14-00000 i 33 Ee: ? + 1 MNO RL Seam re ae aM is) es Baba Loe a ad U t 5 et SECR ET = lp Security Information sq SEC. I. WORK EXPERIENCE (CONT'D) 3. Special Work Experience: Check any of the following organigations by which ' you may have been employed, G1 U.S. Secret Service 2 Civil Police ®3 Military Police . G4” U.S. ‘Border Patrol. 0s U.S, Narcotics Squad _ 667 BL Osan _21 Office of Naval Intelligence 22 Office of War Information 23 rrriy Geo2 20 —ottice of Strategic Services ears SEC, Il, FOREIGN LANGUAGES ke LANGUAGE ® if you have cheeked ‘Fluent! for a bingna explain vour campetenec herein and erithan farm fe.g., Arabic), TNR we eR + oe SRDERAR 2 RITE ah EOS STREETER ET EOE EUR AE ES OER pit a Yea! arto AFapetiaeee eee “guage bor vipelonea: “Pietcribe abihty to da Specialized langua lanyuade oF" “Criminal Investigation: ‘Div. ; [Equivalent 40 24 ~=Air Force A-Z 25 » Foreign Economic Admin. “Counter Intelligence Corps ~ Immigration, ‘& Naturalization 28" Strategic Services Unit: Pee ae . 29 Foreign: Service, State Dept. | 30. Central Intelligence Group” ; 31” Armed Forées Security Agency 32___ Coordinator of Information ~ 33___Office of Facts & Figures. : 34___Board of Economic Warfare ~B__Federal- ‘Communications, Comm. 7 ae “4, List-below the foreign languages in which you have some “competence. - Be gure to- iaclude uncommon modern languages. Check:( X)- your competence and, how acquired, @ > & co} 3 : ma © = u Be g $ 37 on oo , OO % bs ra . that bas significant Wilference in spaken AOA SME eR er SO RR ATES AO sav WOrK tavelvieg veeathitaries and terminslogy In the scientific, eaginestiag, (elecomniuni- tatiunes,, and military fiacidea. ‘Ree rve “ca AY ph ADI Delp EY TEE ah TONER WORE OTTOTT Liat the language with the type of speciality. Security information nag Near a LO AEST TEESE 4 zh aes whe tee 4 ate
14-00000 Site te apd. ee core anh habe Sem sett 7 . . scone A EE ELT ONC NTT NS Liettchae were 14 SECROT Security information SEC. 1V. AREA KNOWLEDGE List below any foreign countries or regions of which you have knowledge gained a» a result of residence, travel or study. Study can mean either academic study, of atudy of a foreign country resulting from an intelligence, militar he commercial or x professions! work i. List épécalized: knowledge - -of foreign country such. as knowledge of terrain, s a coasts. and-harbors, utilities, railrdads, industries; political parties, etc., |” gained aé a result of study ¢ or work - assignment. ; Include naine of. employer . or OF3 anization, ; : _ . ‘Prefer ‘Assignment Using Skill Oitcner [ES Cento o iTime Used Speedwriting. SEC. VI. LICENSES, HOBBIES, SPECIAL QUALIFICATIONS 1, Licenses: Last any licenses or certi- [é. Hobbies: List any hobbies such fication such as teacheis, pilot, marine, as Sailing, skiing, writing, or etc. other special qualifications. Music (collection of record! and study of subject) SEC _ Vii. PROFESSIONAL AND ACADEMIC HONORS [ List any professional or academic associations or honorary societies in which you hold merabership. SECRET 2) Security Information eB A meta anche ane mde act Ret mane
Pp & e “pd, + - f° we an ~ * Saal Tae, a ~- : 4 . # xy 7 Jag, ~ ae - Pen os ‘SECRET a se) Security Information eS: SEC, VIN, PUBLICATIONS List below the type of writing (non-fiction: professional or scientific ‘articles, general interest subjects, current events, etc; fiction: novels, short stories,otc.) of any published materials of which you were author or co-author, ' SEC. 1X. INVENTIONS ee ; Deéescéibe. any devices you have Anvented as to type. of work for which Intended ~ ed. . and whether. : _Describe below the t De 2 of. tests. which. ou have taken in CIA: Some ; SEC. XI, PHYSICAL HANDICAPS List any physical handicaps you may have. SEC, XI, OVERSEAS ASSIGNMENT Are you willing to accept periodic tour of duty overseas? 2) 4 year Tour (3) Not intcrested SEC. XU, WORK ASSIGNMENT In view of your total experience and education, for what assignment in CIA do You think you are t best veut qualified ? Fenl qualifiod. in peanen ‘atadus ich al one for moral grosth ase VEDLSLON rconoletion of field nssienerth wil] reassess status 00 ba OL Bat Bomnest tortinue sperializat george le a YY ” ota atraieh a} = wee ) e ig £2 ded te Share gp a field and at Nashingto headquarters SECRET Security Information
eh we. ye bb en, on 2 vate qt ae 7 . SECRET i - oo Security lnformation { SEC. XIV, MILITARY STATUS Preseat Dralt Status Have you registered under the Selective Service Act of 1948? oes W@ yes, indicate your present draft classification LWA Ne. “Present Reserve or ‘National Guard Status ~ Cee ° : - . a on .Do you how have Reserve or National Guard Statad Wve, x: ‘No. : Ht yes, complete the ‘following. on, woe i | ~~. National Guard 0, 1 “2. ”_Air National Guard. - : 3, ~_Active Reserve Status (member of organized unit) Verte meena sean Som DR gy 4, __inactive Reserve Status | Service _ oe _Grade Location’ ; Reserve Unit with which currently ‘aftiliated = GR. ited av vnrcre cere Memes eam on | Service Mobitization “Asélgnment, if any SEG, XV. chat TRAINING | List the training courses. or subjects you have taken while in the CIA. Course ‘or Subject- SEC. XVI. REMARKS Use this’ space to indicate any other qualifications you may have which you do not describe above. Met ae Mantel Sane DATE 1 November 1952 SIGNATURE Bribie. ? 7 Edi bell SECRET <7 Security Information Sis 7 met
14-00000 ‘ : 1 ete RA re teed erat aie emer nomi mireemnetibe me RANDALS, Frederick Ce ~ = rt STATEMENT OF FEDERAL CIVELIAN AND MILITARY SERVICE PORRECE way SERVICE (IG BRANCH OF SERVICE Il hereby certify that the above Civilian and Military and accuret: ic the best of my knowléuge. 72. ditcemnbee (95S Gare {CONCERNING ABOVE SERVICE 5 " Way BE OC atte oo oe MONA OT arm awkE MEVTASE S16E EE Po ETO ISSD — : PLEASE wnh® SHGTRUCEION -BNBAT BRPORS FEAPAGING ..83 FORT : see wm Sota epee at a ne SIGRATURE OF EWPLOTLE Hiei $tOe FOZ service ts cont . ra eo My nih and pee aah
she Pop betere ne He eek epTpriT 4 aatb ernie seapteangetn ¢ TR ee NAME ona oak a BoM ashe Wo enaabadBeeire te 0 sat « Petty PBS Mal oe caene vanaen WY ce ONE Rt + deeme bob teats > Mee eee r eR ot, : inictenge cinta nomemaerentsiss ‘iat uel ei ab 4  inerRdcr ont peri rar Senet ne, EA! RaRi Ta OTATU. RESIDENCE AND DEPENDENCY REPORT aw a aan * soe eg 37-79 BATE Jus MARRIAGE ine 3, Sear 1 1951 Suomit, ine trips icate when ordezed overseas: aed. ahénever Gesignated: piace of resigence of sarital or aMPoRTant: in Getermining | travel ex ; ton, and. : StGuarurg whe CO Cayilelp | res @
6. ‘ABFIDAVIT AS: 10 STRIKING ‘séanist THE FEDERAL GOVERNMENT. a _ APPOINTMENT APFIDAVITS . re IMPORTANT.—Bofore swearing to these appointment aftidavits, y ou shquid read and uriderstand the - Tam not erigaged i in any strike against. the Government of the United States and that I wilt not - 60 engage while an eiiployee of the Government of the United States; that I am not a member of _&n otganization.of Government employees that asserts the right to strike against the-Government | “of tie United States, and that I will. Trot, while a Government employee, become a member of suchi - mee. an organization. ve oo ' D. “AFFIDAVIT AS To: PURCHASE AND. SALE oF ‘OFFICE I have not paid, or offered ‘er’ ‘promised t to pay, any money or other thing of value to any person, firm or corporation for the'use of influence to procure my appointment. E. AFFIDAVIT AS TO DECLARATION OF APPOINTEE . ; . The answers given in the Declaration of Appointee on the | reverse” of: this f form are true and Metre wor mL, a ae - ~ oat . ow ameee Snes rrr errr rete Soret iro.) “(Cetad NOTE.— If the oath is taken before a Notary Public the date od expiration of Ais commission should _ be shown. . ro~eane-e’
14-00000 a irat ion, will be grounds. "tor cancelle ¢ cfininal offence and will'bé Piceecutéd accordingly. Geren ae : 2, co.You a acti . COLUMBIA GOLIANME NT ‘ ~ GENER COMPENSATION [ORs - char 4: ‘ ow 3 iv qa ban retiremess. pep, f f eta aR OER + nae nena ae sere wn tmdepe tet made eager: - } if retuned teoen mulitary ? — end a cca heasenoaaines pen ; ick your answer Yee", divain leam io. the ine dod atthe. f employer. date and sonaon r?) éach,6 . ttss) SINCE YOu FILED APPLICATIGE, ALSU TING UA Te Soot oer Hf your answer is ““Yew', List all ouch:casss sander Fteery £8: Quve in oachpase: (4) Ths, dais; (1). the fatare of ese tas |, oF wroiation; (3) fhe reef ‘Bo: of Pe penalty tmiposed, 284%O8 a appointerds your Bracco ate" alt be taken, a : . INSTRUCTIONS 30 APPOINTING OFFER P. —_ Y ~ af : : . The ppeciasing: officer Before whond the farrgsing cvctificate Is made shall deters ef kus owed set factlpn that th: ERS evubllte la confarméats sith she Cw Covel Service Are, oppileable C2 wwe Rake‘ aady » Requiatsorta ead te cate @: », get aining 19 oppont ment, SY CF senshiz The agercin intlng. affect ts rrapensible “bor obterving tbe Thue ferra cern sisi tec rcked for busting of offices, prencn, guiteblity te acer ao 2 Froyrtiees of the Cri Service Rales emt (7) aprengnutind pecs! of Pk PRIA gay rota. of socenk duchearge ag aren, ud pesticularty far the Bore 0% cwmtiulss am afidant for bech purp-see aml te av epe stb . ‘ ge citiceomhip stots te the hens Of canes ti nq eee. fa duytefal Saeee inated . aca. cteergiact hes ‘bern eecastad Grace (tt Hentity af apzontes.tt is Use duty of the appcinting after to eppun ment thnetd gut te somusmetes quad agent tamereminton and.to determing beyuad ceamccacie dushi thet the tha certefyiag cfietof the Ctrl Segvice Comm mee vtates, 68 thc tame oun wher Sppentee: was ‘anthoruet The (4) Mesrnors of Famity Section @ of he Cre Sertice At gevwnlict thst wad ARice'® Bigaat abd Randeritig are to be coceparet with theses tia =o wAenereg thege vee Berady tee of mare armbers of 6 freely seewing onder aaniay ciher pertihéat: perere Uo tha appctedt oe quibéad ine wrtvtces esac  penbstamal of Poreracent aentinen? im the gampwenve saretec, Go Liber Sain-a, Me gre ure ose far, shoul be compart win the aignaluee oR aewber ad re deals we thoke he pre Sage dat ee Feraaet edpadatcert ba the di lgatian ahact, ahah wap magne? wa the stemaetias mom, Hey.sipacad | the competing wirmce Cie aiyanet mess 4 peracne eartiod ta veto an . BACH BL 4 may be chevbod aguins? the metwat cerct-ate, The sppantce feettrenie are mee taht ty tae Tequirerne sa Toe mets bores Samy tasy abo To quevticocd om bis pervcaal.bistary for xreemact wth bee greene «dare wel apply tp temmwary apouhtewats Thx. (efid reseed be sehared 82° sietemeceta, the ap pn painie efs'e of tO" “unk Servere Cumialvbess for decwenain, ‘ .  & aeetemag a? enenIRG HEEEG La BEES F 4 rr a er. cr a 2 i i a ors He we ee ee eT te Cem ewe ee eee Ce a re ee -
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14-00000 wy ae ee coin te TERED: wera areangs oe Sustct’s* nan . -~ : [ecus tsre ney on eooET APPL. L0G, BESS. L i . ' } = : 0 COUCAT OR ° by i. > . : DIRECT CUPERRENCE Jf ‘ es . - - ; tmoimic? caegauence ETI + . : r toucariow SQ woe x fers ‘ ‘ a - oinect cupeatinge = RO i : / 7 tiptader eerenteee. Ep. 4 : ‘ : foudaTioa = : ‘ . v OIMECH CePrereecs | a | . i iegeeec? gaPcatiecs = ETT} ¥ . Qobiib CATiGRs Tew iay : FORH a0, —_ —_ a i #45 segq 97-700 -
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’ 7. a QUALIFICATIONS UPbATE 4 : READ INSTRUCTIONS CARREULLY - BEFORE COMPLETING TYEE. OR. PRINT, AVOID UAING CiGiuT COLORED inks Now that gualif ications ere @ matter of computer record, they must be_pericdically updated. Thts ta done -aute- matically jor much njormat ion; Roweter, some. must be obtained directly: from you. Tf te ff orm ia for that purpose. Section | must be ‘Completed in. ail-cases. Fou, ne heed’ provide other’ {ator mation ony. 4 1 Anes have been changes since you submitted. 5 r Form 444), “Qualifications § pelemen : taenit.to the muted oat atemen ction ate form. . 4. Ate ARO AbORESS OF scuidos. " ‘bo ede om ereceas czar irom | vecw Yo jee. oF wots ~ = i - ‘orate: “Boa AGeH CY. EOUCATI ON O8 TRAIBIBG HOT iMOLEATED Ll _ . aes ii STUDY Of SARCIALA EAT IGN eoom | 2 THe. of mowtwi ‘ble ‘ - é . maue oF arouse aoep - Z - = “(8b de . +) fidasdeny oo fg. Bare oF BIaTH i . . o eos ~ ~ feet C va 2 . 2 &. occuPate ch . 6. PREGENT -EMPLOvES z ~ . F. CaP aanseie — é. FoRyEn "CIvizeuguih is) Coue tart ig)” ? ee SATE YB. ‘itaineni acguiaad : 2 MAT fee SacTiOn 14 . : odes Cui bees Age Op nibtaTS otnea Tian spouse . a =e REL AT LON SHEP, DATE aN Fiaca GF Dimtn | CATE rat S508" PEouseEWT ADDRESS road $440 ote e680 20ene . SECRET ee <a 7 ew A a ga aO- 68 geateons Lepeomapeeninng sn Gietoreti a8 ra ‘ is ~ be
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cea tetyn = + eee ed Bap mt Let ne, nine nN, a a ce ra shea seas Cd 7 for a s Ske, Onay, (word -hied i ms Tor oa arnt “avon USING UGHT coon INES " QUALIFICATIONS SUPPLEMENT 416- piitconat HISTORY STATEMENT READ ISIRUCTIONS CAREFULLY BEFORE COMPLE Titet, DOGKANEC AAG | AAD Soumnon pala $ SCE OALG _ 600 WaSHee Def» AGENCY. ventas 8 ‘Seevice “ UPS OFFICER RECTOR 9 ce Toe Pong Bde a ETT [a CATE OF Be te 022276 RANUALL FREDERIEK -> vO 4 “a8 § +09 4094 ° @ 8° ¥ Fou 8 GFE UF Bole F (QCaTOM (Covers, Cop , i i ay Henge 5 AT", i is iva raed . : . t { i ; H i toutaton : COUEGE . oe OHARA BUN UNTV “& | GEORGE Washinargne uNty a af SecaeT Cece] 8 Rape ENT dey ta? ae Es ‘ew het aceite ee Ser ed Ve ® pase t ‘ Myke remy. BP Ala om Pen sees tw wee ob eee! 5 fi a , : tw ” ot 4 o # +
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or ere aan MAPA RII wen am Vitae Nc a ile Samal EP we Vee remem a tone Bo alee | AID PORTION TAVES ° SLEDGE aCQuiaeD By - CHECE Mt) DaNt 9 warts Ost & Mace po - oe : bi 8 £. A tree “We SPECIES FOWL EDGE _ . ” $PECIAL CUALTICADONS | SECTION, : 1 UST Abbe nous Sk) SPORE te eerte VOU ARE ACTIVE Of vave. ACHVELY PABNEPATED PuTCAIE YOUR PeCeLIENEY > pry - > Me Pa . - ? ‘¢ 2 OUOING BUST ESS EQUIPmE st C8 MeCrIrd ) WHICH VOU MAY HAVE USTED IN ITiat. 6, SEC Ct8 dS aber eeCiak REG 1S SOBAS $. ates 19, oinea EQUIPMENT AND . AG PUPGES SubCos AY OPERATION: CF RAED MOAMSATILGS fadaate CW spend, tandng & vecquay TATSED PRESS, TUGDET tated, 125 sD Otmge - Scant & PROFESSIONAL Oevices “ SABE vou Fuaws Ou Mave 1Gu E0ES BEEN a TRENSVE Ga CONF IED satianen OF AON tae Teateseon ba CGH BSPAGL gc Eo] vs | — ELECINGIA?s, BAe OPERAIO’, TeACrte, baveven, COA, MEDICAL Teco aiats oben 1° Serie BC? 5 a n° oo. nara Steen ene nearer nee = —— » fae percent wine — 4 YOU MaVE ApehwEPED VES" 10 Esa 3 ASOVE, INDICATE RIND OF UICENSE Gt CERNE CRB B64 HE TSU State. . ° : MUR PALIT, ETC iPrerite Foame sopitiy avaies Uf baaeal. 2 RAST LC ECASEICADIBIEA'E com gh oneel . ae * ceestscisisicate treme of seve! a FOUST ae WGnACATe SuBusHES WATERSS OF WHICH YOU ARE Ine TRUTHGE ide Ut mee events alse requested: INCACHSE Ol BEE “PSuCAGH Dat, AMD IVPE.OF wai. . : tras Loner de séantale -pt.cles, genzent sere aubrecis, Rosnle, shied sei. an, of¢ f : _— + oS! . INDICATE abet GEVICES Weiter YOU FAVE DTVENTED AIND STATE WHETHER OF PoOT Tak? ABE G4 °EIE, @. PUBLIC SPE Aa eS alc PYBLC SELANOPE LAPEDFRCE - ~ : “ SECRET - , we
14-00000 . * : as ew - ‘ - ; cs a o¢ . . - ECRET.. : . : . ; Pitted te! menos amano ocnagetemnmenneinsasonmoesnnnennisiiig % . . Sy SERVICE a4 ROS : kt YOU BEGIBIERED O8 THE DRAFT . Ow Es . 3 (OCAL SEREC VE SEaICE 854R) NUMBER OND ADORTSS- } - alk li ainlehiichatiats toe 7 SCANCH O% LORPS 3 UAIES OF FERVICE sovtonded votes dotg! “< * 10.. Be . — ce, 6 Sas, SLAVICE OR BRE NUMBER oe . as - a ee ree tse ~ - c, thap MONDR AME DISCHARGE | ; ORC PE OF ees tast 10 act buy — “$e aRAtION-~ wes Unrest - __ Glteviewwenn eon'sot - A. CREP DEMCAP TION OF MATIARY DUNES (record ie . CHECK RESLAVE OF GusmD.GAG ANE sg vg! oni: 3 { ZATION 10 writes YOU. BELONG > ; a SAARING CORRS E)- coast! ovata Oo MATONAL GUARD : ! , . i vr ; Els CJ ame dice : . ~ E] ant wanna guar a en { 1, GURRENT RAN, GRADE O8 RATE - 2. DATE OF APPOINIMENT IN CURNENT RANK 3 CAPIRATION DATE OF CURRENT RESERVE OHIG ANON .4 f ’ a & a 4, CHECK CUBHT NT ehoFOVE CATEGORY [J eam seseave [7] stanmey tere fT statdsB0 vnactee! Piieimu [of oscmanceo ft - . BREF DESCRIPTION CF MAITABY RESERVE DUTIES (record the deter end shail, whch best decoby vow work or fuoet an 0 the mittery séeoe!, a cay Jj we ° : : gia - . . 3 , ee an sree ee ern a - a ne ec arene en er ne are ee a nr a nena ee . & WW YOU ARE Comal teh s AGREE 1 A RESLHVE OR NSTCNAL GUARD HRathonG UNL HOENTEY Iné ural ata 1S AUCAESS, , - ; A NEO : ‘ — sr } . : . MILITARY SCHOOLS COMPLETED fActree Duty Reserve Stars or.a4. Civitas) mS Aol: : J ; Tse AND BDORESS OF SCHOOL “ GAIE COMPLETED i : -- _ ; 0 t t 3 4 . i ay ey > . . hee eet ache . sees - . - .
Me A net weenie Ne teh Sow oe Se eet wes eee Ree ee tee fine ett nr LTE cS he Pr yy “ * a ce oe ames = 4 PREECE S284 73 hege torad Widowed teow onal. fe satan BMG CHAPTER Airevilltes Carel, a7 Ivkbe - ba teapl Lap . oa - 2 : aed Prered, Baried fomorves BICEY Ae Of ang E. feanta Uf p y [When Fed ta) ‘PROFESSIONAL SOCIETIES AND OTHER ORGANIZATIONS {etendent ADORESS sreumbar, Sereet Cap Hate, Country! Vushupton, ZC. SUPER LHE OOF ERSLGVER . 4 ao. a 7 , deel OL Lee SECRET «7s wt fies siekate te aceel . digke pigls 4 Bete Coa ra Rompe re et Fredo n wtemetts ome D oremegaes enite PRS ER EO + Fe ens 1 et Mea cna ANT ATE Ae In “tren apaantemnedanene men” enc cer
14-00000 - ABR REE ENR IEE att 2 + Aree eae Ramee septune Gene Me teen eee eee ee etre ecm yeah EEF (AO FUR HME TOME EB Ochs fo pth A “e. fa 2 ne fee Bag aN om beets Ne ee tne eee Deere) VW /z- (7 y ‘[seerio ‘fy - Randal | Facdewele Ct. cee oe Reaaige aks gig eect eget er ewe ow me a os | . SECRET Pen Filled In) Cteap LANGUAGE DATA RECORD PART. 1-GERERAL, 1. tame {hea tePir et: meddle) ; eae CD) a “~ aan 2. pare oF aiatm lB BR, 2.8, § wave NO PHF E ie anv fondi Gn Paw et . owe Mg EAS ‘Aga8 3. suc Aa aritey sans, NEGSPAPER wehOL INES, ETE. , - oo. - . : . x pa |secrios 6. oo, _Writing (41) een - A Lat - . ‘Section ¢. Oe, ~ . 4 can wnete PEAsONaL ievrens, AND Sum ILAR MATERIAL WITH COMPLETE SUCCESS wt HOUT USING THE O:CTIONARY. * he GRETE, FACTUAL NaaRavive Ano EXPOSITORY MATERIAL WITH REASONABLE CLARITY, GFT VERY FEE CRAMMATIC AL” MATIWE STYLE. USING THE DICTIONARY ONLY RARELY. t RARELY. ERANPS, BYT th A STYLE BHICH HAY HOT GE NATIVE, USING Tee DICTIONARY OCCASIONALLY. A Wile REASONABLE IUCCESS Ie CONVEYING MY a Sur WtTr OCCASEOMAL MINOR GRAMMATICAL ERRERS ANG OM CRVIOUSLY FOREIGN, avagand STYLE, USENG Tee OFC Gs CAN PARTE PERSOMAL LETTERS AnD SEMILAR SEMPLE MATERIAL, OCCARIONALLY. . 4. § CAM GRETKE PEASONAL LETTERS AND TIMIRAR SEMPLE MATESEAL, BITH REASCRADLE SUCCESS Sur wit MANY GRAMMATICAL ERRORS AND IN A VERY FOSESGM, AWKWARD STYLE. 5. 8 Cannot srive IN THE LANGUAGE: Promaciotion (42) 1. MY PAGHUNCEATION 19 NATIVE. - _ USING tue, Bt eT OWARY, racguentey. ciety baw auade ¢ Casi cmnoas, tn Car, 8a1Te PERSONAL RETYEAS AMD SIMILAR SIMPLE MATERTAL Git COMPLETE SUCCESS, USEING THE OICTIONARY ONLY 4 CAM @WRETE FACTUAL MARRATEVE AND ExPostTroey MATERIAL BrTH REASOWALA CLARETY, Bitty few SR ARMA PECAL. Ean EME, TIOMARY Fa is CONVEYING Mav Mia as, USING THE DICTIONARY FREQUENTEY. sasaaaeaaasteeninet maaneneeneeteeaenamamnenatae: " 7 2. WHILE NATEVES CAN DETECT AM ACCEN? $M MY PRONUNCIATION THEY wAYE MQ OLFFICULTY UNDERSTANDING WE. a ) MY PRONUNCIATION &€@ GAVEGUSLY FOREIGN, GUT UNLY @ARELY CAUSES DIFFICULTY FOR MATIVES TO UNOERSTANG, - “4 4. MY PROMUACTATION FS OCCASIONALLY OIF FICULT FOR eaTiwes TS UNDERSTAND: » S- § wave NO SKILL 1M PRONUNCEATION. . . CCATIALE GY SEVERSE SIDE . t FES $7 (4-63)
” be it 1 sa nda og 9 } i aa? ano” 1S € GPLAR PLUTSTLY 260 ACCUMATELY 1% ALE PRACTICAL AND BOCEAR BETUATE t. OWATICALAY $e ALR FEEL OR wit aero 7 AME FAREL EAR, SPE ae ftutativ rrr) accusarary is we aaLy ata Practica (ABD BOC HAE ws anny ee aa ae Faieinras’ aap § cerLey” ‘g ee POPULAR gave 16S. corenary Ou tees ied ro" es ares Poin race: ees aw ea. TH wtidingoat t ydoadsrand toe ES OF. batty. at73 Ane Teaver, sors . at 8T 4 “WEAR Os THe RAdIG, amp “Ate WHE movegs,. Peay : pant 1i- EXPERIENCE AS TRANSLATOR: of INTERPRETER (ag) . . =. eesti 2. € HAVE Had E77 ECIENCE AS aN mTROPAarTeR, 2 GOI OF THe Kasse Sravturwrs abeuy. Ga) HONE OF THE AECCE STATEMENTS APPLY. an guaT TON Cives Agove 35 rau Aw ACCUGATE TO fue BEST OF MY RNOWLEDGE @aG BELEEF. THES CEQTER ATE Ge ‘IVieS wy APPLICATION. FOG A BAUMTENAnLE BOARD POovIDED | AM-ECEGESEE’ UNDER The TERMS OF Atiow Oo, Z2g-'35 PRA. FO48). s UNDE RS Tan® THAT | wus? PASS AN QHICCTIVE LANGUAGE PROFICIENCY Tas? auroae t OECOME LUIGI OLE 7O@ an eeans, SRD [HAT 1GBRSPECTIVE OF THE Gate OF Festias, ANNUAL MAINTE ANCE ABAROS WILK BF TUMULATINE &9° CF THE AnwtTETEARY Date IF COMPLETENG THIS FER: t crariry twat wee DaATe’ SIGHED ‘Stem aiuoE 17 (4 Wes! LISP | ae SOOT SRE Prrseeee eercrzenrarercerreemtmeneneem_———
Sencar + te sang n ME oem tes 6 wae i 4 ‘ cmclastit densith atte toe sake ae see ~ ee . = se eee se SECRET. + thee esitea fas : © Sy ANG PERIODIC SUPPLEMENT Tae eave” 4 February 1959 PERSONAL NESTORY STATEMERT . : INSTRUCTIONS met secords weli be bept current, Even thewgh 1? duplicates Rae fore provides the peane sheceby pous offscial woe aplordation you have furnished previoualy, a¢ wall be weceasary for pos te complefe dec tions ff throwgh Yi aa thelr entarecy. ERS GF gens beCsae Berard, You need coapiote gectione Vis theowgh agit only a thece how boom @ change eines pou entered on dufp wth e 4f pow Bbedseve the §fem caqueree BEEe complete coverage thas vas heve peévicusip reported Taant toay POSSESE0GN Ce COuMTaY tm erie VOW MOG Ci Aone ara ENET PGs -BUGLMERS TEL EONS: 2 Fuant en Cate. ». None . 2 oe ne ari Ee wérehed acre than once, SPCC SE 44 vou have Seen dusbaes givang data below for adf Previous merciagae. “L [stacee. x] Prerite PLACE AND MLASON FOR ALL SEPARATIONS ineluding anagdwente, None - < MARETAL sans — = . : DIVORCES OA ANNULMENTS uae @ separate sheet far former wife oF plated. provede same datacfor fiance. Ef aarriage 3. Rau - (Faraty (Maddles 4 2 O22 A829 a 5. PL Ae TTF, a _ ebraska MABE $e: City, Siste. C. -t173 OO ADORESR OF SPOUSE BEFORE MARRIAGE (Forgotten) - RIVING a. @ OATE OF DEATH ES = Qe be foal. addrese, lexandria, Tenen Y ADDRES Pts pat cf Ot ain [iz. eiac “TE GORY OUTSIDE O,S.-DATC OF FHTAy fia. PLACE re . a. . tS. cifistusuer (Country) ” 18: U.S. 29. BATE ACAUEACO PRESENT CurLore® ¢ Alias gave * cause oF BLane do ‘ad deceasedy Va. Of ENTRY par. rer: FEQUEREO (Ceer, Siste, i ns oe “Couater} coer erearecrlenoret tate ate ements ta ammo neiee 8 ea eo vaned oF formes araloyee, ao if epouse (tas COUP ATION Housewife vsenployed, fast geo seplorers) aw om an ere re ee AER ACER RRR RE ieee mn = eg etre ets” rta. EMPAOYER’S C@ BUSINESS ADDAESS (NO.. Siveat, Gety, St ste, Coun tri} == ees WORD ose peecsaua azrteons. SEcTion ¢19 COnTimu€® > Pace 2 SECRET a
at, GATEH OF Miki faARy SeMETCE OF BPOUSE (Prom and Fo- 38. phaRce OF GeavEcE aa. S8 fates } @Y woute ‘None OF Otwre GOVEMMMERT SERVICE, Ub, Of FORE 16% name (Leste Pirat-Widdie) ‘ a separa, SR COUNTRY EM GHECH RELATE YE RESIDES FuUaL a e ' 2 fF AL Oj sfction ¢ separ aan 2 St ret Ht, ae vey TwPARELY OCPENDE =? CM YOu Gag awyt- 2.3 wu WAYE ANT FIMANC HAL etm Un. aepeeee “VES.” Give cOUPL ETE oe b DD ety BMCEee ON ABRULTY FACW Ene UNSTED STATES Of DISTRICT OF FOLuwarn pd wes | ong 80 PERZION. ie gata RACE A SO 4.49 FOU ea.g andagnia Fe B+ Gui? SECM E TD Owe Bag say, B Cubedimanie eCoumtey) FACQUENCY OF CONTACT oe rernnenar eeu See @EMARAS, 16 AMY, CONCERAING INESE RELATIVES Fi aah AL STATUS EQAPOGATIONS GCA BUTINE RITE MAVING SUBSTAN T EAL FORE LES DETAIL GR & SEPARATE Su€¢7 A959 83 at ee etry RIN eT TO NETS MR A LA Ba TOM EREATION POR Minitady of maya seneica? ae cnn ntraetenemetin °vES* 80 Question 2 above, Greve Commer TE OF ‘Rone . SECTION Wwe Sontinuls [mo ; SECRET 2 teigager fa OR ORE IED AL CONNEC THOS site, a SECRET . (Brer Pilied Fa, - SECTION 144 COMTIAUED FROM Pace 3 : Aut Phat os Oave OF Laat Cont eet BEL ST 1Om SH Te 7. BATE OF LAOT Convacy iL? ‘ mom vs 4. CORPORATIONS UR BUSINEESES “@ fm O8 tesepeeese [" fres Xk wo $F ey wave face te 8 Seer EO Evvecnre, . wee peunententem ermun, CR ae UROER ANY HEVIRIMEST BCT, Tesea. . peta er mearNnie? =, temene ranae near siete Btate OME SUH ES Oe HEC yeReat TROICATEO BY PRECLOlee FILS, tee Tag wT Fast 4
“~ = SECRES o, — 4B8en Fieled tny SECTigg .¥ COBTiNYED FROM PAGE 2. S. RANGE TESTED TEAwS BEM BHICm FOL Maed ACC OUSES awe WTTern - annaras (Coty, Beale, Country) Washington, B.C. oF Riggs National Dank yy? 1MChUR tee cover ver) paresis Ticiaaes, awe} <7 sented 0, ev . eweca tm) oie } ¥ ~ TiawT Cwawag: voue patent Cl TN TEASH EFS: . i ans = atuny, “g. Govince Gk “Gnave Sim GER HAS, ComPLereD iSrecelys Universi ty of Omaha a. EwaPe, COGMERCIAR AND SFECEALIZED ScH0 DATES ATTINGEO roTae HOUaS NAME OF SCMDOL STUDY OR SPECT ALUTATION ~ a. Pape : Pe i 2 . H : a. aay TRAD ENE fPull @ime duty tn apeciacseet schowds such as Ondnanee, Inteifigenca. Comsunteat sans, ete.) 2 4 oneereerpe nena ee . . . 7 ae Batis attemoed voray MAME UF SHROOL SRS’ OR SHECLAL ETAT ION en easier. 7 wi PR ow . fo - - ataas x ° . a ma PQ. AWA GOCE Ova TRAPNIAG NOT IBPIC ATED Abdes } SECRET a . 3 \ Ee 8 a z yi Oe cr 4 2
14-00000 e sacri vans . GtoaRarniC arta Engi (06e ea ote A lt reer ° teh BE BILOw AwyY FORT TON BEGIERS Om COUMTES ES OF Mice vou Neue BOOL FOE Ghseeo ab A Batak ce RERIOINCE, TRALGL, Bfyoe Of QoRe ASS onuCeT Dine & Fea bly DRGARITATION SOP ERIENCE. UROER COLUME STTHg oF Serer aneies AROBL EDGR. * ame bates OF asioances veavet .. ate. "Teo TeAte. we 6 1 as, a { 7c hy * + z CNB? eecOe any AGBLONNMENT O8 A . aasisences raged | PRaime| . faaven. ere. ing SPECIALIZ£0 BNORLCOGE WANE OF REGION Of COUN FAY FP oF x ¢ TiPtnG AUD STOMOGRAPNIC SaILLS . 2 a more SHORTHAND aestis Usted « CHlCa €X} avemOPs are ptow ] raxorved [> atid (Specely)- "Taal ming (Cosptosetor, Yemog- 2. SHOR tHaNS LR. P. i. o—. ances] [seceows SPEEOUR| TIS a. EMQUCATE ‘STHER BUSHES WAC InES ‘e1tH Bi § Cot 30 Hae MAD OPERATING EEPERIENCE OF graph, Card Punch, efe.) a . SECTION X ‘ | ZZ CPECIAL QUALIFICATIONS . 7 . cemar-at-stenece-aeetemmemenpeameecaeadenmanmane’ a roy arg’ “active. OF HAVE acti ehy Pau liciPATEs. OMGECATE TOUR PROF ECE ENCY a $. GLAST At HOBOHAS ANG SPORES By Bh tLe - te face . : - aoe ereten eben SOT IMT EPRI RTL NYT TITCT ET Sec - _ SULTING PHDia FUP KATRCE OF THAIN ENG, Van ita” erent WE yey FOR & PARTI CuUL aa me JB. SNAICATE Any SPUCEAL Guar icat: as, eosityon Om IvPh OF Bone eect rants re ean et LoSt ame SPECIAL SHrIRE VOU FOSETST SEL aTING Ta Qmha EQQIPUENT C8 Mae SCUEMTETES AeD PROFERSSOuaL OLVICHS. TIE. Dd. BacLUDING EQUIPMENT NOTED tm SECTIOW a, CweoydSs Bylee AY GHEAATIOM OF SeteTaavse @ACIG, MYULTEL ETA. TRO Larne, _ Feaches, Eat GF AMY TAADR “OR PROTEIN (PElot, Blecteicsan, Badia Operator, SMO CATE Ted mibh OF LECHMEE OM CEBTIFITATE, Bam OF EBFVERG FTATE. and =o a. sf yGu ARE A LICENSaD Ce CEB F res Laepor, CPA, Medical Techascsan, gee. 3, RECEATHy NUweRLR, 1f THOR, oo = * ee Se St Feast Rrceesi Oe Cigtrre Cate [Keer ef tease} ae eens erst ocr cece ee ma | - BATEEL LACES GO CHOTICicare (Fear oF asaues SECRET “> _ ‘ . a te
e. 2. t fe * oe .. —~ . SECRET _ (Wen TP ehdod Joy . REST AMT PI OIO SE BHT Py BL tees WAPERI ALD DE wile VOU aa Pee ay teow » (Be wot suboti copies onless 2% ambicatée te te. Oumaication Gate, aS Furs oF ont tang { Ben. Fae fama, ecsewtefae srtseloe, gamer al datsregd tebe gecte, navels, shore sfartee, ote.p enemies ner nO Pentre eemeenttteteAGERaHata Ns tnt toi ie AO car eaeenEtialinae Syl _ tube ale Awe SEYITED welcmw voy waved fevEGIeO and STATE mug toga Ob WOT wy aed Pay rED ‘ ‘ ne “ bacate os = ‘ano PUBL Ie Gs ations curtarzeee =~ a —* eens A me CECT ION a Qoetiavts il Page a nee on eT ~ Field ¢ Cage Ottieer for atx FL Operat woe 4. tncausi va 1988. “CPrees. and Tus) July 1958 - Pregent a. MOL OF iepuovene- ueGER vouR DIRECT SUP EAVISI6e 156 - @. DESCHIPTION OF OUTIES B. SHADE |S. GFFICESHI Ft SION! BHANCN OF ASTLENWE ST cao-uauiieaasaeaieae pe acreameencertne ar Forearm rare wt, SCL YORE Bares (Peo “aie j See saeco seeeete ns ae * corona qsnonrace snp fer eames ee ee FE, WO. OF TMF LG EER Eweee youn pidEery is QPOECT AL POGETIGe TELE \ SUPE OVE SIOe oo ae ‘a. DESCASF TON oF os asa | = a cate eet one nee eet ene cee ne eee oy eeepc pee acer ine queen geaneeecnneman naan ¢ nee te amen neem i’ Teenusive, bates CP rces and Fae 3 [* guage! © STFICE/ Swi Situs search OF adaloaut? { : oa e a a Sa fa. MO, OF EMPLOrEES UDEe COLA OIMEtE I 8. GEFICHAG POSITED Fs LE aOR 2 EP NMEA TUNE 3p Ne ROR © HN SUPERVISION ae : a . Pe pe eterna ea occ etree nection nee fe eer yo egsenieros OF SuFr ks . . oe tees -- yt . ‘ . r . no om “ . : TeeLUS? € BATES Geer. ond Tax } 2. GB ake Te. orrige sy Pim em@enee OF 3b} oF wae eine nena ten cnnes er eee in nn em ae en 13 SURI Ta, FAST He Ti | ‘* Nt, OF yrgnon eas UNGER YOUR SIAECT SUPERVISES - a . {tos srartienal grees 2% raemes esy a PEO EOP ED EE PEE IEE SPR FTE ta rr o Ox m = ab som
‘t j ae ~ ° . = * - , oe 7 ca . ane ra wt a ca 3 . - a : z ; - oo. Co a oe : - woot ° z 7 : - SECRET ; . . ( Bhen Fitted Fa, , e: “ @ € SECriog Rie CHORE aad orth Uli Lataays . "p Ean os yh cone natn tee et stsiRnkatenes tetas Nn nein ene Hn - 4. PevteReR OF Cwe hace fincledsag ebepetstdron, ', f SRE OF Stash viFriarey? inthe ape { “7 ond etopted chsideon) wag 498 yumaesreo vacerie: Slogperents, seater, #F¢ 5 : oe BEPey OM YOU FUR At gH ast 808 OF . . Umote $f YEARR OF AGH, eNO ABE BOT RAL Fe THF QPP CRT, O8, cated wh eae f ] . - of At rere teetirn 7 Rhea) - SuProeting. PROVIDE Tee FHRLOBIOG iaromwstioe FOB ALL CmiLOBES OND GEPeovEGTS oF rh . tes f . cy é i VEaR Be HIels EEA: COPE EC oe ate | £ fe i i a2 - { Poe : a G : 7 i i i : : Ro S . . { ¢ i . + i .. r7 ’ bebe, YG CH a ae fai f GA, 2h0 By LYS? } “et tlbese |
14-00000 ‘ ~ . a a oa . er an OF oe a rs oe: . oe Bo ‘gPERSONAL HISTORY oY ATEMENT Instructions: 1. Answer all questions completely. “unknown” only if you do net know the answer ‘and cannot obtatia the’ answer from -ERSANENT, AODRESS: Bag If. question is not applicable write “NA.” Write i j B NICKNAME: a WHAT. oriER HABER HAVE You: usEb? Here . Ese oie ‘ meeenee oie vonesasnneeseersenannseett ames - UNDER WHAT CIREUMSTANCES HAVE you EVER USED THESE ~ To ; _MAMES?_” wrens MAQ.. wo. ae peeniceremcenar twee wut rininenmeconnont nes wenenennes: vce Sepeantenenennnasinn > : 7, HOW LONG? wedlAL.e IP A LEGAL CHANGE, GIVE PARTICULARS i ri . . . a : 7 | soreameeammeanenancoms es ont eristnenananauresins ane snge names ie a 3 LT : S : rrersy {Rtatn} * @eantzs) : UL, PRESENT CITIZENSHIP A oe BY BIRTH? —..124........ BY MARRIAGE? ...... WA Connery, . , BY NATURALIZATION CERTIFICATE NO. .. FA IBSUED .ccecencere mene BY oe tkorsted iCourt) : Cie “bu -_ (Gane) ; HAYE YOU HAD A PREVIOUS NATIONALITY? sae eecost ese sunremenenee ssinecnee niet cass sememmepane G é hed og Ha) . (Country) * : HELD SET WEEN WHAT DATES? BAL. TO. ~GASY OTHERNATIO: SALITY? 2 i . iGoasiayi Fi Lo. Lo. GIVE PANTICULARS ee . pore reepeeyemeneenenimeree | £ : - ae - * . . j nsoettagencgnneinenser ueeuscomees-eppemnwneneaeresnioneneen nace neresenecuee= pneevaceces H HAVE YOU TAREN STEPS TO CHANGE PRESENT CrTizensuip? Ho | GiVE PARTICULARS: i ; Inne = Ree te a A OE EE A OE ON CTS BNET weer YORE He ne Sere # an. eg nae i . ’ (3) . Frees ar} ! firuie Gon! . -t F
14-00000 tle eee ee ~ se ” nme _ ares ~ ” , “ , - a - ~ 3 : . . . 2 - - not, “ , : ~ = , 7s . Fee TN tee ares ww. seventh ce an et sper nie we tae . - wey . égb ~ - E.IF BORN OUTSIDE U.S. WHEN DID YOU FIRST ARRIVE IN THIg.GounTRY? NA PORT OF ENTRY? .......... ON PASSPORT OF WHAT COUNTRY? coven ate antmanedagamh ni eedte pasta SEC, 2. | PHYSICAL DESCRIPTION . AGE a sex tote HEIGHT Bt aot" a ~wercut 160 )_1bse ives Eve HAIR ee coniiskx0N fait. . Ht sun —Hetiva_—. OTHER DISTINGUISHING FEATURES __ Fens. SEC. $. MARITAL. status ., Ce veecns ley co cme wteniinnty grec iy f “NEe at Ba Bech - abe ‘A sina reap MARRIED cae < ) ee DIVORCER s winowsD a ~ State Bare, Puss, ‘ann Reason rok all Berigaroxe,D Divorced on ANNULMENTS: a - e- oor necuessener canseene oat commanbetenesnnnncteiing sens ren ee ne eae seaman neni dehe ne eerwmnaieduerowiene teagnagreceiocecoos on ME B WIFE ORT HUSBAND- uF ‘YOU HAVE BEEN ‘MARRIED “MORE TITAN OxCESiNeLuDiNe ANNUL- MENTS—USE. A SEPARATE SHEET: FOR FORMER WIFE OR HUSBAND’ GIVING DATA REQUIRED “RELOW FOR ‘ALL, PREVIOUS MARRIAGES.) : . NAME OF SPOUSE:.. ; leanditt «Firet} (a8 ike} { Malden) . t Last} PLACE AND DATE OF MARRIAGE | L. Nebraska, veseganenceuenets guacessssees - HIS (OR HER) ADPRESS REFORE warms ar BAL. m b 3 2 {(Coustry} _ er * t ee LIVING OR DECEASED p Living... _ DATE OF DECREASE _.. NA... CAUSE cosccccescceeecueee & i PRESENT, OR LAST, ADDRESS Mdos. USA 2 Stand” Number cers (state Country) DATE OF meth] pace OF ninTH| sa (rity tetete weuntry) TF BORN OUTSIDE U.S INDICATE DATE AND PLACE OF ENTRY |... MA ee ee re CiTizensuip .... USA. WHEN ACQuIpepy Sint) WHERE? - . (esd asta” Country} occupation .. Pergonnel clerk LAST EMPLOYER U3. Govt, Office af Price Stab. EMPLOYER'S OR BUSINESS ADURESS Ath. & Jaffaraon, DE va Battan. “aghingtons De Fe St. aad Namen) (ec city) «States ifoanery) MILITARY SERVICE FROM ~-None... we FO eee _ BRANCH OF SERV ACE a eevee ce ore -- . tated ~ COUNTRY 22. eens eee ee DETAILS OF OTHER GOVT, SERVICE, C. & OR FORFIGN wes cone cee oneeoe MONG ee ee cee ne ee nee ane sonene Sceccnvesetegtansqaens covatatenes mavrrentvss emacs si 4aR0Sa8 )  @
1, NAME Rone_{Expeoting dunes 1251). RELATIONSHIP monn CITIZENSHIP, awe: — ADDRES ge ig oe _—— (Be on8 Wandar9 au) (Brat). i REL ATION6REP ; 2 NAME pee te TOR bee woe ot a - aiF iy Serraae Pa Sec. B. FATHER (Give the saline - ‘information for stepfather and/or guardian on ‘8 separate. sheet). es FULL NAME acai OI “i ee * imag ‘haat ; ~ __ LAVING OR. DECEASED... hazing... - DATE OF DECEABE. NA... CAUSE. eeeciecimncscnene - ‘PRESENT; OR iast, ADDRESS .. ese * ‘ DATE OF BIRT: LACE OF BIRTH -.. us. : i Tea ‘esUaTEy sity) . IF'BORN OUTSIDE, U.S. INDICATE DATE AND PLACE OF ESTRY ...-.NA...c. ens —_ i CITIZENSHIP _OSA_ WHEN ACQUIRED? _S2r¢5 WHERE? .._.....- Ne ceccee wesemesceereces {City> (Stata) (Country) Fey BAe est saDebomh? ay cera O iy. aed wee | E4 toed 3 3 a Ps : i b- % oa Al x = a ~ | % BE ee FS FJ ts & = ia a po ° Lf © & “occUPATION 4 = EMPLOYEIVS OR OWN BUSINESS ADDRESS we wssseperanwanens seen sree neteecon ~ ~ cee ‘ can sare (Country) . MILITARY SERVICE FROM | . None... TO. ypdes 77 RLANCH or SERVICE, | ona ccctes eee ences ~ (Bate ate} . COUNTRY |. veetemneress econ se. =. DETAILS OF OTHE cae mOvT. SERVICE, U. 3. OR FOREIGN . er cere neem FG. oo eeecessseteecmeetenerenen ot ceedanesteesenesmtcepena ii imeeenaecnteninsansnenensnastetionsensanestereeettuae a Rap A a hE SES EIT TE RE lle TiS EOE LTE STS tenes ce sean ge Sec. 6 MOTHER (Give the same information forstepmother on a separate sheet} + _ FULL NAME | Randall. vevuee cee nus eneussetteveumeranavese vs seve csseueessasees . re . 1Skictes (hast) . LIVING OR DECEASED, Living . . DATE OF DECEASE . NA... CAUSE ue nee PRESENT, OR Last. appress | — iar ze ee : "DATE OF cuse]___—staceson OY BIRTH aru | nn - ciriensuty ... USA. 0 WHEN ACQUIRED? Birth. 0 WHERE? 0000. wo eens qCity) = ¢Btatet ¢Coante yt IF BORN OUTSIDE U. 3. INDICATE PATE AND PLACE OF ENTRY .20.000. RAL. oe ccc tere (3) (o- erase a Be ete ee oe DDR Sac ; pore ee ee BELATIONSEIP mer ACE pe , co ~ 7 ° Foal ceeenieennerane nemimanemtivalied mera ree ‘a . : PREETI LD Sec. 4. CHILDREN OR DEPENDENTS (Include partial dependents): pres | ne eRe rename erent nae unt erp asupet te Dep me ems t SW Lak LBM (otter mer oc caNGEE SA Ser MER lh tetarsedee eee bene oa 19 et astern nt
i : : . eae oa - a . woes : * . . ony * a) - . . : . Fe . an oe eee Near PASSED a dittne, cee et cer ye a oa ae + ree “Woe - - . a (4) occupation .. Beusewife os Last emptoven 4 EMPLOYER'S OR OWN HUSINESS ADDRESS soe neterenene en sat caine nang a+ whom Sommnetna es ee mwoesmnnancogsomescernscee ‘a (8 and Nember) 4Cher d tiated {Country} MILITARY SERVICE FROM ..B@B®___ gg. BRANCH OF SERVICE eroceesese COUNTRY somvectessrameneee. DETAILS oF OTHER GOVT. SERVICE, U. &. oR FOREIGN PRESENT ADDRESS Se ic cecuperasenecneeceisgesqeatenneseneueeenezess fs eccucsaeseenerggscecteesnes ; (8c aed Number) eae ? iCoumiey > " (Gitiscashiny BFULL NAME SL cece eee cee eee ee eee nen entnennnn nnn ann AGE pnetnesemeee Raa (eieadtay (hast) "PRESENT ‘ADDRESS rene walla covese vanvesseeuvavesg sessment sunt earensscegersesneetuenstevees sar tesseaserenmen ‘St and Nuialer) eCity) {Stato} (Countey} {Cttizenship} ch te See eae Sires ate rcp agente See. & FATHER-IN-LAW ste , FULL NAME ......... . cessssotnsseneucevereovease ever aper osseeaneas raenevennese ie} Gbaotd LIVING Of DECEASED Living . DATE OF DECKASE Se.” an CAUSE occ ee cee ce ee PRESENT, OR LAST, ADDRESS . Joos (ae aad Number) cr Tsiats TUSTB yy DATE OF BIRTH PLACE OF BIRTH Us - IF BORN OUTSIDE U.S. INDICATE DATE AND PLACE OF ENTRY a. cen F ? TET TENTS Se dae aan tHe A Re ENE NEE YEOUE TONNES OE TER TST RoE A Oe SOTERA HR aEe SSESU REETEDEN. CER STELEMe YES RATT Aer pauttenee ne ape ree ec cree pene CITIZENSHIP a suns. WHEN ACQUIRED? _. ‘arte . -. WHERES. ; gh aa iCountry} OCCUPATION ..,.... Phaokendth _Uaien Pacifio Railresad 14> O2o19-8 Fe vesenee LAST EMPLOYER — 2 2
Nag eles Ch cells ade Rae alts ence flat don adnan hain ict ett Sec, 9. MOTHER- IN-LAW oo 4 — Lae . . wee « oy beh orgs * or4 Fok. ra whi 7 heey FULL NAME: sesoseecave . ” rome a eu a > & 7 tte 8 LIVING oR DECEASED - tata. oom _ DATE OF DECEASE nsieegenenen CAUSE i sacnnnne é, PRESENT, OR LAST, ADDRESS _ “se DATE OF aumral__J race: OF BIRTH, iF BORN OUTSIDE. C. 8. INDICATE, DATE: AND, Race oF, ENTRY: —— Wheat inena SP5h. ° ‘. & a a ‘crrizensmiP Ugh WHEN ACQUIRED? Birth WHERE? .: mctiesseme F h. a e vw we 8 oa! oF. a Bo Se _ OCCUPATION _Rovepnite. LAST pupLoven eneare cone —rerrapeanimepenaesscessceene sins lenses ‘ . rouR aT TOTES SP Sat a She SALES AEE z ear. esa -Sac. 10. RELATIVES BY Bion, MARRIAGE oR ADOPTION, WHO ELTHER. LIVE ABROAD , . OR WHO ARE NOT CITIZENS OF: THE- UNITED STATES: © ee A 7 b a a . 7 + 1. NAME a (7 ca RELATIONSHIP { a = sioepimannans A AGE” acne CITIZENSHIP... ADDRESS .... cose seers, (Bt and Harter) 2 Pham ewe * &, NAME, ... .--.ecemececerermaresterwecsmmen tienesrens RELATIONSHIP eoccpasecsrevstsstevenanese AGE Lu. t CITIZENSHIP mon memarovcercrmeveacessaees WODRESS: consni-senrs. eente neyo Saetee mee ccnncseeeeneeneeeeseee atrewe semen (Ht and amber) tClty) . (State) (Country } §, NAME secheeneneenteeaartmenesit a sersteemnenesnee RELATIONSHIP oes -snceanee AGE oes ~ * QIPIZENSHIP ...-. ADDRESS .... eevee pov vomneoneee et ” Be “atid | Number) (Chey) SER ete ee TI wir naman wut corer n ray ; Sec. 11, RELATIVES BY BLOOD OR MAKRIAGE IN THE MILITARY OR CIVIL SERVICE OF J THE U.S.OR OF A FOREIGN GOVERNMENT: rory 1. NAME MGR. ne tte eee cence oe MELATIONSHEP oo ee a AGE ln 5 . CITIZENSIIP wW. ADDRESS _.., 4 (at. ant Nomber) 4etig) taney tGouateyy 4 TYPE AND LOCATIOS GF GREVICE (IF KNOWN) 02.000 cote cee reemnenens seceneemw re ane veveeueenter tenes j B. NAMB owe cece eee ecenmemenrremeremerinsns a emer, oo . RELATIONSHIP 0... 2 cee een. AGE veceenees met CITIZENSHIP cece. recess eves. ADDRESS ou ences ccccececete tate cece bee ree vee swine teen seceeeaanmeten 4 (8b and Nuveter} City) istate> {Country} * TYPE AND LOCA:708 GPF SERVICE (LE RNOWN) Voc... 2 cence ccee oa cee cm namnere ete te Sore ees pemesan nurs pe cegma an ot . 8 NAME qomneenes tent 8 cee tee emeten cements vere vents we RELATIONSHIP oo... ew oe AGE oe ‘ CITIZENSHIP oo ADDRESS oe cee eee eee teers ce ee tecpetenee oe ; 18t. and Nomberi cCitg> {Stated $Connpary P - TYPE AND LOCATION OF BERVICE (IF RNOWN) 2000 0 ee came mere tere i €3) fo 4aene-8
ass 8) 12. PONITION DATA A.RIND OF PUSITION APPLIED FOR 22... esceeee ge . ¢ ans seasaen BYBAT, 1g THE Low Be OSOCDA ES PDAAD) -WUSDIUREAGEDURLORE AM EERERLOES BARA! OHO CARED ARATE D: & PERE R Senseo as aren emnmmKnhn eM eAss TT EAE Hoe. AEE + pheetes ¢nenaeasionamacaan ne EST-ANNUAL ENTRANCE SALARY YOU WILL ACCEPT? $9823. , A tobete 8 Aisa wil Not, Be Cofisidered For Any ‘Posie With A Lower ‘Entéanos Balary.). . : ~ t . ~— . . ~ ey “Cu You ARE WILLING 30 TRAVEL, SPECIFY: OCCASIONALLY . ee FREQUENTLY 2.5.00 B®. .crcnn sn DCABCK uw you with ‘accErT APPOINT MBE, iF OFFERED: IN WASHINGTON, D.¢. Yea... nt ey CONSTANTLY .. reas dl BLicenecossesecsema ce temmenmmavedgeeae : aNrwuiie: IN THE UNITED STATES .. : oursibE THE UNITED STATES soeoes Yea... aseee Ble rou Wit ACCEPT APPOINTMENT IN CERTAIN LOCATIONS: ONLY, SPECIFY LOCATIONS: DATES ATTENDED ... 294021944 a i thee. $n the grants mahinston aren,.op tn. cone foralgn.aresias - 18, EDUCATION an mT ; ELEMENTARY SCHOOL Olffton BULL. ADDRESS Oodha, Mobraska.................. T9B....... ‘ (Cys {Hinted iCagatry) DATES ATTENDED .... 19350*1 9390 GRADUATE?) Yee oe ee Niaa SCHOOL _ Benen High |... ADDRESS Casha, Hobracka........ 09h... . 3 eRe, . tighley GRADUATE? . Yee ... j taohington Univereity 8%. Leule, Mfeecurt USA COLLEGE _. South. Dakota stetea Callappresg .. Broekings,. 8 Smith taketa USA Prowenginssring teiy PITY # mastery) “MalOR AND SPECIALTY . .4 YEARS COMPLETED .. ... Ongebal?. InBope pigbs~aees, 38 194d DATES ATTENDED . S8dag.-ldeAegarsh; G945. University of, Caana CUALGE .. Geerge Saebingten We... APDRESS _ Goverszent . MAJOR AND SPECIALTY ..Pev. -Affsiza... Jonuary 19 Jeiug. 1643 PATES ATTENDED ~harebey. LOWesepte. 293k... Riome?, “A 3rsein, TOS _DEGREL .asgede Qeaka, Nebraska en i eohingtons . De Ge-..s.- Mes) ya ahd Sie hal? . YEARS COMPLETED Gao. and. esisehal? AB . , DEGREE Ai. (oonblato, requiconoate Bape. 91) vie UNDERGRADUATE COLLEGE SURJECTS . fousranents- Bistery, Hathasatiag,. . Mreatotry, Pelitioal. Solence, Someniea INF GRADUATE COLLEGE SUBJECTS . Jnternational Pelitios, International " ertanteation, tata anorteen Poliaios, InGernational Lew 0. $O~ C285D 3
aoe 4 + P@erte yet t. “4 y Bae Oe get agate erg REET WS pee tee pao ae we ‘ ow ew ery ~ bt & & fo 14, ACTIVE U. 8. OR FOREIGN MILITARY SERVICE ee ‘ . ® see sonenscn. U8... sige me sennennceen ERY AME POPBOB. see ~BE0, eset oe D/NOPSB ALL 2B L8G . ecnveene meas -Fosifse, ~Adr. Service. Lomnand . wiaadla.. Peles. 749257, angen fe, REMARKS: —.. eS eee Se aan ther nner ae sa Syed . SELECTIVE SERVICE BOARD NUMBER... a. ADDRESS .....Disatiliy Mersin $ Sey “IY DEFERRED GIVE REASON’... Vataran.... ssvneneswsensneeesseetecsenasaumnusupecteineenin - ek oF ane Oe INDICATE 4 EMBERSHIP IN MILITARY RESERVE ORGANIZATIONS mesoemer oe AOD oe cette Bae tates ame + . 5 LOGICA 5 PA _ 16- f . FOR. ALL PERIODS. OR INCLUDE. £501 PE DS. OF UNEMPLOYMENT. GIVE ADDRESSES AND STA Te ‘WHAT YOU DID. DURING . PERIODS OF UNEMPLOYMENT.., LIST LAST ‘POSIFION FIRST. (List all¢ efvillan ém- ployment by a foreign government,. regardless of dates.) - — a. oe wae etic conse” SO" i Se CATION GRAT ie . wo FROM. Dake 12, 221 10). ~Bronenta — «(LE IN” FEDERAL SERVICE) flan. meee nasser 7 EMPLOYING Fina OR AGENCY students. deorge. Miahington. Untvoratty. sadeswsndiond ADDRESS - moesmnewersnnee g;Haah ington... De.. i Fa ane nen sene sensqeeennsensees Suasssavenesecneeser (|, re St, aad Number) {Grate (Coustrys “KIND OF nusiNess ...Student........... NAME OF SUPERVISOR :.0NA cc ceceeeee . TITLE OF JOR... BW osecconcsceeensceeseesenaes SALARY $0 AOA PER Hoe subalate YOUR DUTIES .... .... Graduate fade. oc ces cccee cueneescensse sce tsees sesuperce coven sestseenene ‘ow . oo re i « ‘ nad Pe Ome mee et tek Re ew CREME AEE E TES OO TERE IANS ORE EO ere PRET E TET TF bet 68k 6 ne ROR SE ER PrOR EEE nee Beene taster es Deere ner Ee STS tebe we mentee emer eb mgt terre sree em oe naam eens tener REASONS FOR LEAVING. Dealra soaitian da oy.2leald.afl knowletss. . : 7 . CLASSIFICATION GRADE From ..00t.1948_...0.. To “Saphs 1990... (PIN FEDFRAL SERVICE) | Jona... EMPLOVING FIRM OMAGENCY _.S6 Aa Suanacn 2. SONG cco ceceseeese ceceececesee ADDRESS ......1202. Dougléa Shag. Qoahe, Nebraaka.. aqeensens vecteereeee IDA etceeeee oo: {St. aad Nueber) ok {Country} KIND OF BUSING 38° Pood: ManuZaatureNAME OF SUPERVISOR _. Mr. Clarke Swavdaah _. TITLE OF JOB... Vamafacturar! @, Rape. SALARY 3... 73. eps PER 2! MMe. 2 a anoog YOUR DUTIES «1 “representa. jay fira.to. various wholasulera and retailers... * _-hantling. Sumneon. merehaniias, . promoting anil facilitating the distribution of the £firata gredueta, and aidad in the anlarganant and Jevslopment .... of the sales ant fietet puts on jepartaent a®* the flra. REASONS FORK LEAVING. Desirad to obtain AY degrea... vee be gen cesses peateseense tees (Z) 14 -eg9g3-6
14-00000 a «8) CLABSIFICATION GRADE reo J0n6 LIAL... TO Aum th 988 _ (IF IN FEDERAL SERVICE) .....24004 EMPLOYING FIM OR AGENCY Sd obs UAV AEAANY. OF MOAI ac rnrnnes creme ADDREHA . —--Omabes, Hobraakas USA........... snesctecesscesncese-eas petsssssaseacsasessseeceseresvstsevenenenanens ro) iGecsteys Bt aed Nunabes } |, ane - YER _Ho.sibehata KIND or BUBINESB ao AIAN. NAME OF SUPERVISOR ... TITLE OF Jos _.. Student. eenesane SALARY BT a ~ ot Your buries ae | ene won sins seen sinensis aa snocosvomantesin *. : . a e } ~ 8 ‘ . a REASONG FOR LEAVING otra AAA ,CLABSIFICA RION-OR PROM .. Marans. ADS. to: —Hoveaber i946 IF IN" CATION: SERVIER) Hone. EMPLOYING FIRM OR AGENCY —Sorvedta, Yo, .8 6. Ary. Ain Poteet. ADDRESS: ~—Masbingtons Ds.. Ore. aA. soaecevesajencaneosba eosones ‘ snnepispinsSsitsateeeo Oo (Hee). (Country) ry "RIND OF BUSINESS 0.0.2.2. NArccsmscnsesnes - NAME, OF SUPERVISOR arty. Harold Joyes_ TITLE OF JOB Aewmunioations. hier vanestase BALARY 8.000001 O2-.-200-- PER MO 9 oe ese YOUR puTIES .I_waa. responsible for. all_insoalng.and. satening. pormnications = omaheet tae sivhtion hata thn gtormica ot ap nitions REASONS POR LEAVING ........DLSQNOKKed PROD SOLVE: cc cesscccsceaccessensceeceson oecseconseee CLASSIFICATION GRADE FROM ...Deae 1944 00. go...March 1945 (iF IN FEDERAL SERVICE) None. EMPLOYING FIRM OR AGENCY Students South vakota State College 200 0 uw, ADORESS .....-....... or 99K daa s. Asuka. 1 DOOR BY serrerenerveerenerrersserccces sestenereseeneecee tn - (fuuntry 7 (Be. apd Murber} (Htate} KIND OF BUSINESS, ...Atudont.w0 (NAME OF SUPERVISOR —...2...- dies esac uencasersceseeses coaeee TITLE OF Jos .._........ Atuadent.... .. SALARY 6... Noma. PER, gees eee saa senses soenen stone YOUR DUTIES .. Attended. tha. iiniveraity undef the ASTAP. prograda. oo ene | SeOOUNET IAL HOSE LOOT HHSC eM EY Hee HeTR SER ETAL E YT: ~PeeHEs tT Fe REASONS FOR LEAVING |... Untered Air. Por egg. eeeseeercers eens Veceteeeceeeee one one tress 8 a, 0s i i a
14-00000 SEc. a ty ge “og - £ bg Fr en meme rly eth ‘ Tren oe 1 Nahe en 4 SRA re taden, he te panther can co ta 2e ace Mme ye Sn _ ‘Sue. 41. GENERAL L QUALIFICATIONS Ae POREIGN - LANGUAGES | (gTATE DEGREE | oR PROFICIENCY, As. “suicHT “FAIRS. OR: Lee om 16. HAVE YOU EVER KEEN DISCHARGED OR ASKED ‘TO RESIGN FROM ANY POSI- TION? HAVE YOU LEFT A POSITION UNDER CIRCUMSTANCES WHICH you DESIRE TO EXPLAIN? GIVE DETAILS: ~ San. ane wat. eee thenenaaties 8: rn Dapogiee remaaaaaroaaeenters steel) WLAits AOE Wht SLLEL OMIM D AEG HOS 8%% HR OH IRR Ow SO Ind Ls aadres anna abte tua eos a “wed ro | FLUENT?) --- _ LANGUAGE. _Bpant ah BrEAK SUBIR READ- a WRITE, ... Blight” . LANGUAGE PRONE... SPEAK: SIE. READ .. fil ght... WRITE aes Slight... “CANGTAGE soomeqemmnnansevnnnent SPEAK. eT sncevesnneonsom READ. westegremmcnenne WRITE .. seseneyseseneecmveme ne B.LINT ALL. SPORTB AND HOBBIES WHICH INTEREST YOU: INDICATE DEGREE OF PROFL CIENCY IN EACH: seocera PONG. 2 SOMLOGEI NG POCOLALN GO cccccccccccssssssrepessnsctecececssevareee assovseese Pnan,”::) 5 Sa <:) < . BW MOLE. LOOK, cseceneee pescete acarsseesessacceuezecses ctpreveesrsseereccarsecevenssescer es presensen pocesasenzen ‘ c. HAVE YOU ANY QUALIFICATIONE, ‘AS 4 RESULT OF TRAINING OR EXPERIENCE, WHICH ‘MIGHT FIT YOU FOR A PAUTICULAK FUSITIONT . o Hone.that ere. not praviously. [lated cece Pew nrenene rene atten sete freee ne + teers eeree == ror rr tte TT OSt Pett. Cr Sati reer or ror te teeter er Sie orth fe See ee roe dD. List ANY SPECIAL SKILLS YOU POSSESS AND MACHINES AND EQUIPMENT YOU CAN USE BUCH AS OPERATION OR SHORT-WAVF RADIO, MULTILITH, COMPTOMETER, KEY PUNCH, TURRET LATHE, SCIENTIFIC Olt PROFESSIONAL DEVICES: i en seseneesssegeenescanuttanetesnmneuinececeessotcaseeneatpestacsenomrent te ao enn ee rene ee rt rome rat nO meee ee tern Os wae See e APPROXIMATE NUMBER OF WORDS PER MINUTE IN TYPING SHORTHAND .. nee teeta t (3) wy. * 2 TY ee af : i q- epee gw BO - we ‘ i ea fF ¥ =a ~4) fo r} te, ' & ¢
z. ARE You Now oP | wave VOU RVEE EES ALte enSeu Git CERTIFIED MEMBER OF ANY FRADE Ok VROFEASION, SUCH AS PILOT, ELECTRICIAN, RALIO OPERATOR, TEACHES, LAWYER, CPA, ETC. if YES, INDICATE KIND OF LICENSE AND STATE -....NQ. 22. cecsssseeestecste snus ssmmannessnonenseomacres FIRST LIC, OR CERTIFICATE (YR) oon. cuee LATEST LIC. OR CERTIFICATE (YR) coccnscsscer-naos F.GIVE ANY SPECIAL QUAL FFICATIONS NOT COVERED ELSEWHERE IN YOUR APPLICATION BUCH AS: (1), YOUR MORE IMPORTA NT PUBLICATIONS ( DO NOT SUBMIT COPIES UNLESS REQUESTED) (2) YOUR PATENTS OR INVENTIONS (8) ‘PUBLIC SPEAKING AND PUBLIC. RELATIONS EXPERIENCE (4) HONOKS AND FELLOWSIIPS RECEIVED Pe ey a ce Honor ROLL thine, tned_otiniverssty. of ma . etary. Seaton. -tep $0 Abel tae RB eveapeen tee eusonsarssnsnen rstimmsenotinentse sstenermerniaicasecestssssessuranapensetneniees® PT HP DOLLA LD LAL GOODE Pow « * 7 ‘poracenasaressseanepeaneincsnnssinnsenssshenesaseseeiniessnstmesissecenecartnnimcerwtsmne tnt@enenseansneesSebetetie0 cs tt ceeeentete tate ‘ ar ‘ Pars ce en * : - ne AG LPAI SB ONEASTRIOTES « COIETS TREE r Peentes sane emcssne stare sess atirIar SHU SUsINeaNee Mee tetas ea aAT HOE) Leu eaD ROM oat Ae G HAVE YOU A PHYRICAL ITANDICAP,. DISEASE, OR: OTHER: DISABILITY WHICH BHOULD ‘BE. CONSIDERY. DN ASSIGNING YOU ‘6 WORK?” LiF ANSWER. is “YES EXPLAIN: wee, Veakate gait vt ae ae f ‘ weet. inna He nbene news e 20 EER Ta TE TEV eres ORET STIL ADTIDI ESTES DELEON TO CCLRC ELE S POE EE Ente ERE VERE Nee CMM RENSTEL EEE TET ODM TRE on Don Cok gat gg oe : ‘ PEMA M Ae ameE EADIE ERE DE OOD TE Hameo E: Deer re Resrranepen steer cose crea nse seene. forersseore Pea v eel nas ROLE TELE Dee KotH ID” DHS ee Seed LED ODER LEED OD Osh eeNe™ ~H peed ‘ Raw Oa OEE ee Re REET ETO TITEL FETED ESTED FORA OE EODELTEDOLLE 1ILERCEET SOO ESLOFOONED SOE CUSDSUEUETEEOS OP EEEs Fades SraU OEE OTS deb ees ee aEP eye ee sree er ear seeonee ’ . . 2 OO eee One ote eeZ OTe R EOE tes OEM SEE MERE NEN CC LALA AEST IRER EURO ELAS G1 ELONERISETED EES ION HOF OP TRE ee eae Ene LEOE OOS POEs OED TOE SEES TE EG TEESE EOE TEE TIEN © Lon H.D0 YOU RECKIVE AN ANNUITY FROM THE UNITED STATES 08 DISTRICT OF COI. UMBIA ee GOVERNMENT UNDER ANY RETMEMED iT ACT OR ANY PENSION OF OTHER COMPENSATION FOR MILITARY OR NAVAL SERVICE? [FP ANSWER IS “YES,” GIVE COMYLETE DIMTPAILSs t Pores carn ereteeereree eee Ob aE HOON ORO R TH IPED H PUBnsIEe” Dnmes OORT Om vETH TEN ee ES one ne Y . cececeredencweetmerese cena: (+ utnsttr pe eeeee . Pre rececgmeccenern seghuewsee suenmennnaaerntme remredceeracrens eg ecestneeTen test uceues toneeowe “ Aeewenens erence rauerrrerertsierasrecenenrer rapegeeses sees ae ber emweee Venema ranncces nace wasn necnes saweune ehh open en snausaeewercureters semanas one: ° “en ~ He--Beabd- & i . Fa > - efit ress 4 © _* - , - tease —
18 GIVE FIVE CHARACTER REFERENCES~-IN THE U. S.—WHO KNOW YOU INTI- _MATELY— (Give residence and business addresses where possible.) . 2 Street and Number | City. — State SEC. WE g BUS. ADD Unke : : RES. app I & BUS. ADD. 3 ‘BES. ADD. 19. NAMES OF 1 FIVE PE ERSONS. WHO KNOW YOU SOCIALLY IN. THE UNITED STATES— NOT REFERENCES, RELATIVES, SUPERVISORS, OR EMPLOYERS—(Give residence and bisiness addresses where possible:) - Strest and Number City State i. | BUS, ADD,-lnlk: . > RES. ADD] [- 2 i BUS. ADD. J £ Mie RES, ADD. ’ & | BUS. ADD. Lowa. State College, .Amas, .Iowa............ | RES. ADy ves 4 BUS. ADD. Unk ace ce cee esac sctcecneseecupsunsee eseess RES. ADD. 5. RUS. ADD, ; RES. ADD, SET Co SE ETE AS ESE Sethi a SE ea Sec. 20. GIVE THREE NE IGHB ORS AT YOUR LAST. NORMAL RESIDENCE IN THE U. S.— (Give residence and business addresses where possible.) “Street and Number. - City i State i US. ADD UDKe cee ; LES. ADD, I: a a US AD ES, ADI 3 US. ADD Es. ADD ESN TR «I {Claes ec ceereneeseeeeseee aaa a = Sec, 21. FINANCIAL BACKGROUND A. ARE YOU ENTIRELY DEYrENDENT ON YOUR SALARY? Y@@.... IF NOT, STATE SOURCES OF OTHER INCOME 2 S006 nen cee seen snore sas anen vomeeaesenensnenamatarseceeeceames BR NAMES AND ADDRESSES GF BANKS WITH WHICH YOU JIAVE ACCOUNTS WW. ©... wee weer] qiip ideas i RUS. AD ‘ Ban Sin - RES. ADI . eee a ea dawetal at enter
14-00000 7 . s ~ a as vere - a ~ 2 ne me « - -* ao. . - ° oa “ ' . ty Fake ~ as ree tee ene ema me wan rer ren np aero, te are Me oman amnrane amie ~ an 412) ’ : et C. HAVE YOU EVER REEN IN, Of PETITIONED FOR, BANKRUPTCY? HQ... seston, , GIVE PARTICULARS, INCLUDING COURT; : . — | D. GIVE THREE. CEEDIT REFERE NCES—IN THE ULS. ; ; . i, NAME 2 NAME & NAME g: SEC, 22. RESIDENCES FOR. THE ‘PAST 15 | 4 Le FROM as_395}... 70... Pre pent | i _ _ Teen. 8h, — | ¥ ke From S¢p$..1950.. ro Fen 1991. ————————=— |senynetona_ Dede. . ¢ -. bee ek i oS f oo FRow Jsine_1950.. To Bept_t9%0.. | rat he . Bo FROM. a TO “Dund.3852. hee aks, a FROM. 1926... 10.1949. a os - wes * ~ 8 2 ute — 7a OT SPT yi mas “(Band saa “eeF ‘Tetate} vos esata ” Bee ~ FROM- cone tnmrincnemntne PO ceacernsegcreameesmen  cececsumensecznensunucracsengeuscarsceceannnsaycotiar see; seasenntanayoosonsepnaes st cedanese ~ « . aa wanker) “P-4Clte) (Bator omarion SEC, 23. RESIDENCE OR TRAVEL OUTSIDE OF THE UNITED STATES ; A. FROM ~-Nov_.145.. To.Sept.!46.. Mantle, Philippine. Jalandes Ar. Porte. duty City ur section} Sieur een plea siete whee SP ahi! ORES bi | b= co] 4 ; FROM cocccccccccec noc cece PO secscueteseectsecs one assserscencenstacnssnseunmenaenasasentapsenazensennagarnseansentenssstansanareeseccees j (City or veetion) Country} (Pur pose) ff oon see enE runes HO mNACETE DGD ESOL Be Led HE OM AFOSR TOE NEMERH RE HERCE NES EE Brees vanes wend iChty or nection} (Country) (Purposes) Wi ca PGE FR Ph Sb Ameena tmnt te teenie etmeemer nner. ban Sec. 24. CLUBS, SOCIETYES, AND OTHER ORGANIZATIONS LIST NAMES AND ADDRESSES OF ALL CLURS, SOCIFTIES, PROFRASIONAL SOCIETIES, EM- PLOYER GROUPS, ORGANIZATIONS GF ANY KIND UNCLUDE MPMRERKSHIP UN, Of SUPPORT OF, ANY ORGANIZATION HAVING HEADQUARTERS OR LRANCIUIN A FOREIGN COUNTRY) TO WHICH YOU BELONG OR HAVE EBLLONGED: 1. .......Qmaha Post.¢1,, The American Legions 20th & Dodza Std., nara, Nebraaka “[Poameand Chapser)-  “ “U8 and Nusaler) “Coty iSiate> “1 Country} DATES OF MEMBERSHIP: .2247@19 50 ae occ eeeeeeeeecy epccee ton ee pees coon caeieeeen . - « -* . . (Name and Chapter) ‘St. ant Neeniar) ehy) (Bente erate ee _ DATES OF MEMPERSAIPs. oon. tecsdanescbewesdecSoeendetSAEEEC nace, eneedeccnceed dbs Haeeaecaedseepectengees Se aetenemenceee ence tn sees cm ate nes teas ecetee snenee econ enenee st dacee ceneenees soweeceteweneteseeeeceensnneee (Natav and Chapter) ASt and Nucater) (chy) (Brute) (Country) “DATES OF MEMBERSHIPS ce cecceeseecescoe secsecethops vena seupesvaneasapesactussetesnarevesnaeet z IG~- GARR G-H 1 oh Ode
4 z 3 a MB Ly Et tt <a Namve” sreseneuaam see a Srereneseremetrn eng acces ca oemn amar ore yi ° DATES OF MEMBERSHIP: ... cesses teers ouemeenen nen nae eeee ence eteneennenennanneenee asta tnoenetny esse. sere mhpacoccess peneRE een trates weheanNee sth hhtRtene neha enn enaeeemnemeh sone sun ame abe & 7} -§ "eh beens e nvyenes tcuandenmmevenst vos . (Nemes and Chapter). - (&, and ‘Member’ ¢ 3 en . ke ad tf & DATES OF MEMBERSHIP: oye rg . Cesc en . (Haine and Chapeand ‘ DATES OF MEMBERSHIP: 2220220 acs. ae Hoe He LAMA TALIA SUT OMAR TOLe EE BUTE PRIESTS 9, ewe nanan eon ee a San abr Ae somtoan GES Hes nn ee “s eye es) oan (ee mat " ar "eeu aa 3 me. tt . yoga . sete ares oad “DATES OF MEMBERSHIP: yo ooe Soames neie ane nee tape enero ‘et aay , Mek Si . va } 3 mia 14  s i : ; i 3 * i. i 3 ° 6 £ a i , 4d i 4 i ¥ | ? : dg. - 4 . j 2 ee ee ee mie
iy ARSENATE EMT RC IIT BARRE. GR bee aFEP IIE ES Vl spo yr ~ - alas ake eer - 7 ee aT aaa “* : a4) F.IF, TO YOUR KNOW, EDGE, ANY OF THE AnuvE WAS CONDUCTED AN INVESTIGATION OF YOU, INDICATE KELOW. THE GAME OF THAT AGENCY AND THE APPROXIMATE DATE OF THE INV ESTIGATION; veovvenmconen en MOTO heres eeeen saumcnencaits sets sanrsanenecatucesenessnensuces veecurerseucensennecten omuecnasee sacs prenee See, 26. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY: NAME ee mocemesene, RELATIONSHIP WAL. ncursoonme appness| ne |.” ae ee i Sac. 27. YOU: ARE INFORMED THAT THE: CORRECTNESS OF ALL STATEMENTS, MADE . > HEREIN: WILL BE INYESTICATED. - t ARE THERE ANY UNFAVORABLE INCIDENTS IN YOUR LIFE.NOT MENTIONED ABOVE WHICH MAY BE.. DISCOVERED jIN SCRARQUENT INVESTIGATION, WHETHER YOU WERE DIRECTLY . INVOLVED OR NUT, WHICH MIGHT REQUIRE EXPLANATION! IF 80, DESCRIBE. If NOT, ce - ANSWER “NO? 2-0, en eee seeemmasnareosas fon naman mananrenae we wovenereemeenone Serer Mansa ee TRE Ae ER IT Sec, 28. f CERTIFY THAT THE POREGCOING ANSWERS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWL DGE AND BELIEF, AND LAGRER THAT ANY MISSTATEMENT OR OMISSION AS TO A MATERIAL FACT WILL CONSTITUTE GROUNDS FOk IM- MEDIATE DISMISSAL OR REJECTION OF MY APPLICATION. SIGNED AT... | Learytac a we =~ OC DATE. .. Mey 4, J95LL mo Lae B <ietegs fe ee lf ¢Sigantare of Apptic PORT? Pander 1 . 10, ras» we ewewenere eres USE THE FOU, Low ING PAGES FORE FEATRA DETAILS. NUMB ER ACCORDING TO THE NUM- BER OF THE QUESTION ‘TO WE LeCH THEY RELATE, SIGN YOUR NAME AT THE END OF THE ADDED MATERIAL, IF A DOITIONAL SPACE IS REQUIRED USE EMTR&A PAGES THE SAME SIZE AS THESE AND SIG EACH SUCH PAGE. "BR woromentor wa.eTias CPriCg «16 ATESE-E © A ee ee