74:00000 (2) E.IF BORN OUTSIDE ua. 3. WHEN DID you FIRST ARnIVE in THUS COUNTEY? wuenetneees .. ON pASS PORT OF WHAT COUNTRY? rece cues meee renee Te port OF ENTRY? eer genenee eee Piece at hen serene aaett eine BE eres EL SET ABT U.S. VISA coe wan DESCRIPTION nas puysSical ww. SEX AGE one EYES ccc eres snsnag renee teen PAR cece COMPLEXION eaweewees BCAKS ceceneennneneensneeTee BUILD cee cmean nang eresn serene OTHER pISTINGUISHESG FEATURES = ee ae eee ne ee ae aap ee tS ae re ee ca as epee sec. 3. MARITAL STATUS _ DIVORCED -.- cea sstenewmerc ment wIDOW ED ne wen nnee A. SINGLE, errr MARRIED meee rate Vath PLACK, AND Heason wom ALL SEVABATION|: Divorces on ANSE LcesTa a a : ¥ wees aa oo eneee oneness . MORE THAN AND CF you HAVE BEEN N MARRIED. (AVE, BEEN eT BOR NUS SBAMU ONCE—-TS cL UDING ANNUL- GIVING DB ATA REQUIRED r B. wife OF “use MENTS-—UBE A SE pARATH SHEE BELOW FOR ALL PREVIOUS § MAKIUAGES) SAMi OF SPOUBE Deere Cleese 2 : : wf hg a Le dpe bebe} PLACE AND DATE OF MARKIAGE Naz: OTe Oy Bae ee A a ey v: wy yan - hers nee wis (OR HER) ADDRESS BEFORE MARRIAGE oo ds West! fat dix mo me : ‘(se “and “umber tote) qgtate? [Egantey) LIVING OK DEC EASED | Liv: mae DATE OF DECBASE ener" EAUSE ere $3 ale? as heel. upbank: readin, Dike! 2 A... (City> _ oie) heer re) Si ha and Number) "y As of wurte ve 1 get 5% RESENT, Of LAST. ADDRE o1a7 pack OF BIRTH - De nse neti OSes ques? cpdate) 2 DATE OF piers Agere” IF BOKN OUTSIDE U.S. IN DICATE DATE AND PLACE OF ENTEY ceeeneeammecereenent® icy “Siete “(Countrs) , CITIZENSHIP ern WHEN SS ACQUIRED? nn OCCUPATION ---- 1 ins sal — LAST EMPLOYER rho 4 r.. Cosel Be Angell. Board Arteg Coast ¢ naan a ; Roacd Se iiea lon Paral aia 11S, Fl EMPLOYER'S OR BUSINESS ADDRESS 22 esd er ear aa ook ede gas MAIO ie and Number} (cnr) (Stabe (country? MILITARY SERVICE FROM .ecee oe PO vecenseg BRANCH UF SERVICE recumuenuncnserseeneenee® (Date) (Dated COUNTRY, nonce DETAILS OF OTHER GOVT. SERVICE, U- 5- OR FOREIGN vas
oo {&t, amd Mumlber) qelity) state) CCaaat lege o SO MTLITARY SERVICE FROM oc coe TO ce eceepsnces BRANCH OF SERVICE ecccrccrccrs res COUNTRY once eee cee ee cee PETAILS OF OTHER GOVT. SERVICE, U4. OR FOREIGN ry aM ee ig et eT TS ST TES TE OT eae eA ET ennt plo ee PT Pear i a AERTS ee Sec. 7. BROTHERS AND SISTERS. Gncluding half-, step-, and adopted brothers and aiaters); oe € Keowee (BEL bed “Oe at? TF acne ie aneaters (City) ye. Ait, end fiyenber) AGE wo ee (Fire 9 CSTE) haat rs : 1B, eave To arubant ) qCity) (Btated ids unter} {Cittva ncaa? Ut B, FULL NAMB oo .cnce cee cere cee renee: meee cane reine cteeereaanss inear, qMibiter . “eC Stine toed PRESENT ADDREAS _ wese tee eee ee nce tence eet eet Ve. GO furteet (Cley} : Bo BURD NAME ccc cccecs cece ce cree cteneseneeneene cone seta on cuecemarenecameeenearana cerns ts a gates : Fiemme (Muhiay . t hasnt}? Oth. Bae Nuriber! conyP (Btated (Country) (Citta vated aid OMicbHet . ; (haat? er unt elite antes : PRESENT ADDRESS |... , on or) i Tjader b rents peer eart ieee SST AR Ta RD PRES SE oT ST EETNS { RT ST EE TTS ATE Le gee, & PATIERIN-LAW FULL NAME... WSs DEBI ce Le (Xn ke 4 23 ree , news CAtdee) 4 Lnath DATE OP DECKASE 2.0: LUAUSE Lilie cence ceeeree © LIVING OR DECEASED J bia: 109. PRESENT, OR LAST, AGDZESS cheese lace, Mi 3 Falk cnn nd Runderd (Oley Qhtate) ‘ DATE OF ner fen a3 31993 PLACE OF BIRTID . Nas - Lh 5 CITIZEN SERIE aS: —ownes acquinen?.. Br @ ft | WHERE? Tec seeee wae . _ . . po eCity) (Aint Cees) % OCCUPATION WF arimne C www... LAST EMPLOYER 0.007 Ln ee wee . 7 . 6% ett 2
ne ey \ ser or ' OOK Y anh Nate aamie bime ane oD Len are Se 8 at in ie wetter , ; et Senet A on ws A NIT tn A hi NANA ee AS hata gy fl elm tt Ti eC LR ad tae ¥ Fee Se Oe a ae it eat a le kak emtikonras f LING Sec, 9. MOTHER-IN-LAW -- : . VY . A FULL NAMB... je Yet OPV. OR beat lime ‘ LIVING OR DECEASED 219.6 n4., DATE OF DECEASE . co GCADBK coc ccc cesses . “ oa { bet PRESENT, lt PAST, ADDIESS occ co eceeeeee FUL EL wie i S.. . ehier - . itde: at 484. erel Mumibesy DATE OF pltri Garic lA ZOORLACKE OF NierH LO 2 AEE, igen J situ Ie HORN OUTSIDE UB. ISGICATE DATE AND PLACE OF WSThY o.- _ CLTIZENSIUE .. Cite) fe fefuud a FPLOVE R.. oe WS. oo WHEN ACQUIRED? ALIN FAF GNBRET oo ccc eee eee . a éRiute} ECoranicp? op a, OC UPA’ TON ntaetemstre tT. Sec. 10. REDATIVES BY BLOOD, MARRIAGE OR » ADOPTION 7, MS HH EITHIGE LIVE ABE OAD OR WHO AME NOT CITIZENS OF THE UNITED STATES ALO Ae RELA TIGER TT ce cenees _ AGE... veesereser C44, net Merraiory .. re eectty> OMA phe p {Peasy Fseta ae ' sig) ORtate } (faeatitey } 1Ht. anet Movajes's RELATIONSHIP B. NAMED cocccce:cteeesnees tess csstercseeseressatesmersecasseceneter snare cere eee AGE, necator Etat) i fertey “Wom ry) Aa PT ES CIPS TRE OP RET A EE eet PP TT TER RS Lo : Sec. 11. RELATIVES BY 2LOOD OR MARRIAGE IN THE MIE ITARY OF CIVIL SERVICE EOF THE US. OROFA AFOR EIGN COVERS MENT: A (Oo Aas 1. NAMES wcmetservnewnraseccmeranenenseeeemmsnisesssrenenen et: veceeeate RECA TION UIP neraneenneeoncces AGE wocceecee Oty) 43 ata} 7 (Censreteg?) Ge wad stamens TYPE AND LOCATION OF BERVICE (1 KNOWN) vensececeneneanopcavcte perdutnen pe nmucansannesneoae ranma cnire QO NAMB 0. scenes ccees cecomennee rane same mmmunpnaserceccenmartanserrinwers RELATIONAMSE 00. eect rencee) AGE we rsccneres: CITUAENSHIDB pie. eceeeeneeneerenen: pews ceenee ADDRESS .. deceneetecstcegeneencasrates tense tantmesttarcosens sony eemmne “(ie. aon SWiseter “att y) OSittater p {Cresritry? TYPE AND LOCATION OF SERVICE dF KNOWN D cools ccc cence tennner cnc in nem srrnticnse NAM EB. ceccameneceeewereeaneremumenccenentanmesnnenanesar turer sda nacaneern RELATIONSHIP oo eee cecre ness AGE nee cccer cee (He. ant Hamles3 CITIZENSHIP ooo. cee eee) ADDRESS «eee cone eg ec erence ren cere ri gg poen este aan ones mmcgerne : . Sass}, (Ory) éibtata py (Seasntecy TYPE AND LUCATION OF SERVICE (LF KNOWN) ceecscscecccees cememecereemntetereectieris co 4s crenecre nes . 38~ iB ibe~8 i (5)
Chek, Ameen bee | bee TN ora re ae gee Instructtoetia: PERSONAL HISTORY STATEMENT Answe er ‘all questions completel ueation docg not apply write “not applic- - able.” “Write “unknown” only Myck you ude not know the answer and cannot obtain the answer [rom personal ceeorcs, Use the blank pues at the end of this form for extra details on any question or questions for which you do not have aufll- cient Foon - 2. Type, pfint or write carefully; lWlegibie or incomplete forms will hot receive con- sideration. ; nr HAVE YOU READ AND DO You UNDERSTAND THE INSTRUCTIONS? YES Yea or He SEC. 1. PERSONAL BACKGROUND Telephone: Omce: AoA obttse —_ A. FULL NAME Mr. hee yeas wWigary 2 wwe MAME ne Middle YYNR = ~teo teint) rye Hothe: PRESENT ADDRESS Jf Bes clewT Av., BRoca oa yL1A. SS.ace USETTS Met wee Me, & Ha, cuz PERMANENT ADDRESS 418 Benweat Av, UpplAsirens Massnecmvscrre UL.SA- DB. NICKNAME Seay WHAT OTHER NAMEA HAVE YoU VeED? MONE i . UNDER WHAT CIRCUMSTANCES HAVE YOU EVER UBED THEAY NAMES? ACT AREAS BEE IF A LEGAL CHANGE, GIVE PARTICULARS ‘HOW LONG? By Wi What Authortty ©. DATE OF BIRTH Qeic. 11923 PLACE OF BIRTH N¢cA 7A, AJass $4. . ‘Sais Country city BY BIRTH? 6S BY MARRIAGE? G. PRESENT CITIZENSHIP Countay DY NATURALIZATION CERTIFICATE ’_ a... IASUED .. ~ BY ' Date Cours eres Pee a AA yee nanaaener PP OA yan  annp ener pcetere TT i : cu State : Counuy ~ HAVE YOU HAD A PREVIOUS NATIONALITY? 4 — ‘ > Yes or Ho : Country HELD BETWEEN WHAT DATES? ro ANY OTHER NATIONALITY? ee airy GIVE PARTICULARS __A/27- RE te HAVE YOu TAKEN STEPS TO CHANGE-PRESENT CITIZENSHIP? Ve GIVE PARTICULARS: ¥ eo — $$ . | « Foam HO, Sa tees
74-90000 TAT as pment cae PE SATIN me tease 2 . wor &. IF BORN OUTSIDE U8. WHEN DID YOU Fins ARRIVE IN THIS COUNTRY? Aamo * PORT OF ElIrTRY? _7~ ON PASSPORT oF WHAT COUNTRY? reson ene LAST US. VisA ee —_—_ wen tr ee hte natn eer a Mornnag Type Place of Fass Date of Pseue , . SSS cra et espa nenctanepoesee ao TASES SS SST ee ae, meee eet STR So ne oe pee ae rd SEC. 2. PHYSICAL, DESCRIPTION so a cede yes; lms sex 4A 7 eT ToT s ight WEIONT ASO Lbs . : LIGH Sy oo * ; EYES -BLve HAIR _ Gao@ _ COMPLEXION TAR. SCARS .Afeale : Bula MEP Ium orien DISTINGUISHING FEATURES AOnE_ OAL EET_AR 41 Ar ; LeétBow es erg meer SSS SS ST SSE Soo en ene SSS ease mn SEC. 3. MARITAL STATUS ? a A sinare “YES MARRIED _""—___ pivorcep ———_——. WIDOWED ee STATE DATE, PLACE, AND REASON FOR ALL SEPARATIONS, DIVORCES on ANNULMENTS oo AOL ALP Rae (IF YOU HAVE BEEN MARRIED MORE THAN ONCE -~ INCLUDE ANNUL- B. WIFE OR HUSBAND MENTS; USE A SEPARATE SHEET FOL FORMER WIFE OR HUSBAND GIVING DATA REQUIRED BELOW FORK ALL PREVIOUS MARRIAGES.) » NAME OF spouse __ VOT APP. reaaie ee : . First _ Middle Maiden Lase ; : PLACE AND DATE OF MARRIAGE a ‘ . : ‘ . St. & No. City State Cuuutey — ~ CAUSE CURR Reet are nase ante a renatiens wey Aw. not Hig (or HER) ADDRESS BEFORE MARRIAGE LIVING OR DECEASED —— DATE OF DECEASE si AoE Nerepeeerrecrecmaaasepeeeer cinta se trenpenremoctaaners | - 5 i PRESENT, OR LAST, ADDRESS aa re wee a B *s NT, LA Bt. & Ne. Chey Sato County - PATE OF BIRTH TT pace oF pirti uo ——xxi=iiéisesé . i . : : lity Hate Country : . eseammatnd terme te ears IP BORN OUTSIDE U8, INDICATE DATE AND PLACE OF ENTRY aS CITIZENSHIP _ ~~ WHEN ACQUIRED? aa WHERE? ee . . City State Country OCCUPATION _ a ————__. LA8T EMPLOYER eo . eee ee a EMPLOYER'S OR BUSINESS ADDRESS ' St. és No. Cty State Country ' MILITARY SERVICE FROM ee TO BRANCH OF SERVICE on — Date Date COUNTRY enero mnnee DETAILS OF OTHER GOV'T. SERVICE, ug. OR FOREION APOLINC ABLES
cht etree Geer eee SEC. +4 @ CHILDREN OR DEPENDENTS (Include partial dependents) /WoW¢7, in oe NAME Wor [PP bea 3. RELATIONSIIIP ae —e cep pero ntirrannd i aercieennearinn th CITIZENSHIP ADDRESS St. & No. City - Btote Country NAME oT _. RELATIONSHIP a. ace : ee . at fe nner ce paged an ee eee anne mete CITIZENSHIP ___ ADDRESS Se. & Na. ' Clty , Biste Country .. NAME RELATIONSHIP ~ AGE nero eatestamen tenet ta gun ADDRESS eee eee St. & No, city State County CITIZENSHIP ——— SS RY SEC. 3 FATHER (Give the same information for stepfather and/or guardian on a separate sheet) LIVING OR DECEASED £ Livi DATE OF DECEASE FULL NAME Avs var ——____Alegegeal linen __ Flea Middle Laat CAUSE PRESENT. OR. LAST, ADDRESS Palen (fet cetowr Av., Av. Basch 704%, Massy US. (AS%,, USA, . & No city astat Country - paTE of aintu /9 8 7. -phace oF BIRTH _C. CHICAGO Frecsasars 5. A. Country Stata IF BORN OUTSIDE U.9. INDICATE DATE AND PLACE OF ENTRY Woz APPLICABLE ae ciTizensiup .Uf-.5-A. wien acquiren? BitTM_ were? oo ae ee City State Country Hiaged Senos OCCUPATION _I@4CNER Last EMPLOYER ScHoo. Neer, Haocwroal, 145s, EMPLOYER'S OR OWN BUSINESS ADDRESS Hie Sebo ok» BAoc nro Al, MASS, U.S.A. Bt. & No. Biate Cotintry MILITARY SERVICE FROM alWhY. ¥J9T. TO Ava soit BRANCH OF SERVICE ARMY COUNTRY ALS A DETAILS OF OTHER GOVT SERVICE, U.S. OR FOREIGN. MASS. STATE _G. was SEL LEU. 7 Hee . SEC. & MOTHER (Give the same information for stepmother on & separate shect) Firet FULL NAME EDA ARO LINE {Halt & (HAL & QUES DL WIGREA) LIVING OR DECEASED biviNGr DATE OF DECEASE _ CAUSE PRESENT, OR LAST, ADDRESS A/S Beenovr Av, SRocw7oa Lass. Md.2 4SA t ta & Na. city Coustry pare or pint /8 92 prace oF BinTH -Qucale ¥, Sass. crrizensnip 1. SA... wien aceutren? Bid A wire? 7 Cley _ State Country IF BORN OUTSIDE U.S. INDICATE DATE AND PLACE OF ENTRY Woz APPLICABLE. eS re een mee one ste vere ety soe
OccuPATION House €_41F€ LAT EMPLOYER eee EMPLOYER'S OR OWN BUSINESS ADDRESS EE St. & Ny, Cy State Country MILITARY 6ERVICE FROM es b 6 BRANCH OF SERVICE COUNTRY DETAILS OF OTHER GOV'T SERVICE, U.8. OR FOREIGN. nd i \ ee SEC, 7. BROTHERS AND SISTERS (Including hall-, Step-, and adopted brothers and sisters) 1. FULL NAME BUSSELE He, Std UG ReAS AGE = © Pires PRESENT ADDRESS 2/ f Besmour Au, Basen rey Mass. ot. SA - . State Citisenship 2, FULL NAME AGE = SS SSE PRESENT ADDRESS Bt. ea FULL NAME 2 AQE _——— a a ae : : PRESENT ADDRESS ene . © BEB Rein Btaia Rtg Se PULL NAME _ AOE oo an . Piret oan : Riddle : Last ' PRESENT ADDHESS Be Bel ag Bt. & Be. Cisy State Coun wy Citleenship ns rere rarentnnccrcne feat aay Letters FULL NAME er nnsen ere AGE Pires L ‘Middle Laat . PRESENT ADDRESS : : . . Bt. & Ho, city State Couswy Citiaenah ip SEC. 8 FATHER-IN-LAW VO 7 APPLICABLE TNC ames mention amd PERN LS TAREE one et Rabe be EauS FULL NAMB I an eeenieie rere Firat Middio Last LIVING OR DECEASED DATE OF DECEASE CAUGE — a SRR nasoe eee tne _ OR LAST, ADD , «Ste Ne. City Biswe Country (eet rte ene PLACE OF BIRTH IF BORN OUTSIDE U.S. INDICATE DATE AND PLACR OP ENTRY —$————— i. rt paren hp DATE OF BIRTH CITIZENSHIP WHEN ACQUIRED? WHERE? 22 : Cuy tate Country . OCCUPATION LAST EMPLOYER oe nent 4 Seu
SEC. 9 MOTHER-IN-LAW WoT APPLICABLE SEC. 10. RELATIVES BY BLOOD, MARRIAGE OR ADOPTION WHO ARE. NOT CITIZENS OF THE UNITED STATES: A’evV/E - + i. 2 x 8EC. 11. RELATIVES BY: BLOOD OR MARRIAGE OCCUPATION .___#_e «LAST EMPLOYER CTTIZENSHIP ADDRESS : :. 84, a: Bea. Cisy Siatw : Coury NAME RELATIONS HEP - CITIZENSHIP 7 -———=_. ADDRESS ae aE FULL NAME —— : = a Firet Mbdie : Lest LIVING OR DECEASED ~~~ DATE OF DECEASE _"———. cause PRESENT, OR LAST, ADDRESS _ ———~ : &t. & Ka City hitete Countey PLACE OF BIRTH DATE OF BIRTH IF BORN OUTSIDE U8. INDICATE DATE AND PLACE OF ENVY o.ceceeeee eee en WHERE? WHEN ACQUIRED? ___ eran city frete Cuustry CITIZENSHIP , WHO EITHER LIVE ABROAD OR NAMB Aa Al RELATIONSHIP AGE CITIZENSHIP _———"—"_ aporess 77 : . Gt. & Re. Cuz Stare ; Country ————————__ aoe NAME See RELATIONSHIP IN THE MILITARY OR CIVIL SERVICE OF THE U.S. OR OF A FOREIGN GOVERNMENT. . : . : HVSBAND OF MY L NAME STEPHEN P. An DEN SEA peLATIONSUIP FALLER'S Cousafaag 2-55. crmzensiup U.S S$. aporess sae 722 STNMY, tlasu eran O r % St AMY, isha rar D.C. : Ot. & No. City State . TYPE AND LOCATION OF SERVICE. (IF KNOWN) (1. NAME eee ee ee .-nO0O—"_— RELATICNSHIP AGE smeerenutin nareaneet anaes tt CITTZENSHIP ADDRESS ee tat tt cere . . St. & Mo, City Stace Senin Darina saeteemesncsnmnnmmenanmennemeniee nn . TYPE AND LOCATION OF SERVICE UP KNOWN) — Petree NAME ee RELATIONSHIP. AGE St. & Mo, cuy Bite TYPE AND LOCATION OF SERVICE (LP KNOWN) eee —eE_———eEE $
74-90000 uo. ELEMENTARY somo: WHIT IAAL Sémvoy, ADDRESS Baonloal tase, O84 . Mate Ctry - Coubiry DATES ATTENTED 14 Fooly S 7 ORADUATE? ey a HIGHT ScHoorL MEXIA AGH Seyi ADvress Ba Wy EAA IAS. SA Urey tate vunbry DATES ATTENDED ~AIS7 = 1944 rr GRADUATED es Geteec loa.) COLLEGE YALE DO ivens,7 a ADDRESS MeMAncy, Com LS. : To, : i . : ° ; City ‘Btate Country “par Spay DATES ATTeNpEy Wore oR EE AB Ciyv7 Peis. 1 abe fe: —~ CoULEGE HAR UAeD LAYERS ITY ADDRESS CAST ISAs OEE, Ms SS if SA, hee . ; : / chy Brave - oun try ° DATES ATTENDrS LOG DUPE ~~~ DEGRRE AAU. C1 9: os _ a : RCMRELA EY Tew$n OPAL SEC. 13. MILITARY, NAVAL OR OTHER GOV'T SERVICE _ U.S. OR FOREIGN U.S.A... 4 Ary ; S/ Sar 3 yi Pp LL EES 995 Countey , — Foe = tle tad of Gervice ig, i‘ Last Station . Typa of Discharge : 4 go as 2 7 Yew es ‘g ca Gd Fes iy z i. REMARKS; S18 ao ne RE eens De sy /9Y, po SELECTIVE SERVICE BUARD NUMBER 29 ADDRESS | 86: IF DEFERRED GIVE REASON iswecti FiseTh 4, PROM MARCH 1906 wy PATELBER J9S0 : {SEC, 144 CHRONOLOGICAL HISTORY -OF EMPLOYMENT FOR PAS? 15 YEARS. ACco " or “"" FOR ALL PERIODS. INCLUDE CASUAL EMPLOYMENT. INCLUDE ALSO PERIODS wd 8 | . OF UNEMPLOYMENT. G:VE ADDRESSES AND STATE WHAT ¥OU DID DURING . fe APRA PERIODS OF UNEMPLOYMENT. LIST LAST POSITION FIRST. ; Ey “Sivee my O+S Ct AGE Frorg THE Aaay, a7 Fer. ve), | : Dwave gesy ASTevENT 4p Vale CUNT iL Vows 1947) i Aao ar M&gVvARrD (Sear WY7- Sepyr So ) wvoe PRA VIStAas 7 ; ; (OF LEA Bayo - Tee GE Bice. Dera s OF any STUOYy ARE | To BE Foun VIPER Trea, yz OF THIS Font, \ FROM SEPT 19Y6 _ To ME /9YT EMPLOYING FIRM oR AGENCY kiran, Sra EE ~- ; Yano Boer, OA OS pe Oy BRE S Maa oie ote ee, OF Hom Orr 6 Na. PO kas CW4ee CMI a Sp y
e, ADDRESS SIKAHING. Mersanine Lussiaey Neer Suttrly Cons — ue UL SA Gb. & No. uy Couniry KIND OF BU SINESS $6AGe4had Hestiicit _. NAME OF SUPERVISOR Ais lW¢aaed meuT sy Paar. reso’) ~¢ \ verse ;2HAS TITLE OF 308 LIDE. NEA A ree SALARY sa rer PP eS aR your puTies fasr-Tiz1s 29 fae SARE pe Buse ar canned. ae de LOE HEO f CATALOGUED LET TANS IN CONMES prea ultra YALE Ebr Tiod _ REASONS FOR LEAVING SHAD VALL OF Ao BACE bed haE vcom ie Lot COBMes Pal esuce ‘ renpereerrrriesan tenner nrtereertth SieesaeAnenaTD “9. FROM Asever 1994 70 Fee Giasi Te EMPLOYING FIRM OR ‘agency JL S. cine . ADDRESS MED X oe vent _Oezinty Sante Pune Ya lb SA. . Btate . Couaty TOR pains or | St & No aity + . ; . LG CQ Marisa eh Oued Pi oa * : = J HIS GIORN KIND OF BUSINESS we (LN bh L ALB nnn NAME OF sUPERVISO® caer well Youle, R,- AGE ON . Inv ona Titan EXvearroa , Pears wiSe| TITLE OF JORENSSLED ES RECIALIST CAS AAT, i). SALARY oh per 10.0 . le OF Tees \ : fy FF AGAUAISTE RS PANS fed ee caatical ANC ey After ary w@O.ed rival PACERAA DETAILS © fu. iS, Le i Mae YOUR DUTIES ORGANIZE f64 nO , REASONS FOR | ‘LEAVING Ciscnamaee £8i8 en EAI 4 _ 4 FROM sie To Ogcestses JITIZA. , : 7 : : ING FIRM OR AGENCY Gacar Ariascic + Facece Ta Co. ot EMPLOY : / ADDRESS Dasa. rager ____ Baccnmeat_Yass—__ LL S.A. ' Bt. de Ne. Cus Late Country KIND OF BUSINESS Qgacuay —__—_—— NAME OF SUPERVISOR RANA Pie Rass, : . FAs r-) . oy ’ - arris oF jos Fxoevs see Cuesn (rie)... SALARY $28. per._R YOUR DUTIES ee eT ones sana ve esyS, AMD - i | Susrers |e VACA. oe RI Se : REASONS FOR LEAVING Te LATER ARLY. pn §. FROM cu < Se oe resta [W010 lune LT) __. EMPLOYING FIRM OR AGENCY ABMA OY Bul les. 2fsa Co. seer enn , ADDRESS - a AIALe jAl_s Sister, SaccaTos MASS tf SuAs. : State Coustry KIND OF BUSINESS peru: aec£8Y____. NAME OF SUPERVISOR ALSACE S TITLE OF JOB CLEALS. _(faer- Time). SALARY seci per 4A. —_— YOUR DULLES Scheie Cokes ty Te ay. Bulichs £70. (SATURDAYS REASONS FOR LEAVING Sunmmex Secuetiest cf Meee =e ad — ____- been 2 pea parks bine bait —ealye) —————— ?
(Por f=} EX TAN Sg Ke EE T | ak EG b/oeaer igaery oe — fe osey Resmeet dye, ; . ; Bteca Trav, Anas ~The following matertal fs meant te Ppeceny . [[ Bien tay, 2938. : : ae SETI ' Te wore . che intergotion given in thts Perm os-} ¢ / under Ttem #14, Please use it first. Ovuriwe Mis re ay OF FAIPCOVACIT gy 4 SCV OLAS CASUAL SHIPLEY EMT AND UN EMPLOY HEMT. ONLY MAISR ITEAIS CMIEM ARE MABAED ' B20 u ee me JAKE SICLUDEO Gai REGULAR Farry, Oe rae /25 Ow OTNERS Ca? 104 BE BOP PLIED oe VECESSA RY . PSE Sees Saas ‘Seer Mev. - AP Nome “SEEKING. EMPLOY Ae T 1980 = TWNEF SOLOis6 sar gare GA Pies, Bw CA Tow Mise SOHIS & SEPT. 1997 Warvarnd Uni. Sruocer| & ~ Srupyiaa. fo H (Usogea G&L. B. ) as CHAUEFEURING i aime RIS 2 ulead As we At MER, LIF each, Pd Serr. Iso . For Ma. ¢. €. CHanigre bar, 420 Otter Sr. J ¢ BAocn roa,’ ot4as LLIYT~ 5 fo Fats, SPAiMG, Summa a | 4 Tones, Mu 7~% WUE 9, - Srudyrweg i AGAR. 1946 : Yale Unauu. S$Tupesy ; ee (user 6r Brew) -~DLwogveg (Fawt- me) For Yare EDiTiows af : : } 9 7 26 i ine (947 PRG + Summsg 46 Morkace GlaAtPoce Gee FES POU OLA gE, FCS +17 : ; : Face ra Sraivc, 96 7 ~Crree tdeoaa For Secas rary Ta Deas ae E Var Cons oe Char rt. Time) peal a : oD) Cane h &e, Va.- Baste TRAM ~ FEB + Sune 1993 (2) Yaesu" Unis, CAR ow OPAL ITO TAA iS Pesseen) “Te Juwe’ (92> ANd, guy Ch) Qanep PucKEery, i. =~ 310% Tueanrny 75%! Dyyisisat = Apaico Play. yy “Sur Py Secrean, ISI S24 = IAYy- Yo afore 8. 8S ~ Trike, ad Lb usa rioas C6 free © a bo ¥ Y 9 208 Fhlg ‘ mre Tenet ganyener ettn O SRO etter ae FOB. 17, 1993 oe fea, M996 OW) Sasser Mea ow CIB, ~ Dieewace vo. FEO, be IKE * ; ~ sree YIAIG Gosranw Unis. Srigenar! 4 aan, AeoP Geovegy 5 STAee, Alaial & Cas eran S Teer, Bavenrow — (Pie E-Fed wduvk 94 - Des. t five. ” $a°%, yf Yo | FEB, 17 S43 at dumrork Mion Scnsee | AMO Higwn Seygas STHOF UT “CLERK, NEMAEOY RurreR Srove flaw Sr, Rave: atau (Paar Tine) er, 1940 - ~Jvve By _ - Farce Novrs sg ? STARRED LVOts ARE DETAIL E oO au Farry 2 faf
14-00000 GEC. 16. HAVE YOU EVER BEEN DISCHARGED OR ASKED TO RESION FROM ANY FOSITIOY? HAVE YOU Lerr A POSITION UNDER CIRCUMSTANCES WHICH YOU DESIRE TO EXPLAIN? GIVE DETAILS: ; ; ‘ SEC. 16. GIVE FIVE CHARACTER REFERENCES — IN THE U.S.—WHO KNOW YOU_INTI- MATELY — (GIVE RESIDENCE AND BUSINEYS ADDRESSES WHERE POSSIBLE.) , . . Street sad Humber, Chey State ; . JA Bevel Maveey Say) BUS. ADD. COWZAAA Ma Ti 0/82 CNY! HEM My IAC Foal, MASE, : RES. ADD, dL£.8_ Ws, AEST, Saecktdal AIA SS 3 2. MnO bleseey Iie uans DUS. ADD. LAA Rb ia tad $2, Bevciezaa) IAS Sy) E a . “RES. ADD.24 Gireage Sy, AAOENT ON CASS . 3 8 Shas 4Y09 A Giggs BUS.-ADD, Wied Scusee Laecn riya) _ MASS, ; : : - RES: ADD. LEU AIOE AY, EXOT LA) LIB ES. 7 By ; 48 BYARO “EP udoa Fa : 4 : . 4, Seu. fue. Srove usages) BUG, ADD, Marsaasr cushy bamagioae Aaee. woe oe ., ; . RES. ADD, PO bAVED OI ST, CAMBRIDGE wal 75 7 RES. ADD, LEY eIAUR RD, ALAR ARIDEF ConA, ¥:) LAS 6 OA” Bae o BEE, 17. NAMES OF FIVE PERSONS-wHO KNOW YOU SOCIALLY IN THE UNITED STATES — NOT REFERENCES, SUPERVISORS OR-EMPLOVERS — (Give residence and business ad- dresses where possible.) . i ne . tes ~ RES. ADD. Bo whcUs 57 LENA Lan A14ze. | 2 Aa Deca) ft Gres; BUS. ADD, —— = 2 . RES. ADD. Ataris A-33 Camphidce PIAS S$. °. - PHYSICS LFey, . a BUS. Pal Par Len! EAM ERIE AMASS. RES. ADD. HAAVvAad bhary,. RSMGAWGL Mass a—forrica, Lagoaayoa dt i BUS. ADD. CRT Ba Ltn § BOS Ty ALES, RES. ADD. JY Ala o fo AY alison ALAS, « BUS. ADD, Sooo ee , = RES. ADD. ADSL LALY 2 2a EMA A Miu! Yo £ ic {ty , os
14-00000 SEC. 18. GIVE THREE NEIGHBORS AT YOUR LAST NORMAL RESIDENCE IN THE U.S. — (Give residehice and business addresses where posslbic.) Bireet dud Number City State aed we eee ee ne a Aliss$ 4 GA_E£. HeagicA. pus, app, a. RES. ADD. 332. B¢inout Ay LRA? CcKTeAl AAS Sa 2 Mas..£aa a B YATES pus, adv. a. ADD. Bilis BagrewT. Ay aoc Tat MASE». “Latent fare ily { _ RES, ADD. 238. Foarsr_Aty Brscurss! C1Asf._. 8. ALR. SOWARD HAVNESSY pus. (Aig h boy for Many Years “8. AUD. ». 10 Bowl Avs Baas reat LASS Doe "BEC. 19. FINANCIAL BACKGROUND ; “A. ARK YOU ENTIRELY DEPENDENT ON YOUR BALARY? YES OF OTUIERYINCOME —_ ee Mit WHICH YOU HAVE ACCOUNTS _F& 8266 58. , B.. ‘NAMES AND ADDRESSES OF BANKS WI LEANING 5 BONN, ot LIAS SE BRIO AM, LIB LS A 2 ne C. HAVE YOU EVEN BEEN IN, OR PETITIONED FOR, an GIVE PARTICULARS, INCLUDING -COURT: a iF NOT, STATE SOURCES . GIVE THREE CREDIT REFERENCES — IN THE UB. NAME MA SAU C, BEvd£0T. appness 28 2_ 2 Gasca Sr, Beacxram, Mass. NAME AIS. HAAOiNG E _SRATER ADDUESS Le Kies. wean Av, Zaacxradly LIAS 6. NAME, Aa Wingiam €. NYE ADDHEBS mehr Be tented gigs. roo oho BEC. 20, RESIDENCES FOR: THE PAST 15 YEARS prom L223 to 1927_ ¢Meslee Si,ftcultd, ASS ‘su SA. 7 Lak Ro, if From JjaZ___ ro 1773. ous diy aac ase loked if . ; OT prom L213 no LEY U5 MIRA oe - ae From 124-0 L950 alg BEL. fear Av. Bivacl Ton Yo ai Cass. U.S.A). = F “Se a el ROM Man 194le.-r0 we Aur Yay Un. sewsavesl Cou US. a we EE — Z deviny * rromligv2.. ro L769 | _4¢ MELROSE S Ta ARLIM MG Lad tIASS LSA - “4 SEPT. re oars Sach year t Me. ee MAGEE... we bh Rs i 1 eer encore arrar mamana en Era momenta FROM — city Gitete Country! TB, Me, Me tat = Ov by te ae — ~ os Levene : FROM 5» sa - — EE ae BEC. 21.5 _-RESIDENCE OR TRAVEL OUTSIDE OF THE UNITED STATES Nome - ef, - A. FROM — - City orbecilon.—s~s~s~SC rg a Parpeee : ~ _ ROM cogil ae FRO City or Gection Country ‘ Purpose ag EEE ae FROM oO ES — 8 .