Oem OR GAD HR CAGE ad fMaRGENCY, ARAM BOTY. Det LARATION OF APPOLITEE a socvtnnd before entrance on duty. Anewee all questions. A-imitted unfavorable arrestzacaiacharpes will be considered together with the faverable information xeue present fitness for Federal employment. However, a fulbe statement or poitinent and is punishable by law. _. This form ty te be o inforthation abort sich me in your reeord in deters dishonest dnswer te sny-questaa may be bre suns for dismissal after ap 2 PALSENT ADDASLS (asesel aed em dar OLE ae Stated ~ ok kl ae ae Sire. a “. ttle. ashe twl, WAR. zo DATE OF UATE . : AD aS oF suites (oity and Stat rey ane feere.gn Counteg » . ed _SL97 fst. J ies le. ve land, Chro. fe ' (8) RELATAhSE rey STeLET AND AGMBLA, CiTW AMD STATE fbi it 4, { f)) TELEPHONE OQ. mM. 4 & NES THe waren STATES GUALANVERT ne, ~ FAR ST LAN CAPACITY. A any 4¥ RATT OF YOURS (EITHER BY BLOOD OF MARAIRGE) with wea: Woo Givd OR MAVE LIVED THis tre rastagmontact [J ves fi] . , fe seecenesennacnwan tics en sensanngasonenoce INDICATE ANSWER BY PLACING “X" RE OPROTER COLUMN VES, na! INDICATE ANSWER BY PLACING “K" IN PROPER COLUMN | YES! NO af ro, for each auch colatiwe A: in the Blend below. If advitionsl space is necessary, complete umier tem £3, ~~ pi ees SCE ADDRESS. 7 (0 rosticn GAT. wonky Om BOT 5 WAR. | SiMe Rang ' (Give cont wurmben fa ) 3 CLPASI MCAT O# AGENCY IN wence «| RELATIONSHIP | aro | GLE eres ee amen nel baal eatin _ _tueortD {Cheek one) a a 1B. en veeneseescscace hae ces rete wwnemeseneus : { J a Corea oer ie SERENE cor ms done RI, oe See coer tne eng en emee Nee —— _— aon AR CREEP ALA ig (AD HAVE YOU EVER PLD A WAIN ER OF LIFE INSURANCE COVERAGE. RATE Ge Jb LAN SAROA OO WCU Cur: 30 Tha, ord TED x Ho UNDER THE FROERAL EMPLUTEDS GhOUP LIFE INSLRARCE ACTE STALLS GF AY ERICAT . y x ee wee op ame re et — ||} RE YGU AM OFFICIAL OR EMFROVES GF ANY STATE TEU TORY, COUNTY, OR y I (8) IF YOU RAVE FILED SUCH A WAIVER, HAS AT BCEN CANCELED OR a i REVUXCOR ~ | it 64 HGNICIPALST YP if pour anawer — SULTING IE THIS APPOIMEMEN TS | - i eee eta 3.00 YOU RECEIVE G8 HAVE YOU APL D FOP EX ka. > ROW THE UNITED | rd SINCE YOU PLEO APPLICATION F STATES GF DISTRICT OF COLMA SOLER PANY RETIRE VENT “LAMAN You RITM DISCRANSLD PROM EMPLOYMENT BECAUSE: f i ' SPOR ANY. PENS ON ON Chand COV RAST BSS AAUTARY OF ' . Slavicey Y PERS OS ON Gh ne8 CONAGRA ER MAATARY OF NAVAL if Gp your concer waa nor sarueactoar? if your anwwer is ''Yos,'* gre details on tae 19 fe. ! (2) YOUR Woes WAS NOT SATISFAT TORY? } Spare S Teh . roa Maren 5 ana os “ is RY 2 Gao con] ee “ BRAND YOU AL GhoD Ab Tat CFRRIAL NOTE CADIOW THATS i Ber RCEMENT A Ta a ae STATE LAW CURE OR URAL Li RE BCL bw PAP SS SAMATA AS FMB LL Pree ALL OTHER CHARGES ¥LST Ee MND 1 SMIBSLO, df your answer fe “Yas.” give sn Poem ff far sach case: it 2) apprasimate date, (2) oPar ga (St sun 6 setivn talea. i d i Ah OR NAME DO (2) YOUR WORK WAS BOT SATIRE ACTORVE Pant RD bet ioe WAS SEM UF TMEY WERE CL WAVE YOU RCEN OIFCHARGED FROW THE ARTO STRVICES UNDER | CEMLR Tek Ob TAME CORD TNS? i af gour anawer ta A, BR, of C is Ve i deen ¢2 asclearly as you cam coment i Aare any adress of employer, epproaimate date, and 1e110N8 If Ath Case. 1 i ! toa ae et | | (1) YOUR CONDUCT WAS AUT SATIVACTCA St ” giva dataile tei x v, cscluding tee b F YOU Pra trees a ind BPAMET A wT HAVE Ye. PCM OANA BOY Ene eee Sn FROM TARING. ERAMNATICH > Ore ACCEPTING cam Me VRADAC MENTS? if your eanewer ig ‘* Yen, anes 3? art reasons for auch debarmen? an trem te 42, SPACE FGR DETAILED APSMERS TY OTHER Q SST Uesicate jtem numbers ta which answers apply.) iw organs nt By WEN FERED? — INSTRUCTIONS TO APPCINTING OFFICER, —~You must determine hat chs” appointment “would be in conformance with the Civil Service Act, apphozne Civil Service Rules ard Regulations, and acta cf © % pertaining to apps ot. fe arrent, age, citize® and meme This form should be checked foe be see of office, pension, any record of recent Ciscly tye , ne! bers of family. Also, to estaba’ the ideanty of the appointee, you should particularly foie, B (1) his signature ndwriting against the application and/or ogter pertinent papers and (2) his physical appearance searpet the medical ceetificateyg th & GOTkasdaT Pasting erence 16S ted 3
or aa ae aie LISTS 8 Ab Re Peeigejaa La Gane om Ne sete = BNE NASIR EE ace Be cee ed Cn a a a eens ee eee PE Naver cee 12 March 1959 Tor Personnel ‘Division — Frost Jomen B. Wilcott, Jre Subjects Supplenenta to per sonnel records Pleage add to my personnel records the attached information concerning my education anc recently bern child, when I abaitted my Personnel History Statement with my application for employnent I was still attending business cehool, Therefore, ny final transcript and graduation certificate ware not ineluded. The attached auto-stat copies are attached as instructed by Personnel Livision. Alec attached is a copy of my grade report for the lat © eta end cumesters at the U. S. Department of Agriculture Graduate school for Elementary Federal Government Accounting. fe Utes ee oF eatentt: “ JAMES B WILCOTT JR
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14-00000 e : . ek + ’ Ao FE a 7, PGCE oe errs ote tee fo. 6 /, i A pee ee Serres Oe ne neat We ee mene serene “tee ‘ me eee ae Ie ot tne an ae & 1 ot wats Sinn wena BY ANSE eam A ene tatyS et Elation Dune ‘atte Ri Sanat 7 one : Bape So amertgay oe eee wen? a dere ye 2 ne eet al oet eta - Men reg . a aed ee ee ort ten pce CR In a te td ae aor’ te EAE wears Ntes Pr corte Stet Feat lase aw gs re ee Pere va Pr fem Et tome EL . . ee oe BERG a ne Lar ore onan ale Aptana ne oe a ant
74-00000 MASLTAL STATUS SEWTELED §F YOU HAVE BEEN MARREED MORE THAN ONCE, (UCL UDINE AMNULMENTS, USE SHEET FOR FORWER FIFE OR MUSBAND an WIFE OR . HUSBAND! GIVING DATA REQUIRED BELOW FOR ALL PREVICUS WARRIAGES, Maddlay DATE OF MARRIAGE PLACE OF MARALAGE . ‘ S- DATE OF BIRTH 7+ PLACE OF BATH . . Y O° MATIONALATY AT BIRTH @- SUBSEQUENT CITIZEN SREPS 10. PRESENT RESIOLNCE eat residence, & GCC RAE @ (SECTION X QULORER PLACE OF BTR TH NATIONALE TY AY BIRTH ® a 5 : npton @ TSECTION XI , FATHER 2. VEAR OF Beare | 3. Peace OF BIATH 4 MATION ALi Ty AT OR TH te FULL MM aNwE ' $. SUGSEQUENT CHTIZEMSHIPS 6. OCCUPATION 7. PRESENT RESIDENCE “MOTHER @ SECTION 211 . ; 3. Peact OF BERTH . I" BATIONAL ITY AT BER Tot 7 6. OCCUPATION
14-00000 ‘e [section ri: , CHIZEASIP ” pi ersten craaasnar | 2. RATIONALITY AT GIRTH AND ANY SUBSEQUENT Catizenswpps CLF different than Item #. J 3. PRESENT RESIDENCE (dadscete 2¢ oomer, Raman? of subs tenant) + PERMANENT AOORESS CLF different than Ftow 3.) a “ . af U.S. MATURALEZED CITIZEN, Std mame, OFTZ, CLTV AND MUMGEM OF CERTIFICATE GRANTED TRAVEL OUTSIDE COUNTRY OF PRESENT MESIGEMCE (Countries, dates and purposes) OCCUPATIONAL AND FikanCiAL DATA @ | SECTION $88 : : @ &. COMAMCEAL STATUS (Baraings, bank deposits, secursties and property) @ | SECTION IV . ORGAN (ZATIONAL AFFILIATIONS t, MEMBERSHIP IN RELIGIOUS ORGANIZATIONS . + PRESENT AND PAST MEMBERSHIP $6 PROFESSIONAL AND SOCIAL ORGANIZATIONS: POLITICAL AFFILIATIONS @ @ | section ¥ EOQUCATIONAL OATA 7 : 1. SCHOOLS HAME AND LOCATION OF SCHOOL NAME OF , COURSE Us. Dept. of Agriculture “filementary Federal Gov, ‘aduatea School Wash De .G an peared -lst.semester. Dept. of Agriculture ementary Federal Gov. Cus : 16, 3 4 9; 4 4 ¢ $8 a et BASH rie LANGUAGES AND OLALECTS COMPETENCE (Last below each Language as which you Possess any degcee of competence. 3 eg *
SECRET és . ¢Bhee Fidied for “| PERIOD SUPPLENENT | | PERSONAL HISTORY STATENERT'< wie _ INSTRUC TIONS | “tor Taie ‘foes provides the measa sheredy your offacaad pectonned ec aeee sig? be “pest cucrent. Even theugh of duplicates eeformation pou Aave fseatahed preveowady, #6 witl be recessare fer tow complete tions ou Ld cS ne £ enterety. You aged coaplete Sectesons thi thraagh “gun: ‘onip af there Sas been a cnenee eance you entered on duty o6 th the ocgendeatson of if yee Seiriove the stem ¢eguiees- ware somptete Sever sae then peu Aare greviovaly reported. ce City, fone, State 2. CyRReny ‘ApDaE SS (Mo., Street, Cety, Zone, State) S. @EmMaxEaT a00kG$9.¢A9., Sereet, Governor Shephard Apts Apt 103 “2121 Virginia Ave MW Washington, 7 D.C. S STATE, TERRETORY, Washington, D.C. - ‘ SEcTion 46 PERSON TO BE NOTIFIED in CAS€ OF ENERGERCY 9. waur (Last Tara aT eT *TEFERABLY R RESEDING IN Ue3s wt Mrs, Elsie L, Wileott HOWE ADDRESS ce. Street, Cety, 2121 Virginka Ave NW Washington 7, D.C. a. BUSINESS ADDRESS (Ve., Street, Caty, Zone, State, Countty }- 2430 E St. Washington, D.C. S$. WOME TELEPHONE NUMBER Ra 68-3771 Sf 103 @. EN CASE OF CMERGENCY, 'S NOT DESIRASLE SECAUSE OF HEARTH OF OTHER REASONS, POSRESS 10% OR COUMTAY 1% HICH FOU NOW CLAM RESIOENCE i 4. Mowd TELEPHONE NUMER Rao8e3771 Ex 103 a. RELATION SHEP fone, State, Countey}. BNDECATE Name OF Fama OR EMPLOVER, FF APPLICABLE @- BUSINESS TELEPHOME NiVeRER 7. QUSINESS TELPPHGNE EXTENSION EX 3-6115 Ex 3229 GINER CLOSE RELATIVES (Spouse, Wother, Father) way acso GE NOTIFIECD. PLEASE $2 Stare, 1f 3UCH NOTIFICATION SECTION {11 MARITAL STATUS ie @vece (aT ont BS [ [sete Joennie | [Jerrnanred Jorvercro]_] a. FURNISH DATE, PLACE AND REASON FOR ALL SEPASATIONS, DIVORCES CT AnnULMINTS ANAULE EO NA use & separate sheet for former e1fe oF anciuding anrelrenis SPOUSE: If you have been asecied sore than once, Ef marzasge (8 contemplated. provade same data fur france. waband giving data beiow for all previous marctages. 3. NAME (First) (¥sddie) (Masden} (Last) ‘, Elsie Louise Paul Wilcott PLACE OF MARRIAGE (Coty, State, Courter) er 4a ona Bees 2 tPF PI AGE $s. | Eagle Bay, New York USA ; . Comex € ey ) Hl j 6. ADDRESS OF SPOUSE BEFORE waRRi AGE (NO. . Steeet. City, State. Cold Brook, New York USA | LIVENG @- DATE OF DEATH B®. Cause CF OL aT F q e Je tO. CURGEMT BDORESS (G2¥e Aaat address, sf deceased) . if. i i: reed aSeabaue - 2121 Virginia Ave NW, Washington 7, D.C. Vr. DATE OF BIRTH 12. PLACE OF BIRTH (City, State, Coustey) ait . 9/9/™% Cold Brook, New York - 1 BORN OUTSIDE U.S.*DATE OF tuTAy [14. PLACE OF ENTRY , NA CUVaZensnipy (Coasteyy 16. BATE aCQuikes FUT. weee acQuints (Caty, State, Country)  csaaeeenataameentannenenetienemargmeememmaeacenmameameememeneenennaeeteed OCCUPATION 19. PRESENT FuPLOveR (Mise gave farwoe euployer, or if .apeuse 18 deceased oF aneaplopyed, iaat tes reployers) Govern. clerk steno TO. EWPLOVER’S Ca Be FiNESS$ aovRess (Vo., 2430 E St. Washington, D.C. Street, Caty, Stare, Cosmtey) SECTIOh bil GoaTiaceo 10 PAGE @ FOQ™UUUD ose peavieus taitrons. , SECRET ; ~ a" i . tO° 8?
14-00000 _ SECRET i" . toe (Rem Fabted In} . . . . _SECTICN 112 CONTINUED FROM PAGE a and Foo ) By WoNte AND VEAR ec nna te eens yng a at. OATES-OF MILITARY STRVICE OF SPOUSE (Fe one None : T2. BRANCH OF SERVICE DETAIRG OF OTHER GOVERNMENT SERVICE, U.S. O8 FOREIGN 89. COUNTRY WET WHICH MEL TTARY SERVICE AHIR EATEO ae $- tuba wang (LeateFrrae-Baddie) 4 None te ' 4. apontss OF COUNTRY CH BRICH RELATIVE REBIOES 7+ DATE-:OF LAST comPact FREQUENCY OF CONTACT 1. rue name (Leat-Firat-#iddie) , ow @- ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES S- COVRPEMSHIP (Counteyy FREQUE ACY OF CONTACT 1. Fubu name (LeseeFeraceWs didlo) ‘@ ADORESS OA COUNTRY IN HICH RELATIVE RFUEDES t. PULL mame (hast-Firet-addia} 2. RELATIONSNEP &- ADORESS OR COUNTRY IN WeICH RELATIVE RESIDES Be CETIZENSMIE (Counter > 6- #VEQUENCY OF COMTACT . Pe GATE OF LAST CONTACT ° 5. SPECIAL REMARKS, TF ANY, LONCEAMING THESE AELATIVES » . 8 @] S€CcTion V ‘ ‘ FIMANCHAL STATUS [es ik fro 1 ARE YOU ENTIRELY OFPENDENT ON YOUR SALARY? 2,00 VOU RAVE ANY FINANCIAL IMVEREST GN, OR OFFICIAL CONNECTION @ETN, NON U.S. CORPORATIONS Of BUSINESSES OR IN Of CORPORATIONS CR BUSINESSES HAVING SUBSTANTIAL FOREIGN INTERES TSE { }ves Cc ao if WOU HAVE ‘ with u.s. AMNSWEREO "VES." GtvE COMPLETE DETAILS ON A SEPARATE SHEET AND ATTACH IN A SEALED ENVELOPE. ’ .  ——oneerrernrntereneten rer 3. DO YOU RECEIVE AN ANMUSTY FROW THE UNITED STATES OR DISTRICT CF COLUMB A GOVERNMENT UNDER AMY RETIREMENT ACT, PENSIOW. OR COMPENSATION FOR MILITARY OR WAVAL SERVICE? [ves (C] se 4 IF YOU HAWE ANSPERED “VES“ TO QUESTECN 3 ABOVE, Gt¥E COMPLETE DL TAILS. My wife also receives a salary. SB WETMOUT REFERENCE TO VOUR SALARY, STATE OTHER SOURCES OF RECURMENT INCOME HOT INDICATEO BY PRECEDING ITEMS, . . * ees . SECTION v ComTINUED TO PAGE 3 SECRET 2
14-00000 ‘ ’ - = ~ SECRET fio . a > . , : .. . . (Bheom Fibled lev | +. ; ~ ; . ; SECTION ¥ COnTigutS FO Fae 2 ~ . ant ’ A fo 7B. BARR TAG ENS TETUTIONS BEfe ame ce TS waked BC COLATS . . : ‘ , RAM? OF EASTITUT ION : CLTLZENSHLP t. COCNPRY OF CURRENT CHTIZEN SEP S- CUUETENSEP AC QIRES BY + CeacaR FNP CRE . . - , Z ° . (3) erate { } wsaerase { 71 otaes (Specefey: Give PARTICULARS RAYE YOU TARLM STLPS§ TO CHANCE YOUR @ PECSENT CHTIZENSWURE C7? ves gk ie TF YOU HAVE APPLIED FOR US. CHVEZEUSOIPL ENDICATE PRESENT SAILS SF VOLe aPeR CATION (Farad Pepera, etc.) ° . Y. CwECR ERD HiteaST Levee CF CPL SATION ATTRONED Pram MIGH S2NOUL GEABUATE mies TOTOUL SHHOUATE SERA AMA AVG LL RTARE fe MECHER DE COLE asec. are Os Comma. dak HEMooR e.ptweas, Deeeee BAR Lass ' 2 COLLEGE OW LNieitsrry stuns SEM/QTR HRS. COMPLETED (Specaéy) Sueaict ¢3 College of Syracuse Univ, TRADE, COMMERCIAL AND SPECI: 3- i MAWE OF SCHOOL 4. MAME Of SCHOOL electrician neer School! Fi, Belvoir En _ | 3B. Ore ege TRUCaTT pea TARIMISe SOF TDC ayeG ase At present taking a course at aS Dept of Agre ‘Title ~ Blesentary Federal Government Accounting — SECRET 3
(ne ECR J, ia) . . a i at “GEOGRAPHIC AREA KNOWLEDGE e t LtS? BELTM@ ANY @CO@LS Om BEGIONS O8 COUNTRIES DF OHICH VOU mAVE BNOBLEOGE @aineD as & RESULT OF BESIDENCE. TRAVEL, Ca BORK asst smmtat “oTmag® Tea OnGene tation Exp EB LENCE UNOTR cOLumy tty eg or BPacsaiiree amowigoge.* fee Stvee : PALL RoOaNg ARO US TRIE PORES icas PAR DATES OF ABCBLEDSE BCQVIBRD BY REBIOEMCE. TRavaa, ete, = 8y' wat OF BECIOM OF Loum tay 2 - * : MESIOERCE OF TRAVEL FOR EAC OF THE REGIONS OR COUNTRIES LESTED UMOICaTE tek PURPOSE OF VISIT, anger piloe ANY FOREEGY ATGIONS OR COUNTRIES OF BHICH VOU NAVE GAINED ANOMLELOGE AS A ALSULT OF ORGaMmtcaTtON ASS GaMiAT OW ACTivetY- BNOWLTAGE ACQUERZO BY DATES oF MESIDENCE, TRAVEL. €7C, twee OF SPECTALEZED KNOWL EOGE Raus CF @EGIGY Of COUNTaY _. TYPING ANO STENOGRAPHIC SKHLLS +. Pyeng CHP.) [2 sor tana ®. Pow. Je SHORTHAND SYSTEM USED + CHECK CX} APPROPRIATE ITEM ho fcarss| | srrtownitinc| |stexorved _| Ormer (Specs: fy}: TROICATE OTWER BUSIMESS MACHINES @ITH BIC YOU HAVE HAO OPERATING EXPERIENCE OR TRAINING (Coapfometor, Mimece graph. Cord Punch, efe. 3 National Bookkeeping Section & SPECIAL QUALIFICATIONS Y. &1S7 ALL 4OBBIES AMD SPORTS IN BHC VOU ARE ACTIVE OR HAVE ACTIVELY PANTICIPATEO. ote Eade Chess = Fair, Football « fair 2. PeGiCare Suny SPECIAL GUALIFICATIONS, RESUR TING FROM EXPERIENCE OR TRAEN ENG, POSTTIONM GA TVPE OF wCRE - US Dept of Agr. Graduate School = Elementary Federal Government Accounting LIS? Amy SPECTAL SHILLS FOU POSSESS RELATING TO OTHER EQUIPMENT OF MR YURMET LAINE, SCHENTIF IC AND PROFESSIOW\A GEVICES. ETC. @ fp SECTION 1A a. INDICATE YOUR PROFICIENCY Beith MIGHT FL? YOu FOR A PARTICULAR B- Ceti lisG EQuUIPMEaA? NOTED te SECTION w, CHIMES SUCH AS GCPERAYION OF SHORTWAVE RADIO, MYULTILETH, Rational al Bookkeeping machines, comptometer, caloulator aF voy APE & LECERSED OR CERTIF EEC wimsta OF ANY TRADE OR PRO! LESION (Pélot, Blectracsan, Badia Operator, Poacher, havver, CPA, Wedicel Tachmscian, @tc.). INDICATE THE RIND OF LICENSE OR CHATIFIECATES NAME OF P9SUING STATE, AND BOG Stay numere, fF agen. Ronse - S- Frage CeCense Oe CeRTiFicare (Year of seaue) @. LATEST LICENSE OR CERTIFICATE (Year of ianue) . - SECRET a“ a
“Pe. AEST NY SEGNIPICANT PUBDLESHED WRTERIALS UF -mHcH VOU “~ “SECRET . - = (dahon Filled iny “ SECctiGa R CORTE @ unlese vequested). Bo nol tebes? copes general interest abe sisentific artecteos, tree and TYPE OF aRiting (von: ficloor, AMCTC APE TETLE, PUR FCATIOM DATE, geste, novela, phere efersee, #f¢.) Kong a Ea a ae : & AMCUCATE AMY DEVICKG weitw vou AVE INVENTED AND SFATE Gui Vals of not leaky ARE PaATEWTED a $. KRIST ANY PUGLEC SPEARING AMD PUBL EC RELATIONS EXPERIELYCE | . YO. AIGT ANY PROFESSIONAL, BCADEMIC OF MOROMASY ASSOCIATIONS Of SOCHETIES Im wHICM VOU ARE NOW OM BERE PORWEALY A MEMBER, LEST ACADEMIC HONORS VOU Mave RECEIVED, "SECTION XI ORGANIZATION WORK EXPERIENCE ~ SINCE LAST COMPLETION OF A PERSORMEL QUALIFICATIONS QUESTIONNAIRE INCLUSIVE DATES (Frome and Foe) ' 8. GRADE] S. CFFICE/CEVESION/s BRANCH OF ASSIGNMENT Rs | 3/20/57 to 2/15/58 Figeal Div. Accounts Rranch | 74. NO, OF EWPLOVEES UNDER YOUR OLRECT . SUPERYESION None eens S- CESCRUP TION OF BUTIES “g. OFeICTAL POStTiOw Tite _-Acecunting Clerk Posting of financiel transactions to. Allotsent Ledgers relates nt oo tetas pt. INCLUSHWE OATES (Proms and Tox) 2. GRAOL | 9. OF FICE/OIVISION/ BRANCH OF ASSIGNMENT --|_2/15/58-to Present [5 [Finance Div, Tax_and Compensation. Branc -O MQ. QF EMPLOVEES UNDER YOUR HIMFER |G. GPFICTAL POStTiOw THTLE SUPERVISION None Payroll Clerk &. DESCRIPTION OF OUTERS . Preparation of payroll documents considering base and premium pay and allowances, Maintaining of leave records, Conduct liaison with area division on payroll proble Application of Agency pay regulations, otter rearareonn erty ety a ~ WReLUStTVE DAYLS (Froe- and a+ |’ GRANEIY OFFICES GIGI SION! BRANCH OF ASSIGNMENT ' a SO. OF RMPLOVEETS UNDER YOUR Beeecs SUPERVISION rf e \> OFFICIAL POSETTION THTLE &- OLSCREPTION OF BYUTIES & GRADE] 3. OF FICE/OLVESSON/ERANCH GF ASSIGNMENT to - OFFFCHAL POSETIOm THLE 1. INCLUSIVE, OATES (Froa- and Fae) ;@ NO. OF EMPLOYEES UNDER YOUR S| aECT { SUPERVIStON ‘ pe DESCRIPTION OF DUTIES 4 Frnt teeter & “OC, OF EMPLOYEES UNDER VOuR Oreecy | o. OFF SCIAL POSETION TELE $4 SUPERVISION. . be ENCRUSEVE GATES (Prone and Fa+ } &. GRADE +. OFFECE/Oi vd SIOm/ BRANCH OF ASSIGNwENT bg. OESCRIP TION OF BUTTS 1 . | (Use addstsonal pages sf cogesred) SECRET 5 7
14-00000 So a SECRET 4 ft Bhen Fiised Fay ; _* : rc) @ § 3actrom het . CHILOWEM AMO OIHLR ULPLaptaTs ‘ . pane genes Ae eae ee ip eeennree nite He mae neneoneecemeate te sacsnucenmenanete . [7 wuMees GF OtHle CTP EMDIR TE (FOcludiag spewed, || “3. mameate ‘oF Cwrronen (Ine lodan’g stoperttdeon aed edopted childeon oO ae wane 1 whee ents, sepparents, ssateor, #f¢ 3 ; cus HO. er hese Arnage YOU 608 AT LEAST S08 OF lapy@ GUPPORT, C8, CHIL DEES OveR Ff 16 any suPPoating. ; OF AGL, MoO. AME BOL Saiss suregR : f>- ‘PROVIDE tet FOUL COPING PRP OMMATION FOM ALL rrety age" ¢ Lake tre 159 : , ‘ " oo . umole gt veaRs oe aot, ano ARG nor BUR Fe ty aed BELT I Ow pee " ¥EaR OF Gia ta CHET EN Spee 4000088 a rs : cae aeatanga ane oe Tee eth ethan ADDITIONAL COMMENT AND/OM COmTIMYATION OF PRECLOING seus I feel that my instruction at the Dopt. of Agr. Oraduate School is giving me a good foundation in governmental accounting and I sincerely hope it will be ; considered in future assignments. ‘ > 3 . - , 3 By <3 : ' : " 4 ‘ . ur 2 paid n wwe =D, DATE ComPa dg TES SIGNAL VE OF ErPcover ‘ . ,? . l/s fas | OQ opce. BOY. bee ‘ a ' + "SECRET “
14-00000 . ; CONFIDENTIAL . Be EL. Other Failed fo} Cosiplete in duplicate. The dote recorded on thes formis @ssénteal in determining travel expensed allowable in connection with leave -[at government expense, overseas duty, return to tesidence ypon separation, and for providing current residence and dependency intos- : mation required in the even? ofan employee emergency. The original of thes form will be feled in the employee's official personnel folder]. eae UP EMPLOYER (hese) (Finee) (Midkele) 1 SOS LB da REE Set EWP eB ee - - wi CS ete we IPLEF GS a __ - - : RESIDENCE DATA - PLACE or RESIOENCE SHEN INITIALLY APPOINTED cast peace oF REsinEeNce one CONTINENTAL 0.3. 77; appotniad deo a Syticetse, MG. PLACE ih CONTINENTAL U.S, DESIGNATED AB PERMANENT ESE MOME LEAVE madiDENCE —— Cub Fier, a - , . . MARITAL STATUS (caech ane) = SING KE MARRIED : l [ SEPARATED as [owoacka | [ wee HbORED Se [anwuecee 17 MARRIED. PLACE OF MARRIAGE DATE OF YARRIAGE LVELE E92 WLLGE iF OUVORCED, PLACE OF GIVORCH DECREE - Date or Decree GAVE SF OUSE OED i? MIOOwWEO, PLACE SPOUSE DIED 1f PREVIOUSLY MARRIED, INDICATE NAME(S) OF SPOUSE, REASONIS) POR TERMINATION, AND OATELS? Dee te ene cpap eee _AAEMBERS OF FAMILY eee ep MAME OF SPOUSE ADDRESS ‘{Ne. og Stroal, City, Zone, State) TELE PHONE NO. LS 40S | OO BO ALY NAMES OF CHILDREN ADORE SS | SER BATE OF DIRTH leven’ THES etd Ercor HY: pifeq WAME OF FATHER (Or male guardian? — ADDRESS TELEPHONE NO, Lees yy A DAES BREAHRPE Hae | MAM MAME OF MOTHER (Of ‘onale guardiany ADORE SS TELE PRONE NO, 6g STH nd MiL eck. EVE LIMO EMLE. the. ttle? AV WidT MEMBER(S} OF TOUR FAMILY tf AMY, WAS BEEN TOLD OF YOUR APFILIATION wife Tre ORG ANIZATION | Tare CONTACT 1s RE} QUIRED I AN FMERGENCY, PERSON TO BE NOTIFIED IN CASE OF EMERGENCY __ HWAME (ire, Mee... Whew (LaatePirat-dichaiod RELATIONSHIP HOME FELE PHONE NUMOER Ger Qh he ERP HOME ADORESS (No., Stroet, City, Zane, Stared 510 Beitirclscvl poise. tice fUY, _ _ BUUNESS ADORESS (No., Strvet, City, Zone, State) AND MAME OF EMPLOYER, (F APPLICABLE BUSINESS TELEPHONE & EXTENSION 1S THE INDIVIDUAR NAMED ABOVE WITTING OF YOUR AGENCY APF EIRIATION? fei *No® give name and address of organiza- toon he delieves you wark for. (S$ Fours LZ, AUTHORIZED To MAKE DECISIONS ON YOUR BEHALFF (if *¥o* give name auf addraa of perean, e Ay, whe can meke auch decisions in case of omergrmcy.) on GOES THIS INDIVIDUAL KNOW THAT HE HAS BEEN OESIGNATED AS YOUR EMERGENCY AVORESSEE? LE? (if anane: le "No® anenwer ia "Not explaw why a stom 62 Me : The persons named in item 3 above may also be notified in ‘case of emergency. H such notification is not ‘desirable because of heelth or other reasons, please so state in item 6 on the reverse side of this form. ; CONTINUED ON REVERSE SIDE 14} fore 61 use PREVIOUS CONFIDENTIAL HOrTiOns, .
14-00000 Pe _ CONFIDENTIAL ae ; iwhen Filted ta) ne pe ee el Tn MOUUNTARY ENT RES nn ren en Experience in the handling of employee emergencies hes shown that the cbsence of certain personal date ohten delays_and compli- cates the ‘settlement of estate ond financial matters. The information requested in this section may prove very wselyl to you family or Gttorney in the event of your disebility ordeath and will he disclosed only when crcumstonces warrant, A ANd, INSTITUTIONS WITH WHICH VOU HAVE ACCOUNTS AND THe NAMES (6 Erich Tre AC- INDICATE NAME ANO ADDRESS O! BANKING COUNTS 4&RE CARRIED. ES : ’ : CtAZEnS BANK &. MARYLAND ~ ~ |. eveconte, AG BVO -1-SH% ; ‘> eeamawer | cee a ence ne re Ae it RA RO . HAY 3s A LAST WILE AND TESTAMENT? Cl ves al) NO. (If *¥ea® where fe document located?) nner nee et A AR NN I RE HAVE YOU PRE PLANNED AN ARRANGED GUARDIANSHIT OF YOUR CHILOREN In CASE OF COMMON OMASTER TO BITH PARENTSY . (Cc) vee 54 NO. (1 "Yea" give asada) and address) een ; . WAVE YOU EXECUTED A POWER OF ATTORNEY? [—] YES BE] NO creves®s aio possess the power of attomes*) aorctcamerrrenermree sean ADDITIONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMS oa DATE . VWs Drnck f7b CONFIDENTIAL - a TORR esd ote ‘ -
14-00000 . oes . ‘ - . 7 A ns ee _ | *MATEMENT OF PRIOR FEDERAL CI’) aN AND MILITARY SERVICE : __ AND DETERMINATION OF CuiPETITIVE STATUS ‘Went Cuartens 48, aA AND $a 4 ANBORTANT: The information ‘on n this form wilt, ‘be used (1) in deter mining creditable service for leave purpoace and retention . eredits for‘reduction in force, and 42) ite recording’ agency determination éf competitive status. The employee . ~ should complete ‘Part’ I “and: the Personnel Office should complete Parta 08 through ¥. . PART HoeTHIS COLUMN 1S FOR PERSONNEL OFFICE USE 9. RETENTION GROUP “PART L—EMPLOYEE'S statement. 8, MAME (Laat, Aret, ensddle intial) -}1, Accocstarus ("].ves [7] so @ TyPt OF- PRESENT _ APPOINTMENT WILCOTT, JAMES RERNARD, JR. - 3. UST THE FOLLOWING INFORMATION, CONCERNING ALL FEDERAL AND DISTRICT OF COLUMBIA SERVICE YOu HAVE HAS PRIOR TO YOUR PRESENT APPO:NTMENT (De not include mittary service.) . WANE AND LOCATION OF AGENCY 4, LIST PERIODS OF ACTIVE SERVICE It ANY BRANCH OF THE ARMED FORCES OF THE UNITED STATES IF YOU MAD NO ACTIVE MILITARY SERVICE, WRITE “NORE.” S&. DURING PERIODS OF EMPLOYMENT SHOWN IN-ITEM %. DIO YOU HAVE A TOTAL OF MORE THAN 6 MONTHS AgSrLE | 12 TOTAL SERVICE oO g WITHOUT PAY, INCLUDING PERIODS OF MERCHANT MARINE SERVICE, DURING ANY ONE CALENDAR YEAR? ["] YES | nO IF ANSWER §S “VES.” LIST FOLLOWING INFORMATION. 13. NONCAEDITABLE SERVICE (Leave purpuses only): TYPC iF KNOWY {LWOP, Puri, Suap, AWOL, AMfer Mar) 14, WI TOCOITABLE SERWICE (RIF pur peuses only). $. OURING THE FEOCRAL SERVICE LISTED IN ITEM 3, bio YOU ACQUIRE A PEMMANENT COMPETITIVE CIVIL SEQWICE statu? (Cl ves [C] po : (i? anewer & “Yea,” in what agency were you emplayed af the time statue was acquired?) “TS. REEMPLOYMLNT RIGHTS 2. ARE YOU: AL THE WIFE OF A ersamcen veTeRAN? ["] ves [}i] RO B. THE MOTHER OF A DECEASED on orsanteo vertrane (“] ves [7] #0 . THE UNREMARAIED BOOM OF A VETERANT { ] ves & ] Es) & TO BE EXECUTED BEFORE A NOTARY PUBLIC OR OTHER PERSONS AUTWORIZED TO ADMINISTER GATHS. Tewear (or affirm) that the above statements are true to the Seat of ny knowledge and belief. . } h Maren 1957 ; iL: . @ary (S26 RATURED t Subscribed and swora to before me on this th day of ——__™ \vareby 1957 # tah Bg gout} (city) 37. EXPIFATION DATE CF RETEN- TION RIGHTS SRAL lay = eect &. fopointzent 4 Clerk NOTE: If oath is taken before a Notary Public, the date of expiration of his Commuss:on should be shown. INSTRUCTIONS: File this forms on the permanent tide of tha employee's clficial personnel folder immediately before o: alter the penoanel . action lavetved, , (OVER)
14-00000 . Pace Pri. DETERMINATION OF COMPENTIVE STATUS. (Complete for noncompetitive hites Kased on competitive afatus av re- s[quieed by instructions in FPM Chapter S2.)) Employce has a competitive status. This determinatrn is based upon the folluwing ‘Tevulence: . : “hin 77 NAME OF AGENCY : SIGNATURE AND OFFic AL THLE | pare | . — PART IV. --DETERMINATION OF CREOITASLE SERVICE AND SERVICE COCRSUTATION DATE FOR LEAVE PURPOSES ~ We TOTAL SEAVECE NORCR EDITABLE ; CREDITASLE ENTRANCE ON ESS CREDITABLE SERVICE COM. ” ~ SERVICE SERVICE OuTy DATE SERVICE PUTATION DATE (feam it} . GPrert 23) (Leave Purposes} (Present? Agency’ | (Leare Purposes} CLeawe Pur pane} > Cremer LG CG ) ed PART V.—DETERMIMATION OF CREDITABLE SERVICE AND SERVICE COMPUTATION DATE FOR REDUCTION IN FORCE PURFOSES, (Complete onty in those cases when the amount of creditable serveca for recuction in force purposes di€ers fron tha amount creditable for lawe purposes.) SERVICE COM. PUTATIGN DATE® (REF Pie ses} LESS CREOITABLE SERVICE €R9F Purposes} ENTRANCE ON DUTY DATE (Present Agoace} CREDITABLE SERVICE (RIP Purposes} ne Toran service | NONCRED TARE (Utem bey (fee ae 22) 4 | —t—__ | ° Ester aa the “Scrvice Commutateon Dare* o4 the employre's “Service Record Curd,” SF F REMARKS ; ' 3  & Goverszeut Paretred GrPOeS @—-Gnea-8 ar es
% 1 “er ocmen cy , + Ae eerie ne reper mame tmeer con em ta 5. oars peor : eee ypiet ys erie on 1 rr semnpreneetensSapererts o Aner sate ears ieee 9) , ‘~ + Saf CONFIDENTIAL (Bhen Fisted Inj ; . oe 7 SECURITY APPROVAL . DATE : 20 November 1965 YOUR: _— _ REFERENCE: .Memorandum'dated 18 November 1965 CASE NO. : —- 109301 ‘TO : Director of Personnel ATTN : SUBJECT 3 WILCOTT, James B., Jr. 1. This is to intorm you that Subject has been approved for the appointment specified in your request under the provisions of Headquarters Regulations 10-3 and 20-5 including access to classified information through’ TOP SECRET as ‘required in the performance of duties. 2. Unless arrangements are made within 60 days for entrance on duty within 120 days, this approval becomes invalid. 3. As part of the entrance on duty processing: C7 A persensl interview in the Office of Security must Le arranged. A personal interview is not necessary. Cc] Please advise Chief, Clearance Branch, extension 5620 when Subject enters on duty. , This la a conversion case. FOR THE DIRECTOR OF SECURITY: Lived hich ify teven L. Kuhn . Chief’, Personnel Security Division ree, 1173 COTOLETE PREDEOUR . CONFIDENTIAL iL. meee sas geeteeag
14-00000 CONFIDENTIAL Oren Filled Fn) STAFF AGENT CLEARANCE bate YouR REFERENCE: CASE RO. 3 To Chief, Contract Personnel Division arta. * Staff Agents ‘Branch suBJEct i. employe een EA OP NANETTE ORR desire at a later date to change the status or cover any proposed change should be submitted use ef the Subject, to this office. 2, Tf your orfice shoul 3. Unless arrangecents are zade within 60 days for entrance on duty within 120 days, this Approval becores inralid. i As a part ef entrance on dats processing: A personal interview the Office of Securlty must he arranged by your office. XXX} A personal interview is sot necessary. i Re ayes arts, Stes atan. Cmeee, SHAETHBEL THCY CONFIDENTIAL {8-403 ‘peer $989
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14-00000 CONFIDENTIAL a SECURITY INFORMATION = - ; SECURITY APPROVAL... “Date: 9 Hovember 1956 - TO: - Cater, Reéords ‘& Serriées Division Your Referen-¢: C5841 Compt. ; . em . : °- Persennal Offies . Co ; ; . " FROM: Chief fSecurity Division "Case Number: LO¢30l . Parsonnel. . . SUBJECT: wiLcort, Jamea Bernard, Jr. . - 1. This is to advise you of security action in the subject case as indicated below: . {x] Security approval is granted the subject person for access to classified iaformation. - {] Provisional clearance for full duty with CIA is granted under the provisions ef Paragraph D of Regulation 10-9 ehich provides for a temporary appoint- ment pending completicn of full security. investigation. The Director of Central Intelligence has granted a Provisional clearance for Sill duty with CIA under the provisions of paragraph H of Regulation 10-9, - Unless the subject person enters on duty within 60 days from the above date, this approval ctecomes invalid. - Subject is to be polygraphed eas part of EOD procedures, cH = Lh tH W ; Cie CONFIDENTIAL . FORM NO. 36-161 ve FEB 2939