantes Fraternal fociety Americon Counct on Soviet Relations Chios Weifare Appeal, Ine. Amervan Crostas Congress Choyta Cultural Center Amétican Jewish Labor Counce? Citizens Committee for Barry Bridres - Americas Leagor against Wer end Fascism Citteens Committee af the Tpr + West Side (‘New York City} American League for Peace and Dexceracy Citieene Committee to Fee Ears Browder ~ American Natinzs Labor Party . . Citizens Eenergency Defense Senterence Amesican Nations: Socialist League CY eases Ke . tist zens Protective League ania oom Nactomas Socta! Party Civil Liberties Sponsoring Committee of Pittsbur« b Pa ine. Rights Congress and its a@Uated organizations, incinding: Civil Rights Congress for Texas American Peace Craada Veterans Against IMacrsmination of Civ Rights Congress of Americas Fease Mabilization Hew York American Poles tor Peaos Civl Rigata Congress for Tesae fesse Ctrit 7) American Polish taber Counell ‘ g Enghts Congress) ‘american Polish League , | Cemmlte Courdinador Pro Yepohlies Espanola dmerican Reacur Sip Mission (a project of the Unirad American Comite Pro Derechos Cirtles Spanish Aid Oom=aletee) (See Puerto Hicen Comite Pro Libertades CivDes) American-Russias Fraternal Gociety Commictes for e Democratic Far Eastern Policy American Ressies Tastitute, New York. alee known as the Ameti- | Commistes for Constituti . gam Russian Lorivate for Cultural Relaciones with the Soviet can) and Polttical Freedom catoe Cosmreitiee for Nationalist Action Committees for Peace and Brotherhood Festival in Philedetphia American Russie Institute, Philadelphia Committee for the Defense ef the Pittsburgh Bix. 5 American Russias Tastitute of San Praselsca . = Committee for the Negro in the Arts Axnerican Russias Thettute of Bouthern Callfornia, Les Angeles | Comecittee for the Protection af the BU) of Rigiats ’ : Aeverican ba iio Comnmition for World Youth Priendship and Cultural Exchange american Women Peace Cemmittes % Abolish Discrimination tn Maryland American Youth Congress (Set Congress, Apeinst Deseriminsticn: Maryland Congress ameticon Youth tw Democracy &geinst Discrimination: Provisional Cemmittea te Abolish a&smenten Progreatre League ef America Utecrimination ta the Steve of Maryland) t : Asmociated Elans <f America Committee to Ald the Fighting Gouth i ' Association of Georgia lane Comenittes to Defend Marie Richardson ’ Awmoctation of Geman Nationale (Reichmleutache Vereinigang) Committe tw Defend the Bigh’s and Freatom of Pittaburgh’y - Sasland-Orgenissam der NEDAP, Overseas Branch of Negi Party Political Prioners Comenttses to Uphold the BO of Rights Baltimore Forum - Comensawealtts College, Mena, Artansss 4 Benjamin Davia Preston Comenittes Communes Party, U. G A, tte subdivisions, gubaidieries, end | Bisck Dragon Souey Lot amiiates } sere ne ote
Ceoomwies Political Amocucsion, ite subdivicions, subsidiaries, end a2ctates, including: 4ucama People's Educecienal Associatian Fievice Pres ond Educeamel League Orahems League for Poccical Education Peccia’s Educational.ant Pree Association of Tess Vargiaia League for Pesan Education Congres Agiinet Diseriminasca (See Ceocomittes to Abolias Tiscrimination in Maryiand) Congress cf American Reralwienary Writers Cengrem of American Wormes, Cengress cf the Unemployed Cannersicut Committee to 43¢ Victims of the Geith Act Connerucut Stave Youth Ou ‘erence Counce for Jobs, Relief and Zousing Counce for Pan-American Semocracy Couns of Greek Americans Coumec= oa African Affairs Crostise Benevolent Fraternity Dail Kispon Butoku Kal Quneary Virtue Society of Japan or Mm. tary Art Society of Japan} Deiy Weezer Preas Club Daniels Defense Committee Dante Augnierl Gociety (between 1605 and 1949) Denris Defense Committee Detrecza Youth Assembly Bast Bay Peace Commistes _ Riatinare Progressive League Emergeecy Conference to Save Spanish Refugees (founding body fie ad ctve ee AMES ek Sythe AI COGeees tts Brevpbedy’s Committee to Ontinw War Pamilies of the Baltimore Butch Act’ Victims Pasties of the Smith Act Ticcuns Pederavion of Itelian War Teeerane in the 0. 8 &. Inc. (Assocta~ ‘gone Neiomale Combate? Itallant, Pederesicme Gegli Stati Unis d' America) Finnish-dmericam Mutual Ait Society Florida Presi and Educatiom’s League (see Corseuniss Politien! Asanetazion) Prederxk Dougiess Educational Center Freeécen Stage, Inc. Priengs cf the New Germany fPreande des eves Deutachiands) Prients of the Soviet Union Gerftardt American FPraterna: Society George Washington Carver Schcol, New York. Chy German-American Bund (Amerikadeutscher Volkaumd) German-American Republica: Lesgue Germas-Ameriran Vocations. heague {(Deuteche-Amertbantecne Berutsremetnachaft) GualGaa Crab Harlem Trace Union Council Hawan Civi Liberties Commetes Beimusts Kal, also known as Sokubel Relekt Gtrasne Kal, Zatvel Nimer Jin, Hetyaku Gimusta Eat, and Zaibet Hetoxusha Bal iJap- anese Residing in American Military Conscripts Amoctation) Helieni~American Brotherhood Biase Eel (Umperial Japanese Reservists} Hinamara Kai (Rising Bun Flag Society —a croup ef Japanese War Veterans} Horubet Zaigo Shoke Dan (Herth American Reserve Officers Aszo- efation} Holiywoed Writers Mobilimtian for Defents Hungerian-American Coumcd for Democracy Bungastan Brotherhood Idahe Prosion Unica Independent Party (Seattle, Washington) (See tacapendent Peoples Farty) ; Independent Pecpie’a Party (Sea Indepentent Party) inéustrial Workers of the World daternational Later Defensa international Workers Order, ite subcivisiens, gubsidiertes and ailiates , depancse Azeuctation ef America . dapanese Oremeas Central Sactety (Eacgai Dobe Chue Had? daganese Oresvens Convention, Tokyo. Janes. 1M0 . Japantes Proeciive Associauion (Recratticg Organization) deSerson School of Social Science, New Fork City dewish Culture Society dikyoiu Tinkal (The Committes gar the Crosse) dohnson-Fores: Group (Sea Johmscr ses} dohneonites (See Johnece-Forest Groupt , dort Anti-Pascts: Refugee C ‘amines setae Council of Progressive Italian-Ase-icans, Inc. Seach Wedemeyer School of Social Science. Bt, Louis, Mimourt Bibel Seinen Esi (Association of U. 8. Cictzens of Japanam An- esstry who have returned te America after studying fa dagen) Enighta of the White Camels Ee Slux Eos Ssfhaeuser, aso known a8 Eyfhacuser League .(Eyfieecceer Bund), HyZtacuser Fellowship (Erf>erceer Kanerncachate} Kyfhacuser War Relief (Kyfhacuser Kriegaiilfewerk) . 3 . aber Council fer Negro Rights Labor Researcs Association, Inc. Leber Youth League League for Comssom Sense League of American Writers Lictor Society «italian F'ack &hirta) Macedonian-Ametican People’s League Marto Morgentust Circle Maritime Laber Committees to Defend 41 Lasuca Maryland Conprres Against Discriminate iSee Commitwe to Abolish Diacrimisetica in Maryland} Massachuaetta Committes for the Bri of Eights Biesopetaseets Shteute Ween for Peers inst commected wth the BMnute Women of the 0. 8. a4. Inc) . Maurice Braverman Defense Ccemmutee Michigan Civa Rights Federation =~ Michigan Council fer Peace . Michigan Beboot of Social Science : Nenke Teikers Guavudan (imperial Minery Priencs Gomep of Southern Cecfornia War Veterans Sational Assocvstion of Mexicem Americans (also known as Asoche- elom Nacions, Mezico-Americana} : ° National Blue Scar Mothers of America (mot to be confused with the Blue Star Mothers of America crganired in February 2962) National Conocistee for Freedom of the Press National Comcmui:tee for the Defense of PeLical Prisoners National Com=auctes to Win Amnesty for Sith Act Vietors National Commcttee to Wing the Peace National Conterence om American Pocky <2 China and the Per Ene 4a Conference called by the Coramittee for a Democrat Par Eastern Policy} National Couorcil of Americans of Croatian Descent National Couns! of Amerkan-Goviet Priencship Kational Fedrzation for Consututionel Liveries Rational Labee Conference for Peace National Negro Congress Kational Kegro Labor Councii { Netionailst Activa League | | : | NE en : Bhat * ep RAEEED CARTEL! nr ~ de en nabin sacs