14-00000 ates be 51% S ‘a qi ble f 5 h ra _ fed 7] . : 7 Bir’ Lbs © ps f 58 38 z & x3 -. 7 GC Vig 7 § a
14-00000 amended, Dear pieansaRes ee Reference is made to your contract with the United Statea Goveramont, . as represented by the Contracting Officer, effective 1 August 1954, aa : Effective 1 January 1956, sald contract, ae amended, {a further amended by deleting paragrapha one (1) and two (2) and all reference to . Federal taxea and substituting in lisu thereof the following: . 1, Compensation, In full consideration for the purchase of certain _{aformation aud servicss, yes will receive from the Goverament, payahie ba such an approved manner aé you may direct in writing, the followiag: (a) Compensation calculated at the rate of $5060 per annum; and . (b) Additional compensation for quartors procurement for you and your dopendenta presently calculated at the rate of $2575 pers annum ‘and applicable only to your initlal permanent post of assigument overe 7 seas, Aa this additional compensation ie based upon quartera costs -at said post, it is. eubject to unilateral adjustment by the Government whenever warranted by a change in the factors affecting its initial establishment, Cuarters will not be furnished you by the Government nor will you accept quartera provided by your cover facility without prior amendment of this agreement; and ; 7G ! (c) Additional compensation for cost of living expenses (other 4 than quarters) for you and your dependents presently calculated at the rate of $1920 per annum and applicable only to your initial per- manent post of assignment overseas, AS this additional compensation is predicated upon the comparative cost of living between Washingt an, D.C, and your overseas post, your cover, family status and basic compensation, it. is subject to unilateral adjustment by the Government whenever warranted by a change in the factors affacting its ‘original e stablishment. 2. Taxes. (a) As your logal relationship to the Government is that. of an independent contractor, all amounts paid directly or guaranteed by the Government under Paragraph one supra, are reportable as income under ‘existing Federal income tax laws and regulations. ; . ; . (b} In view of the security considerations involved, the . Goversment agrees, at your request, to withhold Federal income taxes from the monies due you under this agreement in an amount equivalent to the United States income tax withholding schedule based upon your taxable income here- ender and ‘present examption(s), Sums so withheld will bs paid over to
14-00000 4 \ - _. the Internal Revenue Service, You acknowlédge that this is an accommodation | _ “on the part of the ‘Goverament and does not release you from fulfilling your vo obligations under existing Federal incowe tax‘laws-s nd rdgulations, You will | _ be. instructed as to tho method to be followed tn taking timely {iling of returna, : setimates and payments in order to preserve security, ~ mS - 1 "AMD other torme and conditions of the contract, a8 amended, remain ‘fn-full force and effset, _ SC a | You will please indicate your approval by signing in the epace provided . \ \ : ' | 7 , UNITED STATES GOVERNMENT BY ; Contracting Officer APPROVED: _ ve i iH « Stennett reese nese
74-90000 SECRET Déar Mr. - ¥oeoiemoms ss Reference is made to your contract (asm agaudad) effective 1 Awgua 1994 / with the United States Government, as (represented by the Contracting Cfficer, for the (purchase) teuhe ‘ ssatuoantocrs). of information and services of a confidential nature. a Effective 3 January 1955, said contract (amanxnsad) is ’ (asieieer§ amended by deleting thercin all reference to your pay- ment of Federal taxes and substituting in lieu thereof the following; "While it is recognized that you are an independent contractor, the Government at your request and in view of security consid- erations involved agrees to withhold from the monthly taxable income due you under this contract which is payable on and after #January 1955 amounts cquivalent te the United States income tax withholding schedule based upon — (ee-c present -axemption(s). Sunve so withheld will be paid over ta the Internal Revenue Services. You acknowledge that this is an accommodation on the. part of the Government and docs not telieve you from fulfilling your obligations under existing Federal income tax law. and regulations. You will be . instructed as to the method to be followed in making timely filing of returns, ustimates and payments in order to pre- Serve security." . All other terms and conditions of the contract (eesapmombed) es . _ remain in full force and effect. ; You will please indicate your approval by signing in the spac provided be low. UNITED STATS CF AMERICA ts. o Contracting Officer ACCEPTED: a ee aera arcane ATED ene SNe tT TT AED . . favide tf, WEY NESS: 7 ‘ APPROVED; cise ? aed ,eaornt Seeney
14-00000 e Office Memorandum UNITED STATES GOVERNMENT. Le Ri SPAROAND PORE HO. Y is mea , aya TO Fs SCO (Miller) DATE: 23 yaly 185u FROM :  Srecial wae, tarts Medical Offies- p SUBJECT: hate Subject has been evaluated by the Nedteal Office and Cound physically qualified for full duties (saneral). _ Aurbnistrative Offiear MO, aJ0ijs . Distribution: Oris. + Adiressee Lo = w/z : 1 - File ‘ al
14-00000 \ Reference {a made to your contract, as amenddd, effective 1 September 1953 with the United States Government, aa répresented by the Central Intelligence Agency, for the purchase of information and services of a confi- ; dential nature. consent of the parties thereto and in leu thereof the following contract le \ i i i i | i i i | | i ! ! | 7 : | Effective 31 July 1954, sald contract is hereby terminated by mutual Po ! | substituted: _ . i | i ! i Agency, hereby contracts with you for the purchase of certain information and related services of a confidential nature under the following terms and conditions: The United Statea Government, as repreaented by the Central Intelligence 1, Compensation, In full consideration forthe purchase of auch infor- mation and gervices, you will be paid an amount calculated at the rate of $5060.90 per annum. Payments will be made as directed by you in writing ‘in a manner acceptable to CIA. No taxea will be withheld from: this amount, san ol me tt exieting = Padaw st earn ane mR D mee wae . sabe 8 oe ~e wis ob cares hred POEL TaSPGHSiceey 6G PSPST. SLs sMooms unase income tax laws and regulationa. 2. Allowances. Effective upon your arrival at your permanent poat of duty overseas, you will be entitled to: (a) A Cuarters allowance equivalent to that granted a GS-9 Government employse stationed at the same permanent This allowance will be at the maximum rates prescertbed in No post of duty. . the Standardized Regulations (Government Civillans, Foreign Areas). | | accounting for thia allowance wil! be required by CIA. In the event that | Quarters aro provided by your cover facility, you will not be entitled to the | 1 Quarters allowance herein indicated. (ob) Cost of living allowances in | conformance with the Standardized Regulationa (Government Civillans, — | Foreign Areas). You will be advanced or reimbursed funds for the follow- t | | | 3, Travel. | ing travel and transportation expenses: | {a} For you from Washington, D.C, to your permanent poat of duty overseas. I (b) For your dependents and your household effects from your old to your new permanent post of duty overéeas. i . | _: {c} For you alone for authorised travel within your operational area. permanent poet of duty overseas to your place of recorded residence i i (4d) For you, your dependents and your household effects from your i | upon the satisfactory completion of the terms of this contract or any renewal thereof, sf . i *
14-00000 ‘ + ‘You will entitled to per diem in lieu of subsia:ence in the course of auch travel. | All travel, trangportation and per diem provided for under this paragraph muat be properly authorized, and expenses incurred hereunder are Subject to. paye ; i tfment and accounting in compliance with CIA regulations, io “4. Operational Expensea, You will be advanced or. reimbursed funds for | ‘necessary operational expenses including, but net limited to, tuition, bdoka, $ " entertainment and the purchase of information as specifically approved by {CIA, Such funds will be subject to accounting is aubstantial compliance with CLA | Fegulations, i 5. Benefits, (a), You will be entitted ta death and disability benefits egual to those authorised under the Federal Employees’ Compensation Act, as amended, Claims by you, your heirs, or legai representatives under this with ites procedures in such it ; Paragraph will be processed by CIA in accordance manner as not to impair security, | . (b). You will be entitled te-continuance of pay and allow- ances In a manner aimilar to that set forth in the Missing Persona Act (50 U.S,C.A., App. LOOL-1015). | (c) ‘You will be entitled to fourteen (14) calendar days! H leave per contract year. Sich leava may be accrued during the termof this tract or any renewal hereof but payment in lieu of unused leave will not @8 and places approved in ! cen I be authorized, Such leave may only be taken artim advance by appropriate representatives of CIA, i i 6 Cover, It is anticipated that you will undertake certain cover employ4 i j ment in the course of your performance under thia agreement, It is expressly | i understood and agreed that any and all dscomests which FOU Way Saccuie in i || the course of such cover employment are subordinate to thta agreement and | any contradiction tn terms which may in any way amplity, extend or restrict | your rights and/or obligations hareunder shall be segolved by this. agreement | which shall always be dominant. j i j 7. Offset. Any sume or substantially similar benefits or allowances vecelved from your cover facility (if you use the G.I. Bill of Rights any an allowances recelved by you under gaid bill except tuition payments) will be ; used to offset thoae due under this contract by the Government. Sume, : i similar benefits or allowances thus received are acknowledged and agreed i i to be payment by the Government within the provisions of this contract. Yeu . 1 will report all gums or substantially similar benefits received at least every | six (6) montis during the term of this contract, : 8. Execution of Documents, If, in the periormance of your cover ger~ vice, you assume the custody of government funds or take title of record | to property of any nature whateocever and wherever situate, which property i has in fact been purchased with monies of the U.S, Government, you hereby i pecognize and acknowledge the exlatence of.a trus: relationship, either express or constructive, and you agree tc execute whatever documents may be required by CIA to evidence this relationship, we ew i th . : H 9. Statue, You are not an employee of the United States Government | under this agreement and are not entitled to any benefiza normally incident to an employes atatus, except as specifically enumerated herein, 10. Secrecy. You will be required to keep forever secret this contract | and all information which you may obtain by reagon hereai (unless released i in wetting by CIA from such obligation), with full krowledge that violation
14-00000 Le fpr arrilysy cn. i: lh, Inatructiona, Instructions received by you from CIA tn briefing, . i 42, Unauthorized Comrnitments. No promises or commitments pertatne. ‘ ‘ing to rights, privileges or benefits other than those expressly stipulated in : | (d) W ithout prior ‘notice, in the event of a breach of thie contract by | i . - . : . . Re bie -of such secracy may subjact you to criminal prosecution under the Eapionage Laws, dated 25 June 1948, ag amended, and other applicable lawa and rogula- ‘ Hons. 4 _tralning or othomwise or. 5 part cf thls rostract and ere incorporated herein, PFs vided that such instructions are not Inconalstent with the terms hereof, owelting in ‘this agreement or any amendment thereto ahall be binding on the Government. ; . ' an . ‘| 13. Term. This contract {s effective as of | August 1954 and shall at ,continue thereafter for a pertod of two (2) yeara unless sooner terminated by iCIA elther: . . i i {a} By thirty (30) days! actual notice to you from CIA, or your violation of the security provisions hereof or by. your other- wise rendering yourself unavailable for acceptable aervice. _ ‘Subject to the availability of appropriations, this agreement may be renewed ‘for successive periods of one year each upon notice from CIA accepted by you. ‘In tho event of veluntary termination for cause by CIA prior to expiration of jthia agreement or any renewal thereof, you will not be entitled to return travel ‘expenses to the United States. Termination of this agreement will not release you séG1m ine viligations wi any security oath you may be required to take. - UNITED STATES OF AMERICA BY Special Contracting Officer Tra ecennmen edatanane arcmin tee ns an ee pete er ct ee 7
‘ _ Reference {9 made to your contract effective 1 September 1953 with the United States Government, a8 represented by the Central Intelligence . Effective 1 Decernber 1954 said cantract ig amended by adding the. following paragraphs to said contract: “14. Benefits. (a) You will be entitled to death and disability i “benefits equal to those authorized under the Federal Employees' : Compensation Act, as amended. Claims by you, .your heirs, t or legal representatives under this paragraph will be processed by. CIA In accordance with its procedures tn such manner aa nat to impair security. ass “(>) You will be entitled to continuance of pay and allowances ina manner almilar to that set forth in the Missing Persons Act (50 U.S.CLA.. App. LGO1-1015). © , All other terms and conditions of the contract remain in fl force and effect. ; You will please indicate your approval by signing in the Space pro- vided below. sry RY Spectal Contracting Cfficer ACCESTED: i i ; i H j i i MLE/pr ll Dec 53 Cc. A. “Agency, for the purchase of information and services of a confidential nature.
fpeedel Contracting Officer 5 Yareh 1954 Fi/Qia/ Agent Service Section Mosanseorts is Vigna ie Woe OFfeet Clause 1. Forwarded herewith is a copy of a remorand:> . received in this office fron WH livision which reflects. that the Subject is atrercing school uncer the GI bill. 2. In light of the Veterans Adnind stration regulations recarcing ertitlerent to allowance berefite uncer thia bill, it aprears that the offeet clause of Curfectts contract should ba amended to reflect that ary suma received (excepting tuition paymevts) due to his etudert cover are to be offset from compere gation and ellewences due uncer the terma of his contract. Chief/Agent Service Section ATTACI Ta] ect Fero csted 26 Feb, 1954 FD/O&L/Agent Service Section/O3K/is ra
14-00000 i. 4 pep vey Poe SECRET Ul , ° ra ta Dates Reference is made.te your contract effective 1 September 1953 with the United States Government, as represented by the Contracting Cflicer, for the purchase of information and services of a confidential naturo. oe Effective | Septermber 1933, said contract-is amended by deleting paragrap 7 entitled "Offset" in its entirety and substituting in lieu thereof the following: "7. Offset. Any sums or substantially similar benefits or allow- ances received from your commercial cover ani any allowances received by yott under the GI F:U of Righte exce;t tuition paymenta will de used to offset those due under this contract by the Govern- Ment, Sums, similar benefits or allowances thaa received are acknowledged and agréed to be payment by the Government within the provisions of thiy contract. You will report all sume o- , -gubstantially similar benefits received at least every atx (4) moanths during the term of thig contract," Sr ee Scat eraemstahemns All o:her terms and conditions of the contract remain in full foree and - | H oifeci, | You will please indicate your approval by signing in the apace provided i below, an , i ] | ; UNITED STATES OF AMERICA i 1 | BY: Seecial Contracting Officer i Uh wlasrerey . oo a 2S SULCEBSY/ LUNE PP _ . ce aed X 26o0 | | | ; i
14-00000 ~ ed | Office Memorandum ‘© UNITED STATES GOVERNMENT To : Special Contracting Officer . BATE: 45 March 195% FROM =: FD/CéL/Agent Service Section : aretd. gL. Zetcrnnap cei CEVEEEE. oftect Clause ' (1. Forwarded herewith is a copy of a memorandum received in thie office from WH Division which reflects that the Subject is attending achool under the GI bill, SUBJECT: 2. In light of the Veterans Administration regulations .regarding ertitlenent to allowance benefits under this dill, it appears that the offset clause of Subject's contract sheuld be amended to reflect that any sums’ received (excepting tuition payments) due to his student cover are to be offset from compen- sation and allowances due under the terms of hig contract, — AYA ie A KE 6. B Cah Chief/agent Service Section ATTACIDENT=1 ces Keno dated. 26 Feb. 1954
‘MEMORANDUM POR! % soe, eh tg ~ Sao wr 8 baa eu ay 26 Fobruary 19S Chi f, Avent pervies Section | SStbatawaneea (1S) Fidances ‘Disoussion between Mre Hanke and Mr, Kline on 26 Feb Si. | 1. Gontract agent Arthur G. YAIVADA, a veteran of World War ii, is presently under an official cover for WH during which he ie attending school under his GI benefite. Ze ‘It is requested that your office inform WH, and the Gontraot Divieion if necessary, as to the necessity of deducting hig OL allewancea (but not tuition payments) from his selary paid 3. Further quostions concerning thia request should be directed to Mr. Esterling or Mr. Hanke (x3581). ‘de Ce RING Cw
74-000007* a ae ay C1240 (Youngblood) Chiaf, Special Contracting Allowances 5 January 1953 and Processing Staff ; . : Chief, PI/Plans/Caver MPA and FECA Protection for Vincent C. PIVALL (p) 1.. Cover Division approves MPA and FCA protuction for Vineent C, PIVALL (p) since a lovical plan for channeling any proceeda tc his bom: fictaries has been agreed UPOR. ; 2, We sre not.in a position at this tima to approve such protection for Arthur 6. VAIVADA under Project PBSUCCESS, since 4¢ 19 our understanding he is not presen ly operating under _that projeot and no cover plan has beon devised for him as yets 3, Gover Diviston approval will te contingent upon the sover plan devaloped and the feasibility of secure channeling of possible. proceeds tg “VRENAEA"S beneficlariegs... Te neti. te ee Ajtteon tse! At
14-00000 stituted: conditions: ‘duty. This allowance _tleu of subsistence during auch trave! and w _ you will be advanced vf “y o Nate: Sar at ALK De tcon ag es Date: Mr, (eohentreVutvads | , Sefarence is made to your contract effective 1 June 1949 with the United States Government for the purchase of information and services of a confidential nature. Effective 31 August 1933 paid contract ia hereby terminated by mutual - consent of the pacttes thereto and-in lieu thereof the following contract ie aub-: The United States Govetnment, ag represented hy the Central intelli- ‘ y. hereby contracts with you for the purchase of certain informa.” ture under the following terms and Ro gence Agene tion and related services of a confidential na 1 ‘> Campensation. tn full consideration for the purchase of such infor- mation and servicea, you will be patd an arrount calculated at the rate of $4200 per annum, Payments will be made ae directed by you tn writing in a manner acceptable to CIA, No taxes will be withheld from this amount. and it will be’ your responsibliity fo report such income under exiating Federal income tax lawe and regulations. i 2. Allowance. Effective upon your aretval at your permanent post of duty overseas, you will be entitled to a Cuarters allowance equivalent to that granted a GS-7 Government employee stationed at the same permanent post of will be at the maximum rates prescribed in the Standard- zed Rezulations (Govarnment Givilians, Foroign Areas). No accounting for . this allowance will be required by CIA. In the event that Quarters are provided e Juartere allowance here- by your cover company, you will not be entitted to the 2 in indicated. i 3. Travel: You will be advanced or reimbursed funds for travel and your dependents and your household effects . of duty overseaa and for you alone for author- You will be entitled to per diem in hile in training in the United States. All travel, traneportat‘on and per diem provided for under this paragraph must . be properly authorized, and expenses incurred hereunder are subject to pay~ ment and accounting in compliance w th CIA reculations. transportation expenses for you, to and from your permarent post lged travel within your operational area. 4. Qperational Expenses, in addition to the allowance indicated above, or reimbursed funds for nacessary operational expense’ including, but not limited to, entertainment and the purchase of information a8 specifically approved by CIA. Such funds will be subject to accounting in sub- stantial compliance. with CIA regulations. , 7 { : 5. Leave. You will be entitled to fourteen (14) calendar days’ leave 7 Such leave may be accrued during the term of this contract ment in eu of, unused leave will not be authorised. din advance by per contract year. or. ary renewal hereof but pay Such leave may only be taken at times and places approve Appropriate repreeentatives af GIA. l 6. Cover; [tis anticipated that you will undertake certain cover i employment in the course of your performance under this agreement. It is expresaly undereteod and agreed that any and all documents which you may execute in the course of such cover employment are gubordinate to thia agreé- ment and any contradiction in terms which may in any way amplify, extend or reatrict your rights and/or obligatione hereunder ghall be resolved by this agreement which ohal! always be dominant, oo
DHL/pr 8 Sept 53 CA. 7. Otfeet., Any sunis or substantially similar benefits or allowances received trom your commercial ‘cover as differentiated from your, atudent cover will be used to offset those due under this contract by CIA, Sume, similar ” property of any nature whatsoever and wherever situate, in fact been purchased with monies of the U. 5. Gevernme ‘ nige and acknowledge the existence of a trust relationship benefits or allowances thus received through your commercial cover are acknow- ledged and agreed to be payment by CIA within the provigions of this contract, You will report all gums or substantially similar benefits raceived from sald commercial cover at least evary six months during the term of this contract. §. Execution of Documenta. lf, inthe performance of your cover sere vice, you assume the custody of government funda or take title of record to which property has nt, you hereby recog- » either express or constructive, and you agree to execute whatever documenta may be required ; by. CIA to avidence thie relationship, - You are not an employee of the United Statee Government 9. Status. and are not entitied io any benefits normally incident under this agreement to an amployee status. iG, Secrecy. . You will be required to keep forever secret this con- tract and all information which you may obtain by reason hereof (unlesa released ‘in writing by CIA from such obligation), with full knowledge that violation of ; auch secrecy may subject you te criminal ~ dated 25 June 1943, ag amended, and othe prosecution under the espionage lawa r applicadle laws and regulations, LL. Instructiona. Instructions received by you from CIA ia briefing or: training are a part of thie contract and ara incorporated herein, provided that . such instructions are not inconsistent with the terms hereof. | Commitments, No promises or commitments portain. l2,. Unauthorized ta Ing to rights, privileges or benefits other than those expressly stipulated In ' writing in this agreement or any amendment thereto shall be binding on the | Government, 13. Term. This contract is effective as cf! September 1953, and shall continue thereafter for a period of two (2) years unless sooner terminated " by CIA either (a) By thirty (30) daya’ actual notice to you from ClA, or (b}) Without prior notice, in the event ef a breach of thie contract by your violation of the security provisions hereof or by your otherwise rendering yourself unavailable for acceptable service, | Subject to the availabilicy of appropriations, this agreement may be renewed for successive periods of one year cach upon notice from CIA accepted by you. In the event of voluntary termination on your part cor termination for cause © by CLA’ prior to expiration of this agreement or any renéwal thereof, you will not be entitled to return travel expenses to the United States. Termination of thie agreement will not release you rom the obligations of any security oath you may be required to take, ACCEPTED: UNITED STATES OF AMERICA BY errs Special Contracting Officer fs APPROVED: ey nse tetera penne,
a TN som _ weal — SECRET “SECURITY INFORMATION COVERT. PERSONNEL SERVICES FORM JOB SUMMARY — Division wi/TIE ae ’ Project _ BPH moe , . Case officer i. Ls Haleoln ae Date ear ee Atv e an 1) (if this information is contained in an approved Project, this form need not be completed.) I. Duties:. (General Description of the Duties to be performed) Penetration of the Cuban Commuidst Party and Communist fronts at the Universality of Havanas II. Qualifications: (Indicate qualifications applicable to assigned duties) ‘a. Experience: your yeara experience as a contract agent in WHD “ y. Education: (Check) High School College__y. Post Graduate c. Language: gngiish and Spanish = fluent d. Other: . III. Present job and salary: Formerly received 44205 plus allowances. fhis is to be raised to $5060 per annua plus allowances under new contract. Iv. Cover Activity: PROPOSED ESTABLISHED (Crose cut one). Give general deacription, i.e., Proprietary, Subsidized, Cultural, Educational, Commercial, Nominal, Military, etc. Subject was under atudent cover in previous project. This cover will be continued in the new project SIGNATURE OF PROJECT OFFICER "SECRET SECURITY {MFORMATION ds WHD/IIT (4h.
14-00000 IT. Til. Iv. Vi. VIT. VIII. IX. x. XT. XII. .A. Duration (Days, manthe , years) _eWO years = 3B ‘ 7 . a ‘ . : ise Office henna Tel. “Ext. ar al | _2 ay isk CONTRACT INFORMATION AND CHECK List Pte—224 ‘, . General Peretick Vinten, oa _ _ . A. Pseudonym _sepgameree ‘B. Progect AMPUQQARGH ©. Allot. No. 3517-21h D. Previous CIA Fa eudenyms or Slinger eee eee E. Category (Contract Maploree, Contract Apex: etc.) Contract Acent a ‘F. Is individual presently engesed or has he ever teen engaged by CIA om its allied activities in any < spacity? lea. te Tescr ite__Cankract Agent since 19h¢ Security Glearaner Tie Dn —e eo G. Security Clearance: . Type _Crerational _—s Te va ate #2550721 daly 1954-— ‘H. Permanent Post (city and Country) inven, cba Personal Data A. Citizenship UsSe B. Age _-32 Cc. Military Status Fstaren D. Legal Residence (ctty and Country) Siex Lins, Illinois E.. Current Residence (City ana State) eoene PY) 'F. Previous Years of Governtent Service (Militece and Civilian). over 12 years G. Has a draft deferment been cttained by CIA?__jone needed Compensation © oo Sn COVER | A. Basic oe ** 5060409 $ B. Additional (Post pitforential) - : $ C. Profit participation or "bonus » $ —————_-__—. $ D. Total cert ee -$ 5060.00 $ Raa Se Seca lag Allowances : ” “(ornliy sranted only to residents of the United States) CIA: COVER A. Living - Quarters $ ——Lina____ $ ( ) B. Cost-of-Living $ — $1500 0G) C. Other $ $ 150 (fransfer) ( ) D. Total $ ; ( ) E. Basis (1). (2) 5) Payments What portion of compensation and} or allowances will de paid by cover? Hone Operational Expenses ; : A. Purchase of Information: _ . B. Entertsinmmen C. Use of Personal Vehicle Basis D. Other Cover Ex enses _{niv. w:ition Foie ete.) Voera, raved Travel , A. With/without Lependents B. -Eousehold Effects _§. C. Personal Vehicle D. If With Dependents, atate og onsnip, Citic exship and birthdate of children: l. two ehil: ren, both J. eitizene , 3. born-in i949 and 15) respectively E. Expenses will be pald by: Cover CIA x F. Basis: 1. Per CIA Regs _X 2. Sub. Complisse 3. Other Transportation to Yuba for VAIVADA and family Miscellaneous Benefits oo, : Death Benefits: Per F.F.C.A.. KX Other A. B. Disability Benefits: Per F.r.c.a. 2 other ¢-. Missing Persons Act _ 2% BD. Life Insurance. =. Rospitalization F. Annual Leave OA OG. Sick Leave _& . 3. Creditable Service “TI. Rehabilitation Rights : J. Cther Term fective Tate ec. Renewable: Yes% No OD. Termination Not (No. of days) E. Forfeiture of return travel fcr resignation price to Contract Term: YesZ__No__ _ Will individual take title to CIA rroperty? yesX_ To Will individual work under “controlled conditions”, i.e. set office hours, supervision, etc? Yes. Nok Additional or unusual requirements, Justification: cr explanations he ere PREM Beaecare HIPs wet ervie cc grec rte