74-00000 SECRET Chan Billed pay READ INSTRECTIONS CAREFULLY HEFORE COM “OR PRINT, NG LIGHF COLORED INKS” exe Tee ne ridicady updated, This ts done flulo- ¥Promn inal Thx form is for chal purpase, Mion aad of there have been changes since fory Statement.” Gr ag BeeioUs tpdaly form, aitbed enter tb in the UPPropriate section. . The signed asf Now that yous qualifcations area matter of computer rerged t mnafically far much Preferrreliean: however, some wnat he Oy tein Section fo must be renpleted in all cases, You need pre Ae submilled yerse Furi $45), “Qualifientions Supple mer, 4f wou are in das! whether information has Deen previous : und dated furm suonuid be redurned through administrative ctessinels fo the File Roo, Ufice of Personnel, Room : Headquarters, uhatrer information is added or nod, Additionally, a qualifications update may take place at any time there ts inferm by compleling ana returning un update form on your inituative, ation to be added ur changed simply manners acteecmninmares ween tet i ee ee ~ B1OGRIPHIC 695 Fa 2;TION DATA FOCRAPHIC #903 woe 035655 2 — _— S€CTion if WiGe “Len LAST pita Blau te aS et Ore ° . . _ , ADDRES, (Orty. trate laurie} pt wes STTE NOE th een aun CONTPAL th Sot € VOM IS TE? MAE | 7932-9 BF Att Cpe GENS on ELT y eee SLA LU crane bese ee aes ee eevee ee SiTy sTuoy COLLEGE OR Lat? MAME AND LOCATIC@ OF COLLEGE of UNIvEMat TY i ng TEARS AL TiNtED | onsen 1 ¢eee i two. sescota. wer NCCE IveD | aeceteenl uns (Specity) Waty OC — ! . a noni eee Punt euteetenenntinnencs ete Te ee eaten nt es io OF «4 BRETTON THEAES, INDICAT? Fe Vivir oF THE 2. tree eat Ane empty ene NT EO eer oneness canoe oe iF A Ghanuate DEGOES wes ELEM NOTED AGOVE with REQUIRED Sate THESIS AND NRIf PLY ofecHeren ATS CONTENT. ADE, COMMERCIA 005 SFerM ITE SOOO —_ #0. OF VONTHS Lag if oF SPECEALE SATION FROM 14 GNP FECAL . ~ : . . WEUAL St peck. Sor Pussy nar SPIE 1/99 an nn acne EWICATIOa Ge Tesi wine WOT inti CATED WOVE ——— a HAME BNt soveEss OF 8OHNG0L Ble ue SPLCb ALE TATION PROM La AO. OF MONTES ee renee rr PEEL or en ML PAS YY YT FEL 1B Fee VN Ft EMO ME Pi PO ‘Ges rose os 2 SECTION 444 rn nt ert ee ae PRESENT sYatyt CSscgde tas ried istaned, Separated Divars en Beruhiet Pemareiedty SPRCIFY: 2. NAME OF SPOUSE . (Laat). ‘Rema eates ot aneee tte ae yonaee en ene a one (First) ereemaenine antennal Taryn 3. DATE OF fiAty PEACE OF GIMIM (City. Atere Country) LO PIF hes! | WOROMESTER EL A &. PRESENT EMPLOYER VA 3. OCCIPAT ON fou fe Wwf 7. CATEZENS HEP j9+ UATE OLS. Citezemenie aCgUIRED 6. FORMER CoCRER TIBI Sy can "SE ENDERT CHILDREN AnD DEPEBLEMTS OTHER THAN SPOUSE | , oe iD PLaen PLewAnE A? augRE SS MPL ATI UNS ee eo . ne wR GATE ano PLACE 9 store { CRePa PENS 7 . -- men ae . [| Pope Yun 2-66
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rs SECTION fv . “GHoaearnc AGEA RPZOW HARE OF PLGIOIT THEE CE SPEC ai Dates ce tee Date A race G8 COUNTOY ENOWIEOGE Cs SEMCEN LE OF 3syDY 9, SUBLIC SPEAKING ANG Suadsid GELATIOS.", CaPERENCE, - . SECRET Wyvhen Gulla les € 4D POsrGn TRAVEL nanan antemnccveronnemtene A TYPING AMD STENOGRAPHIC SKIES J. IMGICATE SHORTHAND $9 STEM USED» CHES gar APPROBATATL ITEP, tHEQ. (] catce cs 0 SPELDW RitiG (CC) stencrece srecity, a INDICATE OTHER BUG E85. peranrerr efile Weicet FOU HAVE HAD OP! HAD OPER ASNG LAPERIESCE OR TARIRUEAG scomstumater, mmsngeaph, tard euach, ef] POWE Set CIAL QUAUFICATIONS SECTION V 1, Presi {WPA | 2. Get etek fas LA RPAE SECTION | vi Tush ALL ALL HOBBIES ANID SPORTS itd wertict ¢O1y ARE ACTIVE OR HAVE ACTIVELY PARTICIPAILO IMUICATE TOUR PROFICIENCY Id EACH. PHomFRapty, J PW We, CE SFATINd. (wee) — KRLS TOU POSSESS BELATING IO DIME QUENT AND if pass. ria LAINE, COP ANO OINER SCINTIFIC & PROFESSIONAL CEVICES 2, EXCLUDE BUSINESS EGuibwer at oF PACHIGES PORICH eerice you ma¥ HAVE LISHED IM ITER 4, MAACHUNES SUCH AS GRE2ANG 7s TF BAL IGATSSMITIERS sadeote Cw tneed, testirg A reveemyl OFF SS MO MLE TARE VOU NOW OWNAVE Voir EVER ELLTs B LCLINSED GM CERIFIED MEMBER DF ATTY TRAE G8 PROUT SNOT ICH AS FLor C] ves POECTRICIAPL, RALIO CPERATC’, TEA THER, LAWYER, CRA MENCOL HECerad tard, POYCHOLOGISE, Brvsictan, FIC? > oO NO YY cs ly fe LW YOU MAVE ANSWEALG FES" [CO hea 3 4AGR, INDICATE arD OF LICETSSE O8 CEQHPICANON and Def iSound, STATE, PAUPHCIPALHY, ETC Prande heesse cogstey samba f bageal . e NOE FAUST ANY SIGPHFIC ATID PUBLEGOED PAA TERIALS OF ‘e7 HICH YOu ARE Ps AUTHOR ga NOT pwhot cuges enlecr ceguaied, faoe habua oe seranthe arinalen getercé sateces? aybyaets, novels, shast ctosren, ote) /V° We 8 INGICATE ANY DEVICES weniCa YOU Ra Or IAEVESTED AND STATE WERE OR NOP felir AGE PALENTES WOME S FIOST LICENSE/CERUFICATE ipea0 of tee! ©. LATEST GICENSE/CERTIFICATE fysur af ree IMDIC ALE THE TLE, SUBLIC ATION DATE, AND TPE CB @ TINS Wer SECRET -3.-.
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i ' ’ roiags SECNON Vili DAILS iteqme Fonbr woorh & peor! SECRET Yemen bdlad tn’ AGENCY EMPLOMMERT PMiIStO@y (Cant'd} y DMECICCATE OF FILE GO DSN faance z (OCAND! Lovee Loe 4 HAE OF JOB o CESCRIPIION CF DUTIES 8. DESCRIPTION OF DUNES T INCLUSIVE OATES {From-To-by manth & yaar! 4. THLE OF 108 6. CESCHPNON OF DUNES 2. LOCATON (Coustey, Cary: 2 OMECTORATE OFFICE O8 DIVISION BRANCH $ GRACES ELD Ira 508 2 BHO J Courtey, Citys ‘ 3, QIRECIQRATE- OFFICE O8 DIVISION S2ANC HH neces —-~ 5 GAGES HELO its JOB SECRET we -6-
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TAD EE 97" ADC ACATION FOR FEDERAL EMPLOYMEN) a DO NG? WHITE IN THIS BLOCK For Use of Civil Service Commission Only i { ] Arie. 7 Subtnettest | 7 Nemippera [7] Me tond ia - i Pace if em “Das nt apyiest tee fates aed Meare! Washington D.C, or ‘victnity EMisabee d taticnne: fawn. Hevicw: | | y By gf nner ett fae nd i “ Apnreveds a soba Fopract | Peadere Gprinn 7] Grade ine Brae al gst a Mate | , HT] plan eeu y Cay ap pos aide fanituding p - of -——- Alexandria , Virginia wenerenarenenaee Powers: foc t. Viace of bith 1] tenn Icity n HaMeR NER acorn net on ieee nae Th Orher wd OG Po _New Hamp shire se feeeere eee one » Date of bie yer en [5] toisat. — , Mate ee . April D, 1917 Female 9. Height ajthent chins Sg Cp rrrteecrertt es breeencee perenne PRR, Facccocn Poet « RE) Marrs wales | | : (| Riegie . Ye Tt yet bree ese beg cmolos ed Yoo Set ULS Aimy’ UE | ay aten oof segs des peatat peade "Rew | Naupehire” ’ ; yast hat a ; b bron: bee entrant Hther yo . intcate the boweat salery you will surept & 3 adored for awe portion with a lou yeu wilt A.C Pe la, AVAILANIEITY INTORMATION, 11S yon are nue a Bee G. Wil you accept apprin ane eangund neg ot, “brea any? © Oo travel ‘f | Anywtiees te-Uniied tage Ziv Ww ashington, db, sere are cet enna teen itary eases oT pum well secege appisncnent omy in eestain Leativn, Hive then Washington D.C, or vielnity athena mt ° IS, VEG ERAN PHLTEIOLNGE. AL i you clam “point pretercuce Datel Ol Wefan tabitaty waving, atihieades [Seriat wereber, Ho nese, pve Kiade ar ' . PHraneh ab aereice PUNK AE be fratations Datetal of aarcy inta active service pHateen ad verirstion 7 t.temg, Mutts, der fonve, ated ral Feb 25, 19h] Expected to be mad hn waly 1 1961 Der oe at De. yeu alsin JO-g rit Sersice Commun. me i avaatable. be wi . lave pow ever ect gran Moveteray pretereaer we Mes PVes 3 Ne db ae, midicete halow the offee Whak mseitted tetuemed f19 you, me at ti, §, Civil Service Connmistion office ue mame of Bound of LU, t Seevine Examiners Hopteletence 29a pravctine a athapta fant “hy fhe SOPreh rose ba pou, Attecty yest athena pacdescree altars G ta sented wath the din harge ation cemteutd i anwar 60 question S48 faa HS APACE (Ok Gsk OF APPOINTING OFFLCLR ONEV, ‘bbe as seemtate, whict shows thar the seperation way andes hOmedably Cuudioaas, Agency - Sigutatase 20 cae cemeen ees ee nee serene Vitle ccseceece eee Pale eee eee cee tener eee creas tLeastiraesd ea grat pagers ee oa)
we te rob baby JAriRi ONE aortte yam pogtent fy vet tile ot wane geese rata inv mt or o M/Set- “U8, a SINE . Fmrstihae tutte ge. dee cenee Nf, bmpar: adits ome eta ‘ ont ee ate rene a te ca ne nt eae tenenen eterna ne GUM te bee . o Cans vf employment foronth, pened Pevn my fae Bre aent ue aso, Feb: 29h) OF eaeings ; toe Carne 1 tur as danleral seresie} ‘ rf ae * e So oS y a hOb.00 .""" month i. ney sand ailtress uf etnplepet Efrem, urgeviiatiany cfc d Asa't Chiof of Staff for Intellironce -US,Arny..The Pontagon Washinston,. D.C - Ute -Col-Pralla. enn et naan wee aN Maman tet Fee “Retiring: fron: military 0 DOTA 0 Dewteption af wegh TRENT ROR ON Re ee dae eee Or ee ee ee eee nee Sletten Ae meneame cameme deme an an Lance tide of sane porition a) Dates of ceaployaent Cmunth, pears - t . Fron! [Satay of ern aoe Fi PMR RGRIRR OR ne ‘ yocat aw Cataead rersssed Feoutefeslareme. sceneieg, lasers Hi . “Kudting 3 per i Giry en, ated . i .! Tinat 3 50,00 cf wk | Stare . ; ™~ “Name and pide Od OG. (firm, i fe tian, ere) : “Name and ‘tite af iasmediate pupenieoe. : t . i Borgeois Studios f — 83. Walnut.5t—Hanchoster, N,H,——-— -—Ulic-Dorgeoie ~ re i wasn fog de eveng . .f io Pe ‘onlist- ‘in the uss. Arny Tremere te a area ob work ‘Assignment, Btudio portraiture work,” l¢0"leb’ work Russe Cte of pour posaion sent a eee Place of employunns Rind af business og Meg auigation Crmastubsclmrimg, eo ORI, aa Bt, tlaed Clawip. aman Grade . Caf pe Vedercd seraice) Staning § ts pee ' Salary of catnings City Seate Nsme and tite of immediste supervinar sect ob ape erento rteenememct Name and sddecas of tinpluyer (fem, orguuleatlos, oh 4 . . t ror mnnnrnennenetreernncrereemae ne tr 208m bens Mee
ep | & Alle Spectal qualifications and Skills . , (D) 1. At tho close of my assiyrment to tha Nffiee of the Arvy ‘Attache, Addis Abana, 2tiiopia, £ waa avorded the “old Medalion (Order of Etulspie}) by Rmporor Haile Lolaasin for oxtraordinary pislormaphy accompe lishzenta concernin’ the Amerfcen Emvasay and the Enparor (1953-1955). 2, Also on tae personal recomerslation of Alfred Kisonataadt, Lifo Magazinn's head photesrazphar, 1 was econtractad ty Life Marazina to cover the Silver fubhiles of Boperor valle Selassie (19555, Thie ine eluded all phogesranhy wor% and literature concerning tha Jubilea. This work appeared in Lifa ‘agneice fasun Novenber 20, 1965S, ‘ 3. while ausicned ty the office of the Army Attaches tn London 11959-1903) covored specisl avsiynments for the American Embassy, in- eluding the Ambassador's presenting of his credentials to the Court of St. Janesy King Georve Vito funeraly sn Queen, Plizmtietnta coronation.  " All ef the above 1,2,and 3 wore photoyrapned and processed by myself up to tha finished product. ; he Concernins my recent photovrephic work, T won lst, end, 3rd, ith, and Sth prizes in the Milltery District of Washington ihotographio Contest 160, Also won 1st prize for Fle Myer, Virginia, photouraphic contest 1960, ; , Mecauose of ry extensive knowlndge of Ethinpis, fT have been lecturing ot the Foreiyn Service Inatitutes, Arlington Towers, Virginia, ‘from 1956 to the present tine. This also included tha showing of my persons] eolor slides on Erriopia at all of the lectures. 6, Have also had ry photos accented for publication in TRAVEL Kegegine and have appesred in numerous {seues. ; 7, Shot offielal aerial photos of the Pentagon Building and surrounding sreas in 195%, — §7-2 = Cameras and Laboratory Fquipment that I an axtensivoly familiar with: . Cameras - Tr Yelea 35 am ?, Karoan 35 ns ; 3. Kodak 35 ma “hh. Minox Miniature f, Rolleiflex 6x & 6. Speed Graphic Lx § 7. 8x 10 View Caceras (Kodak) &, 70 mn ROLL Carrera - 9, e290 Acriel Cazera ‘19, 4 mm Turret Movie Comera Lah Equipment Tr Standard Photostat Kachin 2. Ozalid “Machine 3, Recordax Copy Carrera lL, Robertson Copy Canera 5, omeva Pnlarger (ix) Auto Pocus 6. Gaitz Focasat Model [TI C Auto Focus 7, “Orse Contact rinter (Aerisl Type) . 8, domaco Power Contact rrinter — a ts athe Bs ! z £ Ee FS Aes 5 & : x iB ip E *
Prior to entry into military serviee worked for Rorreste Studios, Manchester, S.H#, 1935 to 20h] ag Laboratery technician. In 195 resumed photos eraphy cerear in U.s.Army and continued in thle flold up til the present timo, Skills wero develeped in the photocrapher ani photorraphte letoratory flelds and rose to my present rank of Master Sarsent, My skilla aga photorrapher inelude an operating knowledge of all characterisation ofsfamaraa and equipment uned in Army photerrarhy and the theory and practices of still and motion pice tura photocraphy. For example, goge of my duties includes i 1. taking st) photorraphs for news ralonses, publicity, medteal and historical value 2 taking still and aerinl photorraphe and motion pictures je takine of rotion pictures fer use in preparing training, information, and historical film ; . : lie supervising thd taking of atill and motion pictures ~ ; pevasststing superiors to establish priorities, scope of missions, . and work achadules a : oo 6, assicning photoyraphera to mlusion on bnatia of qualifications, criticising completed work in discussion with photorraphera, pointing out technical and artistic deficiencies and methoda by which such defecty can be avoided a My qualities 99 a senior NCO Ti thie-finld include knowing tho capabilities and Limitations of subordinate personnel, Usinr—vary_eble to instruct and. demonstrate propor camora techniques, and be able to cOnstruct-— ively erlticlze and evaluate the composition of photographa and motion ple a - tures, . “My skillein. photosraphie laboratory field include a knowledgo ef all the oparating charactoristics of Army photorraphic laboratory equipment; the techniques of both conventional and semtautomatic photorraphic processing of otill and motion picture black-andewhite sud color filmy the ability to demonstrate and instruct the appropriste photozrarhie leboratory techniques | and processess the ability to organize and supervise oparation of a large Army photographie laboratory; the knowledge of operating procedures. and: ine atallation and. organisational maintenance techniques pertaining to Army photo;raphie laboratoricsy and am able to aupervise, plan, and condust traine ing in all phasaa of photorraphic processing, Am oxceptionally akilled in ‘making copy nepatives of all types, performine lige ak work, making line negatives and haltetone negatives, view vraphs, 35 mm alides and 2 1/l x 3 1/u alidos, - . : With ropanis to my physical qualifications, I have very vood near and far vision, good oyv-hand coordination, good manual doxterity, and very good .color vision. My hearing is above normal and my speech clear and well annunciated, ERE, ES eikiroed
tine oe 4 é on o Kind axl Trppeeere ph OF heganisotinn j Mace uf penploy inset J tmrsctatustnesg, sestueting, siruee 4 a abide fe Feats werent fof ose Fereqrad oe Salary of earnunme Beating 8 pee Tr | pen Ci — er Srot@ os { 4 — Name seb petie of umes jace supetsiser \ one and addeave fl emplepad tfierm, rganitatio . Beaten fay de seing ne mepey gemneecmminCet 19 memeetinginetretitetntent a man shen BEE Hecate At ene Sctere att Deas sila cif werk sod | i) iw any epeeeal quah! ations Het eure ehawhere os pour application, tndivate, the hi Ad Licanace and Cartifie ate theoraty which panied Ny ae Srampic, plot, | suek ass (Po mot submit coples sntese the Keate ace asrmeg brea geen : teaches, alectsicien, fama radiy byrerainr, La AL, ete, 132 Yau more tapercar publications. i feguastedt t : 42) Verse patents ar inveatione, . ’ 18) Buble speikiog aod public relations eagere ney, Kind of . Licensing {4} Aaphessliep a profesional ap seer Qcihe atm eetess, CEC. Ausheriy ted ene cane e een eee (97 Viustors ard tellowaliipes resets cede PL. en (My List sey opeccdsl ehitls ying pieeooe aa and Prathencs end equipment ws «at Goan, pai Ph ae eleeete maswe candies, seenlelstts, coengetseriedig, hep purnien, barge tathe, acierenfia dee grulsaonslé afcvicee, Photographer, still md motion canera Photostat mochine, ozalids all types photo at ewe and. film precess- Ci Sha’ a eau atts per minute in: Typing .. f aren jue econ uf Last high school atended: In, ELE ATID A. Give the highest stomentary of bigh-senol grade completed... POBR. Uf gina crnapleted bigh oheued, give date... 22... ance en en eee C. Name and ducation of cuillege of univeesiays Degrees Th 8 atizodad reugaerad Credit jef undergeaduste college subjeces we C Bents ster of Quaceee Sere ster of Cpartterl ia V, Other echesds or trainneg, such at trade, vucstionsl, Agnus) Doris. vr bus certifigaree, and any vthve pertinand Sata; eee nernermeereercememteemtn angen ate 2 and locstiun of ssbuul, datet atteroled, gubjects etadigd, ess. Give fur cach ng fu lindaste pee heweledae vt tesa bacguegss t4. Have puu lived of teavelod js any furergn auntsical fg vee [J No WW soewee ie See.’ give ins teens 84 names of comunesivg, dates, a r Jeugeh Of ume spent there snd teases of Purpusd f erdeelery satboes, Bevemers, obser cliui, OF 84s dh he 4B — LO BES
t ! i H } i } H 3 4 ’ vot AND SCHOO Seuss wind ate NOP REP ATHRS the Pasta Gearee ne Tartitoris ot the at RELPR? tex Peomes Eeieg at a 7 tias | : Mee wel Sanat ee avray as tenes eed faneas ben tre Rweraw. Steth wea wih apply ua, Pia age copeat Gere af eupeew sees Feresd simeat NG i Sub NAME BREST INT BED . Edward &. Swoomy - 725 15th Street, X... Wash OC, | Attorney . Edwand Sing [_ use Qakwood Street,5.5, Wash och Adm Assit to wenn: Senator sridceg——— jAgs't Postnaster | s Willies Armbrust | 006 Loraine Ave Falls Church Ve. en ae a oe INDICAT ONS SEE SE PLACING ONT PReTER Cont uM ANSU EE BY TLACING © ; NC it 7 ~ — ‘ ~ nent 7 ~ co . of. tad Ape ae et othe Uraited Scare eb Ameer H teh ane native bo Sams abe gem one shares f be eb saue preeenc emplore regarding mn ad States uy : Ses OR a, th! 4 ce have yeu applied for aa acre fret the i Ik Arena eon, of are fou ener Reon, & ec: we Ghatrat of Gelwabot teovcmmend under ang f arumisg Parcs, Xu nS Me ve any Uasmmcist ore ate So RD Perna of ofbee ean atrow ber cusdsoty 5 9e . | "at gta g detaile da trem 34, | 2a Ars ven aoa, ce have quel ever heen, a meinber aha Faseser ft ed ed ee Ranga ! wth we employee of, any Maik, Darsiiery, H eee ane ee = nent anne eet . Ye es) cite hetails bee Heme 4 Te) Are soa new Sauce rout erve heen a me B - . . oe wr doaiestis eat Oa, MECETROL, ROOUE, OF Ete SE. Uses we gave Bown burend bo ihe 0, c wat | binatiwy ait pore. tro Cottbeeteat, Das sat, oF mane FART Thai CR EMIEEEIVOS OE atvents Be euibaaouere subsersinc. & alegerd, or shoes, an athetd at | appointee sscoen art acts ait do laneg te } Et snen awcues a Ves," glee cuter of and rearaes for sack rales umder fhe € tfothe | Bae tay : * achowene ce altes ghe ase ard governme: Beth a — a ere pete fee uatisaaad ave anys? fi i ~ tore we yee avee been distharced from employment Bec aute: Num vvenduet wat et eatenbacton f tet 4 od, we SS ehsne da Ve, gate be atlas Bed bo eo port ad this eFoais one opens wade Cab rte ath, wateon af pr abeten ab tire one up tent aeiertet therein aod a urve tegatding Neue crembecthip ar seeedd ea a refarate ad picts abe Faots mess bersdi ds 6 anake «By OX Piaies wtaities, t& Youg werk was vor catefactary? wo weve cnipied after official eertige: a News asituet woe ner aatiadadiory? werk wan araactory? Yous 26, Pere the F eapaciy ane rel yuu fier oe have Moyeter cement om eclatine abt sete ere Bree diahitgeel from che Armed Services leeee (by Bead or maniige? wethe a best ao Ryemegadic camefagocene, ut tbe pase 2a mail cw tach Che redes aad (ys brn alee aaa bs wihivd ene? ne ene int Tar is Ve pied bet in free 36 get a! See eat remcmehin, inifading jhe wares asd adelvese and re tie Sati he i we? Souced Gavemmens emrhw feos chili | i t amststate date, cout Beant aetested, ct J, cr laid by bedreal fs liweenbetoement authariies far acy sielitodt al eo Mie bio, county ae mana iSal low, reguieteatt Weocet inchide aovthing fat haanet bs furs We not aehide Geattie 8 rene fet which ALD other charges sum be BPP See 22. AL Mave you sar paosieal handicap, chronic des ase, ur dohoe alisabality? TR. Hace vom mar had 4 vervous heraksbean? C. Have yeu come bad dubervulosie? eracce TO Yeo give de brem U8 fee each care: (Ub tltvdarge, CTP plave, OF) atabin, apply Bove Af saan aan tr ¢ L SPACE YOR TYTAILED ..Rew-juinea.....1943-.. Lye. —Phillipine..-19bh- 7 0 wD f2-ye--- hase 19US af 7R . United Kingdon. A9GOAIISFe otro oo a os 20 years of active” “service in the U,S.Army : _ dete of birch, and examinctiar ti Atiach ta inside Tf mute spece o aeins, tee Paper the same gise 49 UDis page. Y te Om wash am of thee asprin ints, Qheferye shend f sour Enge ry gihee applic ae q ay can be decided ea (he Bard alr oe Pects. Re anand Poavione wath the favorite intart ra of verue eacered at Load SaASaakies ansteel Bd She puesto may be gtareele far a atieatiotssat ua ive be subject 1 inveriestum wt et & ate appeiaed, afl fate y ATTUNTTO fier, mo Dak oer Ad seven ater deterra so toe Desde ed yuur applscarnat Of 2Cae destiesad BETES aN Acresti ia penal tant duacene ia the Best uf my knowleige and bale’, sod are Smad Wochat tte wtacements mode fa me in this application are true, comp ran 2g Peng iM APSO wee . Signarare of ave 2 _ ce A LCT a a GBR s4--35780 8B. B woese meat Fusaliwe OFFICE
14-00000 PART {-GEalPaL P. Seer leather ets stdin, CPs laa fa. PATE OF Bem for Cea. 10} ; } won yer vead ee 3. kanglage rate bie fet SSA AR « AGES PA _ a oe : | ’ save wie beg i , ' toh/ LEY aA? #Oy- 12? Af | |. ANY FLEES Git Lan quAst: SECTION A. Peating (49) , PAMILGAR wITH, USIGS Tue OICTIONARY f CAN READ PRaTS Be Bee SissaTL Te. OF & GENERAL MAT 99 YH IN FIELDS baw ' GNuy Wamigy, aN READ T@etS of wir TEDNARY OC46T Amel, poe atc $ C4N FEAD FLalt Ge avieeci sarriculry (newspapers, ¢aference raterrsis, @fe.). USING Tal SIC tisueny FREER, : ° : TREQUENTLY, a. € CaN READ Sieh s SFels. Te RE STREET SIGNS, NE@GP S95 F HEAOLINES. EFC... USING et O'CTioyaee FowOxf NO OF AIG Bere tte am fef LANGUAGE. meee teat Writing (41) FZ SMD SIMILAR MATEREAL WET COMPLETE SudiTEsS wh tHOur UGING THE OP Teoh hee. ot CaN we Peet TONY MATERIAL @t Te FL PS ONAMLE COREETS gi TH VERY FOow GRamwsisosl ERRORS, IN 2rsGaaPy ONLY RARELY. . - PoaM @RETE SESS cea 6 1. @eETE fattuaL nescate ey WATESE STYLE. ties we TESS S&S SIMILAR SIMPLE WATE SES OL TH COmPaR TE SUCCESS, USING PHF GE Te tm ePY ONLY TLR GRAMMATICAL £ Cae GRIEVE PLeingdn 2 2- @astur, Qe C40 whe Fee Le BAP RATIVE AND ERPOST TIA" UWS TERT AR mite 224654 a4NL£ CLAM TW. @i ta ERSICS. OST §e & STKE we ite he NOT BE NATIVE, USI@% Teh SECTISwaty SOCASIONALLY. . $ Cie WUEPE FEPSAmsL LETTESS 203 SIMILAR SEMPLE waTearst, with REASINASLE SUCCESS FN COMNVEVEURS ary WEARING, BlT BET DCCASITeS wih Ee samaTICAL ERAORS AND $9 GEFTOUSLY FOREIGN, ANKHAHD STYLE, USING Teé TICTICNARY OCT ASTON AREY. . + crater RRA ETE tn erence eh te rt T Cee BRITE PEStoese LETTE eS mB SHMIL AR SIMPLE wardoner, wit REASONABLE SUCCESS 1% CONVE TEST wr MIARING, But Btu Maye Coane 710 z BE AND IN AVERY FORESGH, AWEWARD STVLT. USING Ink DICTIONARY FELSUEATILY, Cannady eeyg7e 4.0 MY FOIBUNCTATESS 94 Tote tite eile OPP SCULS FOR Nate CONTINUE Gi REVERSE SIDE =4 t4a°44) 1 FFB ag
0000 Speaking (43) tt enero Se SGCUAL Salus hiss: § GevEnSt reeELY AND [OtGMaricacyy SECTIOR O. eile $88 ACCURATELY EN Lk PRACTICAL 4A Sorte mC Faw FS AMIL FAR, b Shahar Fe: rN ah Fee . 5 PCa CONSFRSL I6 MOST FRELES PV TATIONS, ASD COMMUN PRGOVERUS, VUSFRaAd fifa % + bn ACCURATELY th SPAMLY OLE PRarticatl ayy: ot wie wey le f dee TAME L EAR At 4 GMPi te SUMEL FOPYLAR Say pN4 ree ere ers MOuUTTRE AUSIMESS IN PARTICULAR FUELIE A GET ALGBS Ser th BELLE IN SETUATIONS OF DAILY LOFT AND TRAVEL &8D Sa Euesils? linderstamling (#4) SECTION €. ; > i Baree foe 6 pee BNO ON THE TELEPHONE) 9 UNDERSTaRD ' POUNDERS fh BEN: TECHNICAL CONVERSATION ON ALL SUBJECTS, Byte Pane . SS Po mEAR ON THe PALIG AND AT THE MOVIES, PLAYS) ant LECTUOES, NEABLY Eat ae te 185 TOUNDERE Tan, Oe TENE AL CONVERSATION ON -NELABLY ALL SUBJECTS 2. UNOLTS FANS UST VT maT fo mE A 04 THE RAUIO AND AT Tek MOVIES, 8% PENS. . ‘ . te FOE TS- FACE AND ON THE TELEPHONE: 1 $74, ab LECTURES. INCLUDING MOST JORES ann £0. GOT FACE: TOsPACE ANG On THE FERe~ £3, PLavs, and LECTURES. P UNDERS Aus S74LY ALL CONYVERGATIGN ON TOPICS OF OatLy Lire é 1 PHONE) € LOSS RDIAND WUCH OF mar 4p MEAR ON THE RADIO, @ND AT th. ess 4 PE UNDETET avs Pek SHPLEST CONVERSATION, BOTH FACE: TO*FACE ANG Su Tet TELEPHOnED | UNDERSTAND SOME OF wWeaT . Powe ae Ou tee F419 BND AL THF MOVIES, PLAYS, ANO LECTURES, eee ere ESC eter enh a ennsnentntor bo aM MOT 4.8 9S UNUERSTANO Yak ohOzEN LanGuact. SrwTIMUING ~ CHECK PART 11 TO ENSURE THAT YOU HAVE Ci@7LED ONE KUMBER PER SECTION. BEFORE : PART CLImEXPERIEWCE AS TRAHSLATOR OF INTERPRETER (45) LL EE EE te to EEE lassa ta peye—iiw NNePeEeeareeececccsnwar-cbcics i. P MAWE HOD G4P EH 1 ENCE AS A TRANSLATOR, 2. PoMAVE Hat ZePEKTENCE AG AN INTERPRETER. 3. SITs OF Tee #eeek STATEMENTS APPLY. NONE OF Tn 44358 STATEMENTS APPLY. PART I¥-CERTUFICAT ION Yee 8651 OF MY RMOBLEDGE AND OELEEF, ScefSES § Su. ELIGIBLE UNDER THE TEAMS oF FECTIVE LaNGuUAcE PROFECIENCY TEST SEFCRE 7 ra EOCERTERe Peat THE IMFORMATION GIVEN AGOVE 16 TRUE AND ACCUMATE 14 TeiS CERTIFICAT ¢ om CUMSTETUTES toy APPLICATION FOR A MAINTENANCE AmARS PB PEGULATION MG. 24 545. Paw, 1Cf4a}. P UNDENSTANG THAT 1 MUSE Pass ay 48 SteCGue £LIGISLe 61 Re BBARD. AND FHAT IRRESPECTIVE OF THE SATE oF vee? “CUMULATIVE A5°9# Tet ARNIVERSARY DATE OF COMPLETING THIS FORM, SG. AMNUAL MAINTENANCE A@AROS WELL BE ATé StGNED SEGNATUR G REGHE 4 'f Z g
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CONTINUATION OF PART TI-LANGUAGE ELEMENTS Speaking (43) SECTION O. . . POSRPE AR PLGENTL§ AND aC cme tity FY ALL PRACTICAL Aut NCCT AL SPTUATIUN RI TF LON ek OSE FHEOLY BND FOTOMATEMaLL® Pe ALL FUER DS @E In autt F aM FAMEL FAR, ‘ StToa Pr oes F Gate CoNve est IR MUST FIELDS POSPEAR EERE NTL§ ANU ACCUMATEL © OEM SP AMD + ALE PRACTICAL aun socedt UMM PHUYVLB RS, PAMT SPAM AME OF PPI Ge Rome OL ae DALENGS, LETTER AR® QuUUTaTEG, Alb ee enna tenn ) P GET ALONG COLTE BEAL PS OSE TATIONS Of DALEY TERS 2n0 FHAVIL AND CO% ce wets anice fg oke ult BOUTESE Husieh sais FART cuLca® Fitton POMAR AGE PO Chl BONG AM Tet MOSS COMMon SEfUATI Ses OF DAILY LET awh Phaert, Fu uat freer CANGUACE 9M fur OF feek AROVE HESS TSE, HAVE NO ABILETS ‘Uivleratanelinge (44) PUNO RSTASS NON TECUMECAL COtmvFUSAPIO’ OM BLE SuBHeers, OGte FACK+ TOP alg AMD ON THE TELEPHONED Ff UNDFeaSTanh EARLY EVES in rhc Fo wean ON Tet HADIO AWG AP fue MOVIES, PLAYS, ANG LEC TUBES, POUNDER STAND NUNS TECMN EC AL CONVERSATION OM MEAWLY ALL SUBSECETS, BOTH PACK? TOP AGE Ahh Gh TE. TLERY BONNET | HADI AuG AT Tet MOVIFS, PLAYS, AND LEE TURTS, PNCLUOING MOST JORES AND Of UNE ASTAND MOST OF at AE 1 BAR OM Pot PUNS. TD UNDERSFAND STARRY ALL CONVEHSATION ON TOPICS UF DAILY LEP AND fRAV2L, BOTH FACE> HU: FACE 440 ON THE PELL: MEOH Of Taf HADI, AND AY THE MOVIES, PLAYS, an LECTURES, 3 PHONES $ UNDERSTAND wuce OF aMAT 1 UNUEHSTAND SOME OF amar 4 PUA: ASTAND Toot SEMPLE ST CONVERSATION, G9 fe Falte fO-Fack AND ON THE TEL GP anne U . bE AR ON Tet SADE AND AT Tek MOWERS, FL aAgS, BHD ELC TURES, in 1 AM MOT BALE TO UNDERUTAND THE SPONELM LaMGUAGE, BEFORE CONTINUING = CHECK PART 11 TO EMSURE THAT YOU WAVE CIRCLED ONE RUMBER PER SECTION. PART 1¥-CERTIFICATION b CERTIFY rat Tht ENFORMATION GIVEN ABOVE 13 TUF AND ACCURATE TO THE AEST OF MY ENOELEDGE AnD atuite. THES CERTIFICATION COMSTITUTES MY APPLICATION FOR A MAINITNANCE AWARD PROVIDED ft AM ELIGHOLE UNDER Tot TEAMS OF MECULATION MO, 20998. Paw, FCS). 1 UNMERS TARO THAT J) MUST PASS AN GDJECTIVE LANGUAGE PROFICIENCY FEST BEFORE ! GRCOME ELIGIOLE FOR am AGAAD, AND THAT (HAESPECTivE OF Tul DATE OF TESTING, ANNUAL MAIMTEHANCE ABAROS wILk 8b CUMULATIVE AG OF INE ANNIVERSARY DATE OF COMPLETING PRIS FORM, OaTt Si thio Sb Grea TRE 27 MV SES __
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SECTION wr CLs? geice aur OIG RIG OTCing ne As, REUNT ETF Sous Ne HIRE AALS waa P Pree oF NAWE OF @EGI00 Of CousTAT Special Presrort 4 1ét9§ t. TYPING (apap if. gene PreanD (wpm) ~ erg tose fe ore Hi Himeogmph, Casa Pura, Ete), SECTION ving dees we BP hotogrann; a &. imOtcatTe ayy SPE TIAL SVALIPICA Pissg ® Paaticuar Porriaeon tree OF #Onm, - All types of Phovocrapn tate CW epged, Sande ad sec erving),OF FS@ y GEOGPAPHIC ap tenn ne ee NE IE AR im Bie Ste were FY aye TRAVELLED OM Gainey CBOE POSE 24 & OFRUL TE OM “TATE Pere Ce RMOPLEOGE Gucn AS fe mrmain, aA By, UTteateng, mary. ROAD, OUEFMAS, POLITICAL PARTIES, EPS, SPE Ctauizeo SeOPL OE 2. OIC ATE Tog PumrPosg OF wigir, RESIDENCE. Aten ! ata Qnans 5, me od 8. INDICATE Gig @ DUMMESS MACHINGS @iTm emi TOL WATE MAD OPERATING EXPERINCE OR FORtuiNG (Sarrgtamecer, 8. 2ACLUOING BURMEDS ESUIPWENT OF MACHINES @ we SALAS VOU FO99858 MELA Tin TO OF MER EOutOwene aw ‘ OaTes ano | Pace OF sruoy { : | | | ater Ve TEAS EL ee RCH OF fH@ REGIONI OF cOuts } UNITED STATES PaaseOnT NUMBER AND Sehime tion GATE iF 84080. : Teo fi fut vices SECTION Wit : TYPING AnD STENOGRA PHIC SKILLS (sete y a meena thee Bae ol Olmedo ole EA KMOWLEOGE ano FOR E1GH TRAVEL i Seuce | OMA CEL ata, | AStiaee (renee etree a COvIREO BY { { eoan ae ge 1 waar tmes watag aB3¢2, el Ltek Site} STUTH yaeg - CHE CALA) APD Bre Rw Te 1h goa PREC ARTI (ETEROTEPE 1 i aes SIU TRS eoae @ <P em ENCE OW TURIN Onteee * werk aad lab work Sar oa aneracea MAT Ma78 LIMPED IN ITEM 2, 38cP MACHINES SUCH ag OPE Ration oF PRESS, TLOOLT La Pou@, SCIENTIFIC Am? Pmorgsa: ne ae nate EM Specsfsi: . ern tn teen Sisal Fil §6 FOR w (a0 GU LIST aed SPECIOL SLMS eR ee BEOID Clade Sua DE WIC ES. yo
Sa eee Ce 4% & es? urceesE Oo cae? ee . i} 4 ni ES ATER ALCOR WEN TOO CNT TOE re ~ BBP ame gigwimic am wT Pe Bu heRG Mar EA ans OF SiC (OU RAE PeE AUTHOR (Da OF aude? cosy wet PiLe, PupLIc a P92 SATE, AND? PE OF SRP toeg (Mogee F tessa oF Seromeetse eeticiee, Gove ral Iniges, SAAR a b Aone ws he Ot Mase * hettate 0 sabi dhge ah Lhe ene SF ot nae oan cee Oa eb antes ee Ate tae w PRG aee Bere ‘S's “ROO Auge a umetee, if ances, * ees? 85 aalve. im Wa FILA TE "Voor of bane) FF Ca PERT LICENGE OW Ce ; ! Trae, Ete.r, FEIT Covering ant “wPhle up concernin.; the Silve= ‘Haile Selaszie of Sthionia, whieh appeured in Lite lsc, l1.2 Also a33¢. lol Jona 3, Townsend Us5.. Parer ducines 642 atveadance at the APay sar 7ollese.¢n. "Te. Nor|g fe ft ote al tine ah hae gah EB AIND OF LICEMIE BNO STATE Id3000 - in the sreseration of Ca cent eg at Comal tt lo 2 emt uae ene STC ATE Seer oF lagues cd C08 Galle POU WATE TOU CTE ne  UMDIC& PE SMe C1288 Orin OU mA se INVE“UTPO ANDO STArE FRETSEP OR MOT Trey AHE PRTESPTES owe WES ANY BOSFE I Sat ETRE BIE OMEMOEG. LIST BEAL AIT BONORE FOU Mave RECEIVED. SA SETI 1X . - EMPLOVMENT HISTORY edges BME PUBLIC MEUM TONE CT BOI nt reenter cess TA QUST PUBLIC TPR Aap eS Sue PUBLIC MEL ATIONG BPR MErce, =e Giving bret fiavs to all wtiute perscnehit soins to Ethiovla froa - 1556 to Pli3eit, at tna wLlitary, Institute aPl. Towers Ya, eee ra Bubserte, ceo i] MOTE: UUST CAST BOU Fico PIBST) Indiowle Dhan “tical Atatory of ompiay are! uding Caeuel e-civygrene end ath Peruate of cnemplaymen: Gy veaihitrasa ane ¢ wiowmploymrent, Leal elicsvitian einvioyment by a faraisn Govemmint. cent Hea s of ent for pase §§ years. fale what you shetes, aeeiption at Dutian © comeing your atpacionce carelully amt provide Meoninglul, ohpective Tealemen: ys, pls Me & SAVES SP sce art Fa Grits aad Veo i p=? L to ovresengy pee eth GOD: Ae [* arcae45 ’Mo., Stee 1 Caty, tele, Sovmirys eo eae ig See rer Ta, RRR 17 0-7 a& UR or BUsinegg. . 7 ; a. NAMa OF SUPERVISOR ron he Deile {& Werle oF joe », SALARY OF EARNINGS | shovosranhky ‘8 es ‘lean Oy & Saas OM OF oy reg FIRM Oe AGES oT Gol Anvely Felia i8. Chass. Cease Si Fedovas Services PLD ade i bof Swe Judlive:¢? Esverer dom Ba PILOT, ted). (OIC ATE tovete, Srare 3 FP HONORARY ASENTIA TIONS OF SOC1H TIES im wr cre TO ARE wOO GG OERE FPOAMEALY Account for all partced, - a using peticdsoal In Completing sec 2, * Dre U.S.A. P20t0grapay all types of lab OTH Yor Asst. Chier of Starr Intell. [>a egasonws POR Cea ory aaticeing from accive duty 9-51=61
Fn eer me Re ge AN AMO al En oon wer a nem 2 nee ‘w@ Gaewicg a2. 16. Locay Qaarer BoaRD uO. o8 ates MATING £99 AQSPESE fa tre * aby . 3. (LIT any saa@vice RECORD ‘ a Tn et ate a ee eee ce nt nape enna ee 2 aye Capa ca rion aL MENGE SS ate we ee ne FeO PIA SES ke, Ie aL, et Sed 2 Te re ° on on Cugee gd) ag . \ wages ae “coatr MERCHANT MATIONg, A1® uae APORSPeiave@ « ARMY , MAYT | io pmey . F4ML& + bwRAD ) Mamane , GUARY » SyAmes MOVE D€OsES@ 1} : ; : t ej i’ MOS SER G19 oe . i | : t i 71 eae Sac, Se 5 . 2, QRAwt ae 22 5. ere Se AE ONE CELTS, “eee mi Lar ites a i i id ee ee on af rnsell, eee ee tome ee - mavove vo {FOGt aeewrr ag &. POT RL LP mah OF EEvENOLO aL tiv#® OUT ie ug. aamED PORCES Haar and Curren? eercese; iw eres Alm ERTEWOED o Bae ee “pe | at a §. CATE see ce a ea tne ec + PAS? Seavicg ToPRLal seeing POTAL Lewarn oF aCTIVE’ OUT y 6y FL wEIG Me MBIT Ra OR GARILAVION . Sat ran nsbtnetenmen e” ae Foe a te et ea eee %, BANS, G@s zt 7P FasP yeayvicg ZuPSR ee Sew gig *@. $@9viCt. 4eM:44 O89 FILE BM ee IP mse gerving, preside cur Rusotees RATE — . - $ fae nt wey aft 24 BOLAGS 4 ae ee po 7 Ladle 9, PRiMaae wlet bee TOO OAT IOW aL of * [eursens PERCE a. re S =~. le Acste Chiet of Stute ernst seavicEe & inee ete mnenee ageticanle to Set at Current service) $. Dave gute ses ACTIVE Sa? 6 cam 10. $8COMGAa! we. Loo wATIOMAL SPECIALT F CMe et berignatas) Amy TITRE 1%, BRIEF CHIC a: Brion Ce wiLivaas a Intellivence + MLOUSElny, venersl FIO work for che I nets eee is teceriessete pnovocrazh ee mm Ee ee Ge om ape 11 years. - Pen TD 2barl Iatsile. . . a e cn ' ' . ene AR i a Le De Oe en ee oe een EER sree teen entratetpnn , th. Coker tee tee oe SEPARATION FAQM ACTive OUFY UNOUE eR RO Ge wg . ' Orem |__| woncaaece SVE a8 moe \e@ | SOx 80se 22 mac erive our? ela comget g | A@ringwgus 958 ase : ees: Emo 9 Pewee ar Ot fa, Teh on Te TO er ce CN? iN HRC "Ou Sh RED , ° . A oe cern tte ‘ b Sib ea Unetuteg ay) REGULA® |. O58 HEE Cinchadeng ie Nation) wd ast | seat te per 3, winsTaPy BETES OE, MATION AL GUARD aNd OTE STATUS : : tt ee ttre ene 16 mt cram pete ea eeu eee ere oe oa ee ee green ee ee : - 7 t. GO vou PAG wos F Rasen oy ate & ween oF Faugi P veg 12, aee way 439 & ehuge st OMT ives . RESERVE Salt Do ete Sear er eer e rr ee ope ore? ema ‘ : Gant be uso : L.@.%2 T2097 fe3 4,2 Of J agove, CMECK COmPOneNT mE BERS ae 6élow - dade Ds Have ANSWERED “ve Paes BORG —_— TinDizare PUTS COTESIRY NOt rene ot ee pave . < i : i ;Aoe POACE ROT 3. CURRENT Bans, eae Oe OOF E TF AHP et ws at in CUuRMewE | PF, EaPtRATION DATE OF Cu @reut AOSE RYE Obeid as AATE ; Baas, ; hon RETIED ot een nem ee aaa i Pharr REsenve: Svan Cave dctrer STAM DMT maces 8. CHEECH igi cl sere? m eae ee ns coe o PRIMARY wire ewe PRPC Ae 3? korea se (itme 2¢ Lee rge 110. SECONDARY wiLITARY OCCUPATIOMAaAL taciauTy iMoe e¢ Dads Retot) AMD Tile i igraser) AND FITCE ame ree en tte et pr 4%, BRIEF Desc oresie OF wiLiTAas PEE FOL Buh oks "Es the vou Mave ANMSaE RES “veE" TQ ‘ene 18, GivZ Umer on cree Oren d AMG ADDRESS > 12. ARE VOU CLetgeri yg 4569 Se @ FO A @LSZ O42. earn. SvARg OF ante er rrr tater eC ede ee 14 Mave VOU & air? aey MWISILIL APS Bttisen Meare . ———. ves Th 1 7 Oi Mave ANSOE MEO VES" FO Tee 1E8, Giese UNIT C® asgucey aed 427 ae ss . a ne atte 1G. tuo arE ce B + TR mmtae @@E rOUR nerve RECOMOR aE ETE FOG LOmGa ere Fm 80028 ime oe . en wy ‘eae iG MC Tie€ BOS wateige meet a7 wwoele LONI al Otrice EM ie oe
1M a Mle t e oe e eE a e MER SR mn San mangas smal alte we! Dace ne nae cee ik ee ner, seat neem ne SECTION we FINANTIAL Gf ars @ Sree eo hme eae Naina ce ee Stan ee nt ee eaten pate amma anes Oak, eee ne - Ney . en on ad a na 2 Ee rn aes sane carr mee a ne “ ° NN Br For eretrrenrerssrras AOE be BSR mes nna on : OF ae ge ara vm ad . aot AlOSX Lm A GLE . R wtat vou ee rea Rie voUe aeeeee ig eRe a UMC RY DING Ceo Bes Sate” AL AUDVE, Gee PAaTin gg aa entation A a SR cere Nth fnerberaennen ane Stretitneenenen Weyer * & Give Tmeeg Cage BEPLSENC ESE Oe Pee mE Ar area . ~ leet : SSS VERS Ran Hower, Cite, Frese} Ao een ne rn ene alin nine mayer & Co. sOOdwun) & Lothrsy AP Pee Mn Pd te AF ' me te 7m : ; ceermntetneteteehun tai ee : M.S VOU RECEIVE ON BRU! Pm oe GNP AS SPSTES O@ BTEC T OF AL emia SOVESNwWL OT Lu Lew Awe OL IRE ue BSP. PHNOM, O@ Cowe tute thn SOR Mae OR May aL Seay ICg? eee a? sete eer se glare ae tae tee oa ee a ote ee eee de cree ane cts nag a eee BF POCA ANGE WG RE Pek er oee CVCVTION, GIVE COMMCETE DEY Aine Zand» a - ae ee re o 9 ee. mR : ; ascizenens fren tie Vaoivei Stases atay ZO yours . i : : RIS VOU RAVE Aue Gin duia. eo PDP ST In, OM OP PICIEL SOMMECPIQNT arte wimg § Soe oe ar auy oe Buse ds€a: OA Im C4 were US. CORP SG ari Sesg SP b JMO SES MO Avind, SUOSTANTION @Daei ce POT E GES? 4? . oan 7 ves ere SH qnowar *¥4S4 Ramied sotate am separate skuet,j . : SECTION RH MARITAL STATUS 6 A rte et mt eer oe a ene ete en tte ete Se ne ee tere te ® PASI Euh PT ats (ER Pawres, Hr Somed, Sopecated, roars ek ve Ane ROBesey: : hE Abe O878, PURSE, BOS WES LED TER ACR SEPARATIONS, SIV GRCEL OS AoULL 4 TA A Nt ee a : SWIVEL HUSRAND tf rou hase linen -murried rere than once « eluding annelwadie + cae & HPSS etott fue Cac wile oe fe ‘ OX FIANCE: Rushesd geri feta required below toe all peevione Marrted@s. if marnage ovate sleet, fll a sburopeate iNfcet ation fut fance, : . Peas. [ : a STATE Any OP eee NAMES Coe we EL j ongecara CORCUMET AC ES Cis lading Senger rb tas ee Le sole hee : - . aa - one OF CHEST WROET BEDE IED. CF LA GOL CeaNdE Giese POUT any (aber org de ater methogties VEE RETA PALE PRS OILED Om PATE 18 : dimples OF Pred Bet PO OECD Pols ee Dera tis. : een smaindin A ee te ite eee & Youe Sr nett nee eo be ee : BTA e£ oe WAR GALE & LALO Se waaemiagye «o ners i ' . are = nes ! . Sale or : wove, 15,1558 aclin toa Va. : : Shot AS A BEE SSR wew HALE Ca, Sieewt, Cite. State, Coaatev) “ ee Vinca ce 2 IPTA SEL, 3.56 : a! eatin a ~e —_—. 6 Livies 7 & > ,°3 Cause oF Seales 3 e 2eD i fs. Ve. SURGE NF BOORESE Gore hoes anmeras se wise Thom 2 be wy a Wine. 2 ge. eee ST Gat ee tO te gre Gia tw «Cuev, Staray wommtevr ° rer erry Srey aved 3e25 : -?oce..ter, Mass, : ag i SECTION NUP CONTIN i : L . =9. fe @ i fa
7S ce er eee ee Oe ETE ents ore teeta eee A we CRIED eter ares SOME ‘10 Gee DUT NOE US OSE OF ERIRY IR PLACE OF rr . eee ae Be ahbae - 1a. eOawER APT ee mem Pigs sTonemtere reas” : UP SATE UR Shere wpe FF @He me Ai ae ot awereoet ‘ ace lumi, e ore . : eden ote ee te a en a .» no ete Ninn ne bee re ag ee ogee 1¢@, Te, OCC ume? a0, wae ear Pay es ‘ 4 g60 Fy mmer mmpss be we tt Opes 8e Pb. wate oF Usem pty oe give t vor empl ger es . ae Housevwifs : ' len Pine ee a wo ee we. aday 92. DATES OF WILITAAY SEAVICK (Prom and ta ty Wo amd be? = 13a Cow NT@v ails Origa wiglt ane g SERN E areiniavea i ee i NAS 78. “Oaraice’ or QYangr ESNGE wt SEA VICK wa C8 PoarIgt. id es ————-_ SECTION #113 CHILOREN ANO OTHER OF PEW Den Te a, Pare oe toe #” FOULOMIMGS | tee Oa Me FHI pue ane c CuI DoE ang care as eats a _ a ne DATE 44) PRAate OF gin in bd GETTER EGP tt eee: etntoetwninn yg he pam: MER ATIO meee aug SUURKSS” 1-50-GQ0 wash o¢ a 2. MUWRET TP CHIL REN Machal ng elec MUMTER OF OF MEO DERE OTE EEG Ime hating siees te, Carbide or wed adapted chitirewr? any ARE Hi Berens. Sraremarenie, S1618F, OFF j Berle TREE GO UNwaOOIk) UNSEM 21 van OF au, sf Ou Fon at ae “40 fabra SGPT ST, Ol BOD EE SERPS EPP OWEING, Ge CH GAT TEC SF PE. SF OLE wap AEE eT 1 t BERR BaP POAT IMG. . . -SECTICN Aig FATHER (Give seme intgmmatina, ioe Stentatner ond of Gaeetion om 4 dedeiie wbeets ei ~ en ane iain aaa es neta a na ne nn el terre fn f, Publ, awd (foot Kiret-Widsles I & qivita 3. GATE GF GRA 4, Caudt FP VEAP ES _ propor ee i@® jens f fm? an “Th. . neers ee fee ne a eae ne ee ng Lam mic a Pe CEC UST ONC ES Unthalwig fargin ef (ee, NERA Site ng rbd EVER UIA Peete Manes. 1F LESEL CMANGE, TIVE PARTICULARS (8008 , and &y wheal avitentrh Vit Ed7S4 $9aCe PNOTOTD On Fae 19 UH Tg ~ [208m Fo AEC Ce THe Ie nate ite, 9. Cruseaed SOVRASE ~ Gere tget adktsene, tf daca tend (au, tree, Cite. Sle » Cerra 1 SSIES Tw Hee WES UTED 7, OTH UF Q.8 Tr PR ACR OF MiP LCT h, Satm Cunantee) ae errererryyor. Crees) dea1 1-55 - 16. 5 GG Solbise vib. OPE GF Lev ae Peace OP gute ; a yy, arte LOTS oa Tor SER ACZUGAD (Coie. Itete, Conary) 8. DaPR od Ceti be tae 4a, POMWE RM CITHLaMsmieCEl TC uamiept ions” . ACIVIRED fetietG oo Panchoascan 1 1. OF CaP a Tease PRasen? TEL DEAS brew toes oropimper, of Pathos to toregeed of Rear pslarpa) raticed as ee: Rt a . SUPLGIGS bh SuStnESE ADOREID OM PAP MEMS SubiwEbE ANUARLE IP SELP-BWPL OAD af, 16. OAPER OF Unita? PROC CH (Pramand od 16. QUOnCwe OP LER GIR? ope . ate erence annserreeenresnmnverinar a mnnenen abla 99, OF FAILS CP OF mee GUVEGNaaNE B4GsICE, UE OG PG ars Sy . ¢s7 ‘ 8
= snd ulcer ab Soe uheettnUsscne wees acta! Fo cent SEC Ticnm av ee MOTHER saree were integrate pis Rimpmont pecare On 1, PURE NAMG thee eae Matien 8 a i e nate oF usar Usa ar Obate Parva rer ed] nT CEE cote anwneren wee bce * - fms pte Bree feed 1g, E. OOMMER CiTigG uEmimibs CCiamersreay” re Uncantog fon gem ov Fees HD Tae OEE. Ie EAL Coa Gee POR PICU, Ae TOs Bd NG wher oy Portty), UTE RAP BA OAc e Pee els Om FANE 1B OH Fog { FORM FO MEL ls Fee mA Ti, Cy Oe ae ay a CURRENT ADUAAOT Give COs? AOCMEST, 17 OECE RIE TNOL Street, Cote, Vee L aTD TE 2 ome BAG OS OLS Oe ern a een Gate oF arate (aera Cer, State, Contry) 8, CVTER Me hoor # vm os aus paral we Gaps Ouryog wk isle 4 York TE ORT Ce. CFE Raw TGs, ame ae RCUUIMED Lip, Baler Cami) acQuindD : are wee wowed beta evermore nnn = wen te a ao me a tn on so Occ ura tian 16, POGENY CUPL DOHA (Clee lool emplaver, ii wrthar ob Ser Saeed! oF wer plored, House. A - GPL OVERS GUIINGID SOURED OF MOTHERS GUDINESD ADUAEES IP TER? BMPLOTED an ‘ diy . OAres Oe wiIrane BRA VICE ( Promand Pep Brancu oF 1a eee : RA &?, CouMT AT ‘f 4h. OBTAS GF Qh mde OQVEMNMANT BHeVICE, U.S, Of FOR EID . . SECTION RVI BROTHERS AND SISTERS Uneiaining- tall fed Hrothers ant Stetetas ? ‘| Eee d Pra Zets® Conmeeyy en 1. FOCR Nate (Leer l iros-Miasiod Tse hase re ce es i nner te ge a Ap AS Ca, © Sane ee : ;* CURAEUNT ASHHAED(Ny., Street, Cisp, Lane, Sivte, . R Rigi » &Ge ‘| Ma head. “245 fey;ers ! tae n | mE State, A TE aa Bsa Aleta " re ceyrcerr B. Gif18e msmiP toumirys | alaean : it fa 2 a en recor mm ean carne tte cane BM oS OD. ener eee meee yaar eonratie aroen | eee NE AGOMESS CY, Seeeos, Cry, Lone, State, Comeryy 48 408 a jot, Wa ph OSOO NOME (Laer Foret Wes iiey . . wp de AMR ATED G3. CoP Le we bee! (Commines 3 tee nee 6 oe oe en eee ae a ae a RS | Tee ‘2b (Mus, Sereee, Cire, Zoe, State, Cuaniry) O. bigted $6, age Poth Samshanean ‘ott = Teer Tee] ae yt. 2 bee. 18, BEL API Catwie [2 COP eee wy CComantiv, 4 : ! ; pn a a errno ! Peeraneneemee a p48: CUMe leh ADDAERS LYN, Sremet, City, Some, Stare, Corsry) @. Gipteod Ta. age i ; . . Tose 1a574 ft PULL Name (Reet iret Madiap RAGLAN OnsHIP jd COL eager em rv omieys 8 Lo a en a | * CURREMT ADGNES4 O9,, Itreet, Cite, die, Stee, Carstirys 8. Giving | . AOE | im : tv@e t Tage [" Peek WEE Laem Pe eral Misting , a. RELA TICE ga e B, CEP PEE me sae ie atte py @ ae re ee settee entre epee: aren narnia meetin ee ee ee | & CURRENT 8004638 (4a, Stever, Cus, ane, 4G, Conant rp} @. ki vreg ace ees re 6 Pua aed (Leet F ures- Oe ntios . MEL ah IOM sae B. Catt Se a hiF ec camiry; . hi wieg Te. age @ CUMMGwT ADOMEEE (Na, Gives, Crip, dame, Siase, Cueriey) j ives? a) erent tneeeteete 0. FUR Mee hme Free Mrgaias 18. MELA TO mire $. CrP sew palh (Commies . a i enn be at emnennes , 2 CURMANT BOOMECE Am, Hereet, Cary, gosem, bete, Cmemrp) G, Ried & 498 be eure e a . fe abe halo ser. “gusta 2 eats at 1s we mtr. padre eft soll Momma eae ue ae a. ht
| 4-90000 * ® et eee ee eae ce nner ene ce SE ete oon eden mM sae ue lett ee anaes an erteme caiy tet a neta clit ole 743 J PaTHER. in. Lae @ 2 seer ete a REITER meget mn ons Titan Beene et eee cane rye eee ne ee ee  % ere oF OF ate e. Ca . arg t - SET we was ae oy P bedog baagim ad oy . reg +8) Aways ORT 8OF SOher@ . . tebe Fate seac er PHOeIIED OM AGE TA toe Tess — Oa CY RECO Pett bee pmeeg Frets, . vO eumment Ga cob? Bi yeRTE Min Fornet, Eo0y, Bate, Koveiel “one I Te enna es at oman : 7a er ae ee rs : meee a wh hae me crete OD Bees te oe  Trrecermimane ene ma mo ott mates ae peters sm te . a £8. ML ate ye wee tan ltep, Begre, Countrps . 8, CURIE Rope - i e- h th; . a : , : . . Mle cras es Loma Rage et IAs Tiree ST 8 Gi e401? GA PR OP he! ; it. ®uace oF turer : _m —_—~- Pe ns 4 7:5 cen ene 4s. sQamen Gite Pe wpe eeg) eCmanter ed PL are CIEE sue 68, AKAM ACGUIMYO (Clr, Ste Coumiegs 4 Be uwi Oe” No f Na fe, ‘ abae t . ah trees nin ELSE = Ferre eee tat pee ama AE ee wt Cet ern kt te cece anit tent Ae we erent 1%, OCCUPA TOs i 16. PORTE et Rum Tee (ive let anplinger, of ParharincLaw 19 devoooed GP er omnpytery aoty ’ retired : i : Na . @ ECTION AviNi MOTHER IN.L AD : ~ @., . - A ae itr ro nn rat ee Eg Fe es enn leat st ert ap re ac rete i wee Re Bie 1h ose Pte gs - tis sett ‘ a. giving { 8 Dale oF OB Ato ~r 4 Caused UF Haare ; eoeepmrs art ate ! ; ree 4a { Sree te] ci Ot Och | CO KC PIMONC RPE COMO UME Bm 8S fh fetid Jengih of dimer WNUE NM amides bee 0a i . . . : 1 20H w3d0 Poe oR oS, SF LEGAL CMAMQE, GIVE PARTIC UL AO. f ace : Ma . . f ont Ay stat ania 2 UR ESTP POR PROVIDED OM MAGE 1S OF Peis : . PQA TO RECOM Teed EPs Meed Piegh, tent en deni nen te ee Moet ee Steere cette et met ae ae ton mane eens none necethsene ern eh eerertenr ne rte Go CuRAReS O98 ESOT ACRE SS (Moe Breeet, Seip, $4646, Commtteyp , i . ae . t on nn ns hitter mean dinet e amare enti en etn ! ~ r, are G9 81a ¥ ae OL ere 48 Bie ree 1am, Sree, Comamrnpy. - e Gate R areas © ates ‘Verse eye . ~Aliga741555_. Oe AEP EEY et Land 6d. 1 ORM Qe IGS 0.8. S far spite Puan oP antag i : — j , . } To Dn nn ye . oa . 1911 i ch nh wn nm OOS bg eT 14, @Omma CHP te tat. Ogi sConmrteytiaef PER. VAP] OF. Coreg abe e TE, meee SO UIMAO (City, State, Cuceteys , ee 7) ait ee a ep en MERE RCE SetctT 2 e #8. OCCUPA Titsn LAG. POR sat BHT ER (tee leet omplnsar, IF HuthenincLaw iGderecent oF ceremnsidup ary i : vee . eee og | . stk | @ $2CTION xin GELATIVES S36 BL"), wAaHIAGE OR ADGPTIGN wat EIPee a ely Live ABRQAD, . . wee (3) ARE Ory 2, Tits ens OR CH «CH POS & PGE ian COV ERN MENT ® ' Fee AWE Sous tale tie, I Fe a Berle BE Late PES & A00eg1s ca 23. Wwe 7,8 wet OF NNT ACT 8. Cerra germ Cleary, Fs NAME SL pee P rose atrgsior €wP sees or ia 2 eee ad €. ACORESS 58 AT Late e o werd ert crc smaahnae - SUPER E eh ® OO caw tepe PL @E Tt ae « FUR AH he car 17 90 webs gtt8» S OOTR OF LABT Conracr TUR CONTA 4. Pte ali Gwe ware Whi kD $. €er,ordaueg & BOOTED Soe . @ CATE OF Kase Comracy e. COCtEE ete? 1C aumeory y POEL Cate LF Caer acy &. ger ,oreagar ARB hee E PEL TRS 6, ADORED OF Carmt or in ome 6. sre OF Gate Cumrace B. CaP l ee abe i morre, PBL Lele oF CGMr AcE
Ba ae ae a nae ete Hoag Oda kt om bam pneu sete coe PLEA ie Case erie nt Soe a ee ny ae he oben oe mane ete en ant BEG ROM UE GOS FEET pe PAGE pe eon ea nt en re re tenetcusunuaaenitenppnne o. IPRA, mewace es ie BF, CORE otal PLATES UTED tm RRO Tine eta anaye. “Be ° meLarives ey BLOOD, “wapolane. on ADOPTION Wg AE be THE wiLiTaey 02 Civ @ = ? & SECTION Kx ; SEAVICE OP THE UNITED STATES Seeleeee aremereersereaerereeee [os Beane % Sea ab Boe O, TEP ig ose % wee ee qe So Sm | von ; “SA 123 _ 6. Pere aed Ke Lucarion ‘Or sence a ane: fdne OL Vivi fOLGn@ Lave ls o7* fash Dao Sans a ummappenremmemene Feeent ‘a REL AT OMe ;%. 4G€ 4. Citiggusnie in sora LA 8. Te oe tehd Uae aria t 9 IP nnn ve Federal Avdigis nn needa coe wanna 8 SST et nian eee oe vee teases 2 fa MOORES (4., Sireet, City, State, Couniey) 6. FYP@ ANG LOCATION 98 SER yiCg CIT bane} H : : t 6 | section mal ‘ , REPERENCE RCOUAINT ANCES, AHO «RIbh Five CHAR ACTaN Merenencgs, ot ina ae Sha tle ks, fF arene ere care tee en ann - rm . aus WEIS ADCMETS - ' DENCLNTE ATOBESS - AME . | (Lees Firat Middle; - City arcl Statay H fo. demas, ity awd Satay ow . eterna bers ener i. _ dant, Gniefk Storer i Pt. flyer Ho. srea i Ge : aa e at 7 ~ j . . Haj.Gen. Jona Hetillons i,*22%2)9 Cas. 02do OG uariss 15 Sb 22le TA . i fine Liga’ . Gén-15 57 ave. Alfreed “Asenatacit i. atko Clty ete 3 “le, | Post orfice eo be {UGGS La: Bal Mam teste Mock baal 20. D.Ge meee erento | 3300 Neoragka este ' 3300 1 aiward Svessey ee ae ee _ a ft A ¢ fz} My ; © B45 2 Janes Ansea tarylood Ave. tei, | 292 aa — ok oad en - ne anaes O56 Bnew POD ee 2.08 Fivg Pests, iy Pree U.S. wie mw satea orig RO OT MALATIVES SUP Kgs Ge EMO Sueieg rere et en nee nae _—_. ee. te eee anne en aren (Lase-Pises- Wastes tHa, Street, City and States : the, Meeet, City wend Stare; Mang { Gutiness angnE ss : MESMCENCE aggenss Alfred Siseasradet 4 HeuLas on atNaed Sjaeney a Jfeib1los Jrecs Jono 2re ves Lo abe nea Deft on 351 Geasticutlos aV@e |! G22 Gar aplas - Charles Gulls ae he jel ne wgod dy FL AIST THREE NEIGHOONS AT £OUR USLT RECENP NOMA RESMOENCH IM THe U4. ne ana Nae |  PvVSiwkSs ADORESS | RENTEWTE aOOREIS (Laet-Preas-Uiddio) i {Ma Ssseat, City and Ttete} . } tMo., Steet, City and Stated [a e don Tooney Sir. Leland Far} urst. |
RHA MeN atthe os i em toe Fert ae be en octine ie o Ne cite oan eS teh yeti 9 Peete treme yy Ad SECTION xxi CLUBS soc Tres, AND OTME OSGANI oa Figag ® TT Tt nee ne manne ae nanan et is ieee ee ee - een ee ete , i NOTE: Liat nanes wd addresses uf al! clube, sociedies, br fe eeuinal qua tee, erulugee MPOUNS OF OF anerations of any band (das tute mengerecus in, og Support of, any vegerieation Aaving head guartery ve Spench ina fore cgn Sewmityy to ehich you ‘ belong of heve belonged np ae teers cae rece ° i agceass OAT ED OF Maung maare MAME AND CuaBren | SMeennee, Seemat Cite Sire, Seuunteg) pao [ne nn etn he 2 N.G.0, H “ft 4 . . : : i I f e SECTION XXII RESIGENCES FOR THE PasT 13 YEARS : @- a ”RREREGE Cast sesoence eae - Mouusiwe ares : reece, . AOCRESS - Las? Resinence fimgr . . te ene ern rare rang ‘ . {Numbee, Straes, City, Semee, Conan) ' Fmow ! te so . . rr, Fr Serevent rece mo alex. Ya, | 1958 United tates Aray __}-195 | i953 | : | | | | :
coeemnrnnemr = Be REROR DP se eee an at Fo mee. seo anmltat® ef Caoen of @ FSECTICN XXIV AOCITIONAL INFORMATION 1 oO rou @uvIcare Se wave WU ee Pate wee Ble lg VILE eS Peei@ mgt se ute C8 weer To ¢EE SO 4GCATOD, FO ARF 404 Ne CR wae FDU F, bed PE ALL OIAT ES Mite Awe ET 6 Pee Oy, LAL Dh See : VERT UR De OF Fee Cpe marae Qe tHe NITE ET ates ay to awa Mr am Ce Arce Se eek IM VIOLENCE TO CEM PEAGDNG ‘ Foe uMIPEO STATES ny ty 2.18 WAVE ANSWERED “VE$* Pd THE ABOVE QUESTION, FROLAIW Fane es & vege 38, . eae Fs een a uartar Sia T Ive Beak 34-3 9-7 eee j eee $3 17/99 TO au av gecrme 3. 69 VOU Usd OR Mave VOU pe Yoery. mogergie Le ENGR USEO HTOMCARTS! NG t 8 ORY NO4uD noly a ee oe . #8 OC vou ust O89 NaNe FOU i ives | 6. 17 30. TO wrar gatas i : EVER USE MABCOrS | aoe : Net PAVE VOU EVER BEEN AVENGER OF, OF FUPP TATED, OR HAD ANY COMMETTIOND BITM K FOREIGN INTELLIGENCE ODTAMT “UZ aTIOm OM EPE ac hiwi Ties? {cives Bno 1f ANGWEM 1B VES", Give COMPLETE DETAILS. . . a en ne 2 GIST GELO@ THE NAMES OF GOVERNMANT DEPARTMENTS, AGENCIES OM OFFICES TO WHICH (OU MAVE APPLIEQ 908 € nae PROVMENT SINCE 1949 asst. Cilef stati Intel. Fentugon wasn. 0.0. $.t8 TO ¥OUR RYOMLEOSE, ANY OF THE ASOVE MAYE CONGUCTED BM INVESTIGATION G® YOU, INDICATE THE “ame OF Tae AGENCY AND Te APPRQTIMATE CATE 28 THE INVESTIGATION. a “ [ asst. Chief of su.ff for Intell date of tnvestagaticn 1950 | NOTE $PE Cia) Uf your anawar is °YES® to tha following Questions 14, 11 of 12, pravide the Infarmation requested for each INSTRUCTIONS: question on a separste, signed sheet ond attach the sheat fo this farm ino sealed anvelapae. Sh. OAT AIMED, APRESTES. INDICTED 3R CON AAPHI FIGLATION IM THE UWUITEO STATES OF 18 MAVE VOU, OF TO YOUR KNOWL EOGE HAS YOUR SPOUSE. EvrD B VICTEDS FOR AMY VIOLATION OF THRE LAR OTHER TNA’ & MIGHT iF 30, STATE NAME OF COURP, CITY, STATE, COUNTRY, OA FE, MATURE OF OFFENSE AMD DISPOSITION OF CASE la ACQONQANSE it THE SPECIAL INSTRUCTION ADGVE. 13, MAvE VOU EVER GEE APAESTED COURT WAP TIAL ED OR OTHER BIE O14 F4EO UNOER MILITARY Law OP REG VEATIONE th FO, COFFE AUHE INCIOEN TIS 249 FOGVIDE JATEMS) OF SOCyMHENCE On SEPARATE SHEET I% AG? CORDAMCE WIT SPECIAL INSTRUCTIONS ABIDE. 4 oo . - : 1 AAGLE INCIDENTS 16 YOUR LIFE, MOP MEN TINE AQOVE, wei MAY GE OIMCOVER@ED : 18 AVION, WHE PRES VG) ERE AECTLY Is 7ED OA NOS, WHICH MIGHT BETCIME Ex: * #2, @@G THeee any UNF ays IN $UBS4 SUENP ievesT 1G . PL aeaticul 1F $0. CESS GAS INCIDEN TING AMD PROVIDE DAY E'T OF GOOURRENTE On SEPARATE SMEET In ate TO STAR CORSANCE witH SPECIAL INSTAUCTIONS ABGVE, Cd SECTION XX¥¥ 1, MAWE (Fitet-ilnddle-La st! PERSON TO BE NOTIFIED IN CASE OF EMERGENCY ; RELATIONSHIP io - ; ; | ive — : ee Se B NOME ADOYESS (Vo. Street. Cify, Zone, Stale, Coutey) | HOME PHONE HO. ane ra - OO SUTINESE ASD ALTE Tha. Sireee Clip, Lave, Sisie, Caamiry) - INDICATE MAME OF Fin OAIB. BUSINESS PRONE MOUS EAT, EuFLOvER, UF APPLICABLE Lo t . . a NA . ; HA VIN CASE OF EVENZENCY. JTRER CLOSE AELATIVES Snaude, Muinar, Paine) BAT ALSO DE MOTIFIEO IF SUZm NOTIFICR SIE IG NOT CESIMABLE. BET AUSE OF HEALTH OR OTRE® MEASONS, PLEASE $0 STATE. wnester NH. ee OT EE EBC ar TEI B on eR aed) b ie er cae
BA Sate imate ny ios ae - SN ee Nee emt v0 tame ate bee A ALS a © a times Bnd we De a ok marie, weouste SECTION Kivi CERTIFICATION YOu age INFORMED THAT THE CORRECTNESS OF Ay STATEMENT MAQE IN FHI APPLICATION ali ae ae INVESTIGATED, . . § awe read arnd wher stand the indtevetiann | Certsby phase the foregaing ungwert are fue ond Correct to the best of my Anowletye ong behet. 1 agree that any misstatement co Sere aren FE TO material fice will Conetute grounds for seme hate drenseal of resection of my application, fui £9 Under thong that uny taiee Utamgnt mace herein muy be pun shsole by bow, iv, 5. Core, Tette 18, Section 1601), . y P P Ghee ecee 7 '” AP cae a ame & BUM E eT Clete ang Bie NOTE: Use the fghow (Ag Space for ovirs detetis, Reterence ea: be ntitued ofem be section and item sens, Qiuh your name at the end of the added material, ff dats: 4 er ta whic’ it telates, Nel space +2 requited uve eaten Paces the sane sure aa this pegs and sina each such Poue. ece ALL 4. De Niemmane all her life. gece XE F590 Onslisn De a etea and a snort dane for _for avout 5u year éillian. Seema ane etatedtth Fane St on oN ag ante | Sec. XVII #5. variations of the mane Thomas. for aocut SO years, | tralia- elt | nequainted with the tovns aville. afeseyorrainvisa sized in this droa one t5-— work assigneat. Phillirings- ferrain 3 mens. dead * worl assimnont - “Japan - — . rene ~ tf . te . . vanuda _ " Scltisn Isles 1957-1958 visit . ? Lees 195053 work asohLomeas Tereain,haroors doland - WSys utilities, vailroad. Norway visits Tg50-51-82053 serrain Svedea a an oe .& hardors Venoary “49 ae ie Ay ae re France 8 oe ae fe se . at Gerdany ne an nen S Adtehel PR RR Ep ee en meee. and A Tee RE eB em cnet eT 8 ewe ate eee Rad, Ae, = Swi te erland ee e 8 st as 18 . Italy . rd ee a8 rt u re & harbors Spain rr Sn heat mn . ff GPS80gG. OF 98 oe ee a Lt : Lebenon a ee ee ow ‘ve Q Turkey . e Te te ee an t8 Ireland an " “How " - lek. wee. . Pansler & No. Joast of Africa Visits 1252 teroniht =sype visita. 1952-5 3-54-55 tervaia Sudan. cee 7 se » Te gs 9 a an) ~ woe . Agen - it] ee at 8 tt Ltd ~ - Peach Somliland te e . te ie a? ee senya, 1554 " ~ Italian Somlilcnd Wisits 1954 " arLtria " 155 5-54-55 " Sthiopia Yesijence 15 Y59-1955 Terrain haroors utilises, railroads, dadustries, solicis parcies WOLK assi-mente 4 fo. A . : A 3 Se ot wag
CONFIDENTIAL WHER FLED BM} SECURITY APPROVAL DATE 1 20 Hovember 1961 : YOUR REFERENCE: 01515 NPIC en CASENO. + 19h0G1 Oo «Director of Personnel FROM 3 Director of Yecurity SUBJECT | 1. Thio {9 to inform you of security approval of the vubject person as follows: 2 t rotsd for tha appointment epecified in your request under the provisions of Regulations 19-210 and 40-750 including eecesg to cluuulfled information through Top Secrol ag required in the performance of his duties. ‘foced Subject has been app Cl Subject hao been approved for appointment under the authority of Paragruph 4(d) of Esgaletion 10-219, and under Re-ulation 20.750 including secena to claasified Information through : Top Secret aa required in the performanue of hia dution. 2. Unlesu arranyements are made within 69 days for entrance on duty within 120 days, thia approval becomes invalid. 3. As part of tho entrance on duty procezaing: Security must bo arranged.-—————"——S~—S™ [_] A personal interview in the Office of ___ BEGI-A-poreonatinverview TB HOY necessary. CI FOR THE DIRECTOR OF SECURITY: fen pe 4 f , we ‘ey ” Chief. Péfsonnel Security Division «ab roauno 4473 wets Sus’ CONFIDENTIAL 4 MAR OT
CONFIDENTIAL UVUEN FILLED EN) NOTIFICATION OF SECURITY ACTIO’4 DATE : t 26 July & YOUR REFERENCE: 04S15- oo 7 , CASE NO. ¢ 194082 , TO t Director of Porsonnel . FROM § Dirsetor of Security SUBJECT This is te inform you that socurity approval is grantod for tho omploymont.’ of Subjoet us Tollowss ; . . Lee fee st cr Oo Provisional approval is granted upon the condition that Subjoot: ; te not have access to classified material or Luformation be not have agcess to Socuro nreas Co tot bo issued a building badge or Agoney croduntial ; de not bo abuignod to any unclassified dutios othor than contained in request Gs Security processing to effect security clearance for augeeus te clansified in- formation 15 continuing. Your office will be advised upon complotion of this Hotion. Approval for access to classified dnformation | ‘through SECRET. Badr ho-- “pro= Torre vis hons_ OF Reeulations 2 162236 and 20-7507" oe : Upon succossful complotion of a porsenal intorviow in tho Offiee of Seourlty. re aftor Subjoct reaches age 18, she may be approved for necess to classiftod information through TOP SECRET, Your office will be advinea upon complotion of this action, ; . Offietals of the- -employ ing orrice should be advised of this security limita- tion and* Should bo instructod to Supply Supervisors with advico as to the . limitation 590 as to insure continuod complianca. . ; [x] Subject may be invited to Washington for further processing but ia not to ; f receive classified material or information, a OR THE DIRECTOR OF SECURITY . | va Chief, Personnel Security: Division “tee 1337 nErLActs ronM 30-106 _ CONFIDENTIAL © 2 - | or.