ae ve crt weemun ery fe B. - . €@8 @ os O17. SELECTIVE sevice Bs Avi tive ASP BB ocrve - Ve A SEC CLASSIFICATION ORDER # APPROX, INDUCTION DATE ran BOARD ft ADDRESS ee . ; ‘ IF DEFERRED, GIVE REASON ae bee teeters Lovee “ SEC. 18. HAVE YOU EVER BEEN DISCHARGED FROM ANY POSITION, OR LEPT UNDER CIRCUM- - STANCES WHICH WERE NOV ENTIRELY FAVORABLE? PLEASE GIVE DETAILS: eae we ee ee lotic t beet bbneee bee bereeenees _ SEC. 19. MISCELLANEGUS J DID YOU EVER HAVE OR DO YOU NOW HAVE MEMBERSHID IN, OR SUPPORT, ANY POLITICAL PARTY OR | ORGANIZATION WHICH ADVOCATES ‘THE OVERTHROW OF OUR CONSTITUTIONAL FORM OF GOVERN- : MENT IN THE uNtrep states: VQ. 0000 IP °VESS EXPLAINE 0000000 ccccccceceeeeeceeseeeces DO YOU USE, OR MAVE-YOU-USED INTOXICANTS?,..... Y ebb bbe e beet cee btuteetestepevtreseetestes Fe Eee cr reese eae See beeen teers ny ees Geer sen testes see er serene test eeetererees pone HAVE YOU EVER BEEN ARRESTED, INDICTED Of CONVICTED FOR ANY VIOLATION OF LAW OTHER THAN i A MINOR TRAFFIC VIOLATION? IF SO, STATE NAME OF COURT, CITY, STATE, COUNTRY, NATURE OF | OFFENSE AND Disrosizien oF case..... Boohedt fer, breaking. street. fs guts ; un.tuscaAlecsa, Alabama, police Station, Saw judge in... private ogg ict, there was 49, £12 or punishment, { ee A r enemas rcoP PC aM anTTret ASEAN renTUreT oa OTT==?OOmP A ~WOP POCO CPOE ICOONGUTECPPOSAFECOPOCTURPODIovEPTCOPOTTFSEAFOCY"W-~eT=P "una NRDEOPCOrRarToorAONTERAEOUD OO a eA j SEC. 20. FINANCIAL BACKGROUND fs A. ARE YOU ENTIRELY DEPENDENT ON YOUR BALARY? . Y @.S.. iF NOT, STATE SOURCES OF OTHER INCOME i elect enc cence eens bb ee bebe eeeeeeerene Gieeenees i B. NAMES AND ADDRESSES OF BANKS WITH WHICH YOU HAVE ACCOUNTS wo MOF AR RICCA BIO cee oe oetcteteceeies veees Pee OF Nak ete Mere aT a . 11Q0R1
SEC. 20. FINANCIAL BACKGROUND (Cont'd) D, GIVE thrce CREDIT REFERENCES = IN THE US. Wot a pplic able NAME:........., eeeeeeas Mecca fo ADDRESS oe ccc ec ccecceuceceeecee secuetveneetenes Meo & No wy Stinig A ADDRESS ooo occ ccc cece ge cucceueccescteceteterueneeves t. & No ety Stata NAME? o.oo ce ee. vec hicceeeecerecees ADDRESS 20 o.oo ec ecc gc ccc ccucceceeeuseceeseevevereeees St. & No. ony State SEC. 21, CHRONOLOGICAL HISTORY OF EMPLOYMENT FOR PAST 10 YEARS. INCLUDE CASUAL 38080 EMPLOYMENT. INCLUDE ALSO PERIODS OF UNEMPLOYMENT. GIVE ADDRESS AND STATE WHAT YOU DID DURING PERIODS OF UNEMPLOYMENT. INCLUDE LAST 5 POSITIONS AND COVER AT LEAST 10 YEARS. See sepayate Sheet EMPLOYER............... cere tet eee r gee TITLE OF JOB. cece en ene nee es ADDRESS oo... kee. Lecce cece cbc e dee cee bebe eben enn e eben ene S Sere e deere eet rete nen rd at. & No oy State Qounery YOUR DUTIES AND SPECIALTY..000000000000 00000 cccveevccceccec eee eveeteteeeevapevsbeeeeetersepeneneetebeees KIND OF BUSINESS:....... Voce eet eten eect eee ee ees NAME OF SUPERVISOR. .........00000.50 00h ese eee eee FROM: oe. TOL eee SALARY $........0 eee PERL cece eee eee REASONS FOR LEAVING 0000000. cee RE 8 CURRED Een renner renee EMPLOYER 20 cece cece ence ees TITLE OF JOB... 00000 cece cence cece etree teens ADDREBS ooo een ened EE te nee ES Ree een ee ree nee EBS St. & No, Chy State Country YOUR DUTIES AND SPECIALTY. 00... cece eee rere renee n ener eee sere rer een tene ce KIND OF BUSINESS: ...... 060. NAME OF SUPERVISOR. .........00.00 0.0 cece eee FROM: 0 ee. TO SALARY $00 00 2) 2A: REASONS FOR LEAVING. 2000000000 ce ce cece tenes poe nee nee tenet ne es EMPLOYER 0000 cece cece cece eee TITLE OF JOB... cect eens ADDRESS ooo ce eee beeen ee ce eee es eee eee St. & No, ey State CUR YOUR DUTIES AND SPECIALTY. .. .. Ce eee KIND OF BUSINESS: NAME OF SUPERVI50R FROM: TO: . SALARY $ PER 2 © REASONS FOR LEAVIggg Ce 00 e
14-00000 Dee ne! j Theve never been erplovee rerncuently os dL hove “3 peen in rchord cll of the time. In the sumrier I .Orkee on my Grenermotherts ferm i: wre ver goou Il heve had ere: EG det eseaeen + 1, Stack poy in Surer Merket on % turdern only. San fomo, }ov., Pea. 1945 ; i Fame of Umrloyer ene Gurervisor unknown, fend St. & University Ave., Mer Moines, lows. + emt tnniahme roten dneenet Se ~ o Ne ? Clerk “ Jerrem's Men's *tore Locust ana TLR Streets Des Moines, lows Crvistmas Holicayvs only = 1943, Aeplever git Sulervisor : Leslie RH. Shaw Q Hels YRIS wos conneeteda “ith sy cou Tuseeloore, Ale, Hieh 7 : luereh, Auvil, Ney 1941. Rorloever end Sun rvisar: @, Allen end Jemison Kordwere yo toowineos Gresser one disniey mon, ! of study at 4.0 Fonerhoy. Louisville vimes. c EER ene comet eet sean peters 2 hesenth atte en Men eatteeeitermrie mene eva es LuPh-1Le29 Sumaryisor: unkown, ‘ i eon 1 uy ETS bat path EE de BN DUG EIST RA a rie a PBL AS tere } t é } qo? i t H - hos TR
. ! Ne diane eae ee o . na - 0 Hers a hash pire ‘Aarne + PE Mt Ak eer OE re : . - ett erm etn : 5 Pe ee cee SEC, 21, CHRONOLOGICAL LEBY ORR (Contd) — EX & 7 KMPLOYER TITLE OF JOU oe. . i ADDRESS | Cee ee . coeee betes Lo : Bt & Ko, city: State Country . | YOUR DUTIFS AND SPECIALTY... 0... a bee nn bene nee - | KIND OF BUSINESS: NAME OF SUPERVISOR . 000000000000 0... wee = FROM: .. 7 TO, . , SALARY § oo. PER, : REASONS FOR LEAVING eee : EMPLOYER 2 000 00 0 occ seen eee TITLE OF JOB eter eee ets : ADDRESS 0000 oe cece cece eee e reed! WITT cece eee eben te tease ene eeeeensens i Bt. & No City Beate Consntey i YOUR DUTIES AND SPECIALTY 0000000 occ ccc cence cence cece b en ee nee cee nE cD EE ED Fed EE tebe Etre E Sate { ; ; KIND OF BUSINESS! ee NAME OF SUPERVISOR. ...00000.00000.000020e cece FROM?...00. 0 eee TOR eee SALARY $.....00..000000- PER... cece cce nese eee REASONS FOR LEAVING ......0000..000.cccce ue ce bec ce cab ees veveteetrseaue rete cbeeegceecee tees 1 ~ = ; : BEC. 22. RESIDENCES FOR THE PAST ‘TEN YEARS i ~ Zé, * j Say Madison Ave, Mason. City, Lowa, S.A. reo: 7734 to: JP 3S. | i . & Ra. dtate ‘counter . ; : Lleood. Ave., hoarse. ile, KY ASA. enon: (928 00: J 740 | i St. & No. a vO Cauntey 4 ~ oo } 1477. GQuecaland ase, Tuscaloosa , ‘Als, Lo S.A srom: (77E 0: SF ¥S H 1R/@- 46M ot. Des Maines, Lous OS, tt orpom: / FF ta: (TF3. ; Bt & Mo. cup bounty - ip 7-46 fe a, DOD. Maines. Lowa Ut. S.A eno / TAS to: (TFS if “St. & Ho. Btate # Country ~ : Z SAVY 7 Bard tre “ne, “Calege. Hareier, WH. , fo vrom: (£99 to. (FE aA Btate Country : | “ Pebaccen oh, flue vey LAL bbs From: 79 July Wb go. oo: | Stake 4 cunt . ‘| eens cnn genet enecenee aes FROM: 0... TO; 2 wt Se & No. Poi SJ State County . ; SEC. 23. RESIDENCE OR TRAVEL OUTSIDE THE UNITED STATES | if 1 Vot Applicable Lee, DATES fo : Clty of sectas Cea try Purpose Monts 2 Year Mouth & Year Bae . DATES TO Cruntry Puce . BManin & Year Mooin & Tear ” (tig oF Aectian £38083} icy ener mene annem serene NEN! mck! FESR ERE I tee EAP PE ERA ATENEO TT AL IN SO A
14-00000 il xe wand) a — waz “SC LAL ail. wl bas ae - ee 3 mvet! SEC. 23. RESIDENCE OR TRAVE!, (Cant'd) Aue ; .. an H at VPP (1 t. a te a DATES... ..... Te TO cee cee ee - typ ar Section a uN Purpime . Month & Year Maonih a Tour SAMS: cee LT : te awe eee Mee ee  DATHEL , TO . .. OVy or Sewtion Cuuntey * Purge Month & Year Manth de Your SANE ree be ees cece ccc ees Co PATER TO, uy oF Portion Counery Purpose Moth da Year Mont), a& Yous i err MOP SET eae Levee eee Ae, DATE... TO must: RO? City of Section eerundiry . . Purpose Munth & Your Monih 4¢ Your SEC. + * ewpre . ; v ; . “ WA = SS Se eT Ba ee EEE wut SEC. 24. CLUUS, SOCIETIES AND OTHER ORGANIZATIONS | ‘ ‘ By ; z ft ee pt LIST NAMES AND ADDRESSES OF ALL DOMESTIC AND FOREIGN CLUE, BOCIETIES AND ORGANIZATIONS = ' ne ane OF ALL KINDS TO WHICH YOU HAVE IELONGED, OTHER THAN RELIGIOUS ROCIETIES, POLITICAL PARTIFA wo ‘s “ou AND LABOR UNIONS. INCLUDE ANY ORQANIZATION HAVING HEADIUARTEMH OR A BRANCH IN A FOREIGN 0 : x : COUNTRY OF WHICH YOU HAVE BEEN A MEMBER OR TO WITCH YOU HAVE OIVEN GUPPORT: e: Se ad _ HUET ay DCAD Wo. Looe cleveegecestetetttig teetesen OE Nene Bt, & Mo. qty - Rtste . Country f ctoeg : ‘ be ee ce ee ethene eee be aee . t : Seen signe Ene Pe Sa tate counter . fn. Pee eee ee eee eee tes ne bebe tae ee eas ee be eee bet ae nce ., } an Nemo at & No. cry tea te Country 7 _f oot. é ? ad “ teas fam moa NE erg erate  countey cnet ‘ tos nee ce a cc pte 7 ponte 7 oD H 4 + ; “Rome ce tess ‘on No “_ “ony weer yee , “Country , Pores Fa te cena eee dee anne eet aeete geenae ete bebe cee eee .. ye po Namg (900 ees at. & Mo. City . State Cissntry 3 i; ccd b ene tebe es beset beeen eee veces Ce vee eee bea an . 4 { Name Bt & Mo, cMty Beste Countey 3 a 4 : r H "Sr oa Sea aD Pe PRS SR RO ARE SO LODE A La cA. 2 ORIN oO ha RENTON” Paap ee eae el AERA cen Nene eae a i i t i . E, ! SEC. 35. GENERAL QUALIFICATIONS i A. FOREIGN LANGUAGES (STATE DEGRER OF PROFICIENCY AS USLIGHT?, -PAHG’ Git (PLUFICr™ mancuags Spaniel speak Of 1 9 Qatoooran Silk ih wnern bey ot f LANGUAGE 00. 0... |. SPEAK READ BILE LANGUAGE a SPEAK Heat Wartge | LANOUAGE "SPEAK tat BeETE ‘ | LANGUAGES HEEAK der ate Ga es chee LANCE AGH
Pete erg = hes, NS my Strap SEC. 2h GENERAL QUALIFIG, 1168 (Can ae eS } . Nh. HAVE YOU ANY SPECIAL KNOW USINIE OR THATNING WITH RESPROP ODD, . wr Pn wee ; a od MOTOR VEMICLES? 9... 47 AIRPLANES? ALS RADIO? fe we —~ . ~ GHUVE PARTICULARH  ..... ... Ing | C. Lut all SPORTS AND HOBBIES WHICH INTERST YOU; INDICATE ORGREE OF PROFICIENCY UN BACH. Fs Foot boll —- p fo OF iss Soh! AUD Poise THK AV G62 Fee t'% fe h 5 cy Rated good COACHES Ath Spars UECFES. * rere Had sccce al SeMSIAU Sips bn? ETF EES. a basketbha - gas x Ny e > t sa > y ft é oo Ny ¥. = ~S & & X at as . 1 . ck Oa pple tect nes ee ee eee . Lg tee cee ees . kee ame eg tp pees ; 4 Art. pene! y per tlw spetching = some ails > PAT ? : j . } i Sp epee apeeees sev peers gee aaeee TT Peery rere beg teens ; a heading ~ hobly - Aryd reader’- PAMesepiey pected, yr eblon, : : ve Uk + i | DP, NAVE YOU ANY QUALIFICATIONS AS A RESULT OF TRAINING OF EXPERIENCE, WHICH AGUT FET : ; YOU FOR A PARTICULAR POSITION? . a Pe eeeeeee [ee . t f Hi : : fetes pede bee bebe bebe abet ee Gotu be bee ce eens. beeen eee este een bbb ed beatae ean bbe r sree po, H Feber ence rene ke ete EE EERE EES DSRS CARE Fo bbc bbete ba bet eene beeen Gaeanbtdba tier be bebi bt rbeb rc, a ' i i BOER Ee Re EEE EE RETR REE ERR ER EET EERO REELED FH eC ee eee are eee beens ’ | ; fo tena renee sereerasesesirseveuseevuneeesedbees sasiseeeienesesaee bobcat ee ebb tet es seb eserte van dees, i CE eG ee tect ero ttteccsenuerbectiteneliettteerttti Ga veers . Cc, Dat fet tenet nec ane ecetranazetsescccansansescsesressce tar sce sess ssiaetes Gotees ce rsenareiscaiteieees : D. PRE _ i Perret tenner srt teres nnn en yeneesteceecsneer tenia irecntennnse Se te ce : : BY 5 oe permet meee Bovntereretntas een’ ssi a oe eee Ae nee eeey : AT « SEC. 26. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY: “? i t a as by gs ‘ wave! NAME! | ne recationsine FATHER " mE anoness © Fletcher Ave, Mount Veraor phYn, b, SA. ‘ Jaga, : 8. & No Yay Biate f Gountey HELD yj i" 422083) nos +o ANY opp ER CIT» CITRENSHI ps mes nee
14-00000 2S neiey saree MB ye He AE May oe cerns mm LP nee 2B renege Wace tcage tet ater BEC. 27. YOU ARF INFORMED THAT THE CORRECTNESS OF ALL BTATEMENTS MADE HEREIN WILL BE IN VEGTIGATED, AND YOU ARE INVITED TO MAZE ANY CHANGES (OR ADDITIONS) IN YOUR STATEMENTS ‘THAT YOU MAY THINK ADVISAELE. A. ARK THERE ANY UNFAVORABLE INCIDENTS IN YOUR LIFE NUT MENTIONED ABOVE WHICH MAY BE DISCOVERED IN BUDSEQUENT INVESTIGATION, WHETHER COU WERE DIRECTLY INVOLVED Olt NOT, WHICHE MIGGIT REQUULE EXPLANATION? IF SO, DESCRUIR. IF NOT, ANSWEIt, “NO.” oF g- . DEC Fepav Ate Shee be i cette é a Dede e etn eee en eeeeentenen ae i | B. 1 CERTIFY THAT THE FOREGOING ANSWERS ARE TRUE AND COKMECT ‘TO THE BEST OF MY KNOWL- EDGE AND BELIEF, AND I AGREE THAT ANY INTENTIONAL WISGTATEMENT Ol OMISSION AS TO A MATERIAL FACT WILL CONSTITUTE GROUNDS FOR IMSIRUIATE UDISMIBBAL. . f- HOVER Sbaltampshe re one 1H Regs t19F inid’ oo. Suitin Sgt THE... ae GRD ALLS a Appiceng oorertmarewrennrnmenmnrnroann—= <== Applicant will not write belows mcm rr COMMENTS OF INTERVIEWER: ........ Lake ee ne eee poe nee e rer ee beret eens tee teens : SIGNATURE OF INTERVIEWER INVESTIGATION REQUESTED BY . . Originstiing Udictst i DATE a - > & ee nd wer? a i
14-00000 of LO4> Towag enuentiendda bya In the Borda: Portal Inspector a@bont a letter Thao mojled approzimetely one yenr previoug for a Er. Uolren, Hevea the Dinplay min for Allen ara fordoon Eardws pe i Go, in TMiee: toons, Ale. Iohad been working vith pofotiee ond his: for some tine Cressing wdpdcors, ecoore ting, \ Uh vses to Mre. The Lattiow dn cuention wes ge@creuned Helren, who wis oul of tern, ane guppousaly une tednea neine money, I belfeve It wen no dollsr, Ne letter wea recedved but there vas no momey in it. Toatated treet dobed kroveg nothing of omy money ona thet Jo oalco bed bid a fel ow with me when the letter was rnotled. Towrote to Mr. Haleen ebout the frodaent but mever he: ra Yron hain, further dPrevitieu Tiere were nprerently no mi Tohove heerd nothing asirece the Posts) Ins egter enuestyoned me.
14-00000 PERSONAL HISTORY STATEMENT Z URSTRUC TIONS: Behe ALL CURSE IOUT COMPLETE LG, ES GUEUTIGh LES ROT APE LE ah ETE TROT errr cage. WRITE "Uetbowes Gaye sb 109 OG MOT eNGw hk BRL eho BaD Caungr ORTAIR SHk ANDER FOL PLE GRAL HEC OENS, wo Bot wAVE USE A SEPAGATE ShEEP GF PAPER FOw Fatun DERAN S49 he CUES IO OF CUESTIONS FOR mtiCn 60d ff THiS FORM, UATE Thete weirten Ga ThE BACAR SUFFICIES! bOoe, BTTACH Tw WECE RT PASS BONE 51/6 SIL TURES OF LACH. TPL, PME aS Ye WOT E CAME ULL; FULEG IBGE GH POC GMPLETE FORMS WILL WOT RECEIVE Cte IDERAT AN VEGSTOGD THE ABOVE (MuTRUCTIONS7 ES GS HAVE YOU R640 AND Gay SECTION £. PEGIUBAL BACH Ge OUND i 4 1005/5 @ anes ies EE ETE HE RT ee | 4 Mew fo oeolf Sa IER Ne ct sou STATE Cousthe PRESENT AOtRE SteE Li ARO wUMBL® Gare _ tea JO. NAVY *® ey, $0 FO. «Ad FRANC! 66 Citi, STATE CGURTRY LEGAL RESIDERLE SIRERET £80 NUMBEw GU bx Fletcher “Ae. Moaslt ferion, Mow Hoek Lbs. OTHER MAMED fiat pli BAY NICKNAMES SLOG | MOTn FPLC AAIE UROER WHAT CIRC uM IABCE» HAVE VOU EVER USED THESE a2 LUE MOT fipl ie a ble. 1F LEGAL CHARGE, GIVE PAoTEC (WMERE WHER ARG OF anal aiaeaT How Toney Mol” app bee able a ITT ap ph ep bbe a DATE OF Bina [ruACe OF BIRTH Cre re “STATE re a0), 11 km ae 1 MARCH (V4o\ S1Asen Ct(T¥ , Lewa usA PRESERY CVVITORERIP——TECEOTRES BY. i ae es ary Af. 2. | guets saveiaGe Cod satuearizacion (oO) RKATURA AT wimet e QaTe fS0uke HAM? OF COUR trieate pe wet OF OLE #bIe CERTIFICATE ter# ble | of Applica COcaTiow OF ConeY moel_applitt Of¢ a {cL Ls cen EM, ry Ppds cb/e PREVEQUS crrigiss wy 2 T- A ae Le Cc able OTHER CITI 2ENeRI PS ~ PARTICULARS wUMBES 119 6 5 [50 oaks 4 re aa Ug tOls, LC US rt BLL OTHER U. HSS nave HAD “(Givi apevay ehie Datta bh __ wy Lhe eek he £2. ce we PASSPORTS Of Gink# BaTiges a [cn Plc Bere ir a ee if pers Carve a ASwEsaL TS Countat eYoY £5 garter af Pas f oF CoualTe se tat ~ 2b Poe ade Jet pete fe cot ble. OuTSiDE U8. {oo wo ofp Lie CHrOl &- a ae a rn i enn i nr ater iGate Teiact GF 4Gaue er f Lae Last u.s. ie i isa SoD Z Lol tee ag ; f we -" 4 fe —— TLOM 2. PHYSICay CESCRIPT ION ! nen ppc eg ncn Heat bei Witte es ta its: yeres poate a pe Ciger” 7 . : Shi ta hE ee BROW COMPLERIGN , yeaa ee ag ~ FE kt hit ths Of FEE bROW | MES) A] GENER OIStraLyi sree Fialuats — a —_— ~ ee — a ERATE REPRE eA scene Paee t Pose wo. agar 134@ bG-%
14-00000 * - 2 . Peet & SECTION 3. ; MAPETEO i} SEPARATES yC_ a) cate CF S€PazaTeck OR Divence PLact , SISGLE [yet] i eas earls ppt ase 4630 Fe fu fe REASON FOR SiFaca™ HOTE: GF You MANE ry eet Tae wilt. MALDEN) Last DATE OF MARRIAGE NAME OF WIFE £685 _ OR KUSBAND a a a ath fits vie ope be fe PLACE OF MARRIAGE THis OR SuuKL SS, SERERT AND MOMBER City STATE “COUNTRY BEFORE Mabe ALE py at FE FE come Tee LIVING cm TE OF ISIE ase Cause DECEASEO(__ { _ PRESENT OR F aeC NUMBER cir STATE COUNTRY LAST AQDRESS : . : city STATE COURTRY ~ ~— DATE OF BIRTH [rece OF BIRTH COUNTRY CHTIZENSHEP fcaTe ACQUIRED LAST EMPLOYER OCCUPATION EMPLOYER'S O8 Own S?VEET AND NUMBER cry STATE - .- COUNTRY BUSINESS ADORESS DATE OF F Row: BRARCH OF SERVICE COUNTRY MILITARY . SERVIC : . seeetanentueetnvedansarosrnnane OTHER GOVERNMENT SERVITE, ES. OR SOREION [GIVE GETAILS) . DEPENCENTS) RELATIONSHIP ENCLUGE PASTE AL aeceeverara mera tatters COUNTRY $3. SIREET AMO HLMELR city RELATIONSHIP CITIZENSHIP pheRESS STREET Awl NUMBER city STATE COUNTRY wan cnc La tTiZEasHiP PASCRESS STREET AND rT) cary STATE COUNTRY SECTION 3. PARENTS : ; HOTE:FOR STEPFATNER, S7ETat SET ARC/GR GUAPUFAR, GIVE THE SAME INFORMATION AS REQUIRED BELOW ON SEPARATE SHEET otctaseol 4 ave OF FATHER Sate OF OECEASE TTAESE - va tliepf, oAbL~ PRESENT UF 3 2 MUnBe! —_ . yi “Pehe nt pve. Mead ] Vor Uc) A eu? ay teh SA : city STateé COUNTR “Pyaci OF BiRTH ¢ ALE OF DiRtn ’ , CscCols , Tew ts [orriztxsnie Tree ASST REO i] weet T cir Stair ~~ CGUNERY . gta FAN ee ae f ae c4isse Last EMPLGNE? SCCUPAT I8 5 ; Sar : COunTR? Fide Sh 57a" AAD RUMBLE ‘ cite MPLOTERS C8 On) SoS ang mens , are et a’ at BeSsmES5 ange SSF ee ee! Pa ee ot 4 Pe Ay he aif i Fe. hia # . €cT ion §. eapT arg os
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1 einen er ee Een ne AEUATIVES SECTICR 6. uo wate row THE, OreaT ints Br “ey OGG, Msew AGE CR acct ics. ero CLEVE aASebap, ASE petis TRE PNFLUE SCE ‘er a rOee TON POSER, APL MOT Crta/tug OF THe USITED STATES, CO APE mapaitO Fo alec veg, i / ~— [* CATTOR ERT a ; al : _ Ze fi ff? i ly 4 }¢ av re CUTIZENSHEP [*orsr STRELT A400 woMatR CTT? STate COUNTSY REASON FOR CESTING UNDER THIS “QUESTION — NAME . RELATIONS aye CHTtZENSHIP ADORESS STREET AND NUMBER city STATE COURTRY REASON FOR CIESTING UNDER THIS QUESTION NAME RELATIONSAIP | CHTEZENSHIF ADDRESS STREET AND NUMBER City STale COunTayY MEASON FOR LUSTING UNDER THIS QUESTION HOTE: INDICATE BELOW THE RELATIVES BY BLOOD UR MARRIAGE, 18 MILITARY, NAVAL O8@ OTHER GOWERRMERT SERVICE (URITEG STATES OR FOREIGH) TRETAYTORSHTE AGE L Au a > ae CHTEZEnSHie ADDRESS STREET AND HUMBER city ’ Stare coun , ye . Pf’ - ee ay ~ ?, hel ox DICE. Fray ROA sousit sees TOU 198 C62 SA, bree and LOCATION OF § OF SERVICE Jf row) LS ttt ERIN E ES Ay) AVL dd AlimnkE naNe AGE CITIZENSHIP AOORESS STREET AND HUMBER City S¥ate COUNTRY TIPE AND LOCATION OF SERVICE (IF ENOWN) NAME “TRELATIONSHIP AGE CITIZENSHIP ADDRESS SURELY AND NUMBER "City STATE COURTaY Pagt & T7PE AND LOCATION OF SERVICE (IF KNOWN) SECTION 9. EDUCATION Keeseve tis. Sche STATE SLnRGGL AODRESS ci [o03SA. Jj C AMA _ Tus Aes Hse a Hick thool Tose AloosA Alalah irresceel Sept 1 IYO |" 5 Some 194) 3engk iashees CLyy COUNTRY SA. Stare COus TRY Des aw oS, p Lowa SA focer Eccl gS Ye f7 LG Faure W9tt | “Dy Plom COLLEGE ADDRESS STATE OKT MoOUTtK sett Magee A124 f £6 A B. couRTaT AAMpsShi@e kb. B. fEcaventics) STATE Coulee LUE 4) ate eae antee—aeriney
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