Evening star., 1951-11-02

PoLice department tOtlO1US:
/. What is your full name?
! 2. Where do you live?
3. Have you, your wife. you
ch ldren. or any CT your depend
entS had any other residences
temporary OF permanent, from
, January l. l945, to date.
4. What is your date of birth?
5. What is the telephone mum
ber at your residence? In who's
name is the phone listed?
! 6. What were the telephon,
, numbers at your previous resi-
dences, temporary or permanent
for the period January l, 1945
to date?
: 7, When did you enter Distric
service?
), 8. Date of appointment tt
! present City Department O.
Agency?
9. Present official title. Or rank
10. State present salary.
! II. Shield or badge number
if any?
I IL. What briefly are you
present duties?
13. Who is your immediate
superior?
I IA. List dates of promotions
If any, since your appointment.
I Is. What has been your annua
salary as a police officer for tn,
following years: 0945 through
1950)?
ta) Do you now have. or fol
the period January l, 1945, to date
have you had any source of in.
come other than your salary as 6
police officer?
| (b) Do you. Or your wife, youl
Echlldren, or any dependent. now
have, or did you have. or they
have, during the period January
l, l945, to date, an interest in any
business as owner, partner. stock
holder, or director?
Queries on Marriage.
Is. Marital status9 Date OF
marriage? Name of wife. Is your
wife now employed. or engaged in
any business, or has she been en-
ployed or engaged in any business
during the period January /, 1945.
to date? Occupation, employer
social security number, total earn
ingS.
II. Children? Name. age, school
or college, educational costs, tut
ton. books and other expenses for
years through 1945 through 1850.
tbl If married. name of child,
name of wife or husband, address.
l8. Father. Ia If deceased
show date of decease. (bD Name.
'cD Last address. Cd Is your
father employed or otherwise en-
gagged in any business?
10. Mother. "a If deceased.
show date of decease. O Name.
(c) Last known address. tdD Is
your mother employed, or other
wise engaged in any business?
20. Brothers and sisters, names
and addresses.
q. Mother-in -in-law and father
in-law. (a) If deceased show
date, name and address.
% Brothers-in-laW and sisters
in-law. {a) If deceased show date
name and address.
%. Who are the individuals
who have resided with you, or
with whom you have resided fol
the period January /. l945. to
date?
"a. Who are the persons re-
siding with you who have been
totally OF partially dependent
upon you for support from jan
uary l. 1945, to date?
25. Who are the persons other
than those residing with you
who have been totally or par
TALLY dependent upon you fol
support from January /. 1945, tc
date?
Inquiry on Boarders.
26. What persons. if any. have
contributed to the support of your
household, from 1945 through
1850?
27. What persons. if any, paid
for room or board in your house
hold in the years from 1945 to
1850?
%. What life insurance policies
do you, your wife. your children
or any other dependents now own
or possess. or have you or they
owned or possessed from January
l, 1945, to date?
90 What are the amounts OF
premiums paid on the policies
listed in question % from Jan
uary l, l945. to date, and who
has paid the said premiums?
30. Did your wife, your chill
dren or dependents, within the
period January l. 1945, to date
borrow any money on any life
insurance policies?
81. Did you, your wife. your
children, or any dependent, re-
ceive within the period January
l, 1945, to date. the cash sur
render or maturity value of any
life insurance policies?
80. Were there any other types
OF insurance, such as automobile
accident. health. disqualification
fire, theft, fioater or liability, etc.
issued within the period January
l, 1945. to date. in the name OF
your wife, your children or in the
name of dependent of yours?
33. Have you. your wife, youl
children, or any of your depend
ents paid any premium on insur-
ance policies of any type from
January l, 1945 to present?
"a. Do you, your wife. your
children, or any dependent now
own, or did you, from January
/. 1945, to date, own an automo-
bile in your name, the name o1
your wife, your children or any
dependent, or in any other name
Do you, your wife, your children
or any dependent. pay garage
want ~ <l,,p;,,or ~. ,..,:,