LICOOKY-1 PRQ PART II (ILLEGIBLE)
Originator: CIA
Document date: 01/01/0000
Document type: PAPER - TEXTUAL DOCUMENT

## Page 1

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104-10218-10106

2022 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992

SECRET

PRE NO.

PERSONAL RECORD

QUESTIONNAIRE

PART 11 - OPERATIONAL INFORMATION

DISPATCH NO.

TNSTRUCTIONS TO CASE OFFICER

Thes

officer or approprinto authorily on the bares al she

boss araslablo in.

pari

en all questions

document 0r

Three

fill

for item, use

roc or osse eyes 1o.

appropriate

1. CRYPTONTH

aubes ra handeritine, de pardibles and too 828 coma

possible.

eva 12) copies

"NA." Il additional space required

number.

PSEUDONYM

SECTION

COMTACT AND DEVELOPMENT

INDICATE MOM, WHEA, WHERE, MMY, AND BY ONCH SUBJECT MAS FIRSI CONTACTED OR DEVELOPES.

'"::

'

1c11:00.

1!.": 11

ir?,

!.!.t!.

INDICATE METER SUBJECT COVIO DE TUPNIO OVER QUICKLN AND IN A SECURE MANMEO TO ANY RESPDASIBLE CASE DEFICER ROP

MANDLIPiG.

IF so.

INDICATE

1O wHOw.

....

1:1101.8

-.:i:.1-1

..c:

':..

1111:9

LIST OTHER CASE OFSICERS

BEEN KNOWN.

irrita

;

FORM 1050a

3-38

.!?..

•"!.

WHO MAVE MANOLED SUBJECT OR ANON ME KNONS OR MAS I VOWN, GIVE NAMES BY ANICH THEY MAVE

1:11.;

•12731::1

•171? 611

ised

!!! Mut: 14

.. God! 2001d 1031

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16c: CEd 62El007, Cord 1720 1207111. O°

11D.

18.208 =

SECRET

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SECTION D

ESTIMATE SUBJECT'S MOTIVATION, (Do desolled.

coaounass.")

SECRET

AOTIVATION AND CONTPOL

repo exidenco, Do Rol uno

slock coreans such as

THAT CONTROL. YE

ANT.

EXISTS OVER THE

SUBJECT.(88 no

control

SECTION 11t

1. COVER USED BY SUBJECT

COVER

CASE OFFICER IN THEIR MEETINGS.

2. COVER USED BY SUDJECT IN OBTAINING HIS INFORMATION AND IN CONTACTING HIS INFORMANTS.

INDICATE SERVICE FOR ANICH SUBJECT THINKS HE (Hill MOSKY (1S DUSKERA).

SECTION IV

INTELLIGENCE CONNECTIONS AND TRAINING

EXPLAIN SUBJECT'S ANDAN PAST OR PRESENT CONNECTION MITY

ANY OTHEA INTELLIGENCE SERVICE, INDICATE THE EXTENT

SUCH CONNECTION IS KNOWN OVEATLY.

EXPLAIN ANY TRAINING SUBJECT HAS HAD IN CLANDESTINE OPERATIONS.

i!'"

"i."

thing

SECTION Y

COLLABORATION POTENTIAL

INDICATE OTHER

FOREIGI POVER SUBJECT ADULO BE MOST LIKELY TO COLLADORATE WITH BECAUSE OF HIS IDEOLOGY OR PAST

ASSOCIATIONS.

&ArLAIN.

" 206120.-90410.

it?=

at tilert.

202.00

-timelin

SECRET

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## Page 3

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- .

4

Continued

Section II, 1.

dieldo timedia se

She undoubtadly 18 patriotic but disaprees stronaly with certain FBFRIE policies.

She is, at the tire being it least, alnost completely dependent on the KUEARs

salary paid her.

dust a it aid to athloris"

riled a titani in asiatistatase

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## Page 4

SECRET

SECTION

OPERATIONAL USE - CONTACT

IF SUBJECI MAS BEN USEO DR COMTACILD BEFURE, INDICATE ACTIVITO IN MIICH HE MAS ENGAGEO AND THE IYPE DE

MATION

"!.:

INDICATE HON

FROU MHOU

INFORMATION.

3. INDICATE AHAT MAS BEEN TOLD SUBJECT AS TO THE DISPOSITION OF INFORMATION ME FURNISHES.

DETAIL SUBJECTOS PROPOSED FI OR CI TYPE USE OR DUTIES.

DETAIL SUBJECT•S PASPOSES PP.

MPLUSE OR DUTTES

SECTION VII

PROPOSED LIAISON OR OPERATIONAL ACTIVITY

DETAIL SUBJECT'S PROPOSED LLAISOR TYPE CONTAGI OR PREDATIONAL USE:

.. OMERE SUBJECT IS AN OFFICIAL MEMBER OF A FOREICA GOVERYMENT:

• 7.1903.34

> AN

OFFICIAL MEMBER OF AN

ODYOKE AGENCY:

relitive

i.i'

iting in:

SECTION

AGENCY RELATIONSHIP WITH SUBJECT

LAPLAIN

NATURE DE

PERSONNEL

AGENCY

RELATIONSHIP MITH SUBJECTI I.E, TRAINEE, OPPOSITE NUMBER: REVUGERATION, IF ANT: AGENCY

KNOON TO SUBJECT.

1123

•ili,

sailind

For den

services,

sro

's male sta 250.00 rentain; this salary mis ditcerive i

ice. 19r2.

-9÷2152993?

setter.

For

3

SECRET

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SECRET

SECTION TX

QUALIFICATICHS FOR OTHER SEPATIONS

INDICATE SPECIAL ARISITIES, -TALENIS, OR QUALIFICATIONS POSSESSES DO SUBJECE ANICH COULO CONCELUAORI BE OF VALÉI

OTHER OPERATISAS.

!:i

11!1

mador,

-.?"

teen wili

SECTION X

COKMITHEATS

1$ PROPOSED

PAr

CONMODITIES.

SUAJECT A REGULAR SALIEr.

INDICATE THI DEERLY AMOUNT. IF PAYMENT IO BE MADE IN ENEM

SUASIDY OR OTHER METHOD, SPECIFY AND GIVE DETAILS.

Carlect

15 paid 608 250.2% monthly,

020.1.19

"ot?

it trid

icte

ADMISES

OTHERMISE NOT COVERED MEREIO, MADE TO SUBJECT. (EXARDIE. COMMITTenSI

fanaly.)

1, 02?

1113;

rite

i thou

21..

test rati

::

1..0h

i:::

SECTION XI

CE AND SECURITY

LODICATE THE FUELO AGENCIES ANO FIELD FILES MITH ONICA SUBJECI-S MAME HAS BEEN CHECKED

AND IME RES

1X0

LICENTO-

FADTEATE OTHER TERESTISATIVE MEASURES TAREY TO VEBIFY BIOGRAPHICA:

IUHORHATION FURLISHED BY

•:iles

"itt

"a", strag

INDICATE

MHETHER TO NIT PROVISIONAL

APPROVAL OR OFEHGTIODAL AP.

PROVAL FOR SUBJECT'S USE HAS BEEN PREDIOUSLY OBTAISED.

A- DATE APPADIAL IDIAISED

EVALUATE SUBJECTIS CORDACTER, RELIABILITY AND SECURITY, CITING EVIDENCE MERE POSSIBLE.

?.

:.10121:

-na or chition/ineolo deal point or vies,

maily mortar due to a den infriorite color,

1..

t: aocuri

wooed not

2.

'23"

220723

malari-s:

she sciation:

taro

EXPLAIN

ANY SITUATION OR

INDISCRETION IN ANICH SUBJICT MAY HAVE BEES INVOLVED AMICH MUST

BE EVALUATES FAJM A

CE/OPERATIONAL

SECURITY VErONT.

instrate with in dict while the latter ce in lodeo,

= Intirate wor ring adrone toe

to nct foccordt: to hard

SECTION XII

SUBJECT'S PERSONAL HABITS

1. USE OF LIQUOR. DRUGS:

GAMBLING, PARAMOURS.

ece crinko oeially, bid is not telloved to sant excesaivelto Meat, ge la

nor loliered to coe prure of dog dina, exceet for reitcinel suresos and retria.

incited anitations.

orally, she

Juld not te aralast tri siing bur saus are joes

SECRET

"740

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Section XI, 5.

security: "he has proven to be reasonably security consclous, however, her

Intirate relationship with LIllick, tith Jor Rettle, nod cossible kith others

constitute potential security intaris.

The 13 descrest in her shone conversations

with the case officer, mù in

the rechanies of miinr reetinme

she sonetimes tures

don recting places surcasted by the case officer, savinr that some of her

Bequaintances visit the place or the area surested, or that coviet and/or satellite

personnel ana believed to visit the place or area.

The freatest potential security

hazard, the writer bellaves, is the type oi situation, rexual and/or erotiona)

Involverent, which she wirht allow herself to vecore involved in.

Section XI, 6.

2. In an effort to nave the say for Litin's retum to lexico, are lia

Intercaded : 1th various f'exies Coverarent of 1cials, md causai certain

presa articles in his defenge to be published. This activity, horever, 123

carried on with the nomledie and approval of KUBAR personnel. She prided

copies of letters written, and received fien uttock, clipiania from the press,

and stares oil her conversations kith excan covement persornel.

- waist inte

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## Page 7

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SECRET

SECTION XIlI

AVOCATIONAL INTERESTS

INDICATE SUBJECT'S HORDIES OR INTEREST IN SPORTS, MUSIC. ETC.

ooh cleared and ma-fletion, seene alto, the does

ot "to ti"

SECTION XIV

GENERAL

Or A COUNTRY On

ON A COUNTRE OR SCROSO MEANGARE SORRY ESPER OTHER CHANACTERISTICS, ARE SUCH AS ME COULO PASS AS A NATIVE

se crime. to crusaded taurence, do could phant not par details?

INDICATE WHETHER INFCRUATION

IN PRO

PARTS I AND

CORDESPONDENCE OR OTMER MEANS.

it taint'!

Informanton

on train for colon cotta.an %:

wrest tin"

44202409

OBTAINED BY RESEARCH, CLANDESTINE

ASSESSMENT.

FILES.

11, 1. 011

2aoad that

113:

GIMER

THAN ROUTINE AC-ION IS PEQUIRED. IF AND ANEM TERRINATIDN OF SUBJEÇT IS EFFECTEO, DLÇASE EXPLAIR: (AIRO

SECTIOR XY

EMERGENCY COMDITIONS

RECCA TACT

ARRANGEMENTS

GIVE FULL DETAILS I.E, RECOGIITION SIGNALS. S'MI

AHERE COIND CONTACT BE MADE:

KANISE CONTACT USEY

-.tt.da.

NUAY DON TIDES COULD

?156.71

casablan 1521230

calicor could te beer.

customs trows, lore tore estabitched, tit

Da tirine.

SECTIDN XYI

MISCELLAMEOUS OPERATIONAL

DATA AND

REMARKS

1100 100::

t:1t

20e to 2531:7

cásinos met be cociate and civon tich

shodd eccinitary not be cien mr more information en

do cassaureli

Pon tor to sucronlia: dun testo emitani tor.

stimo alooner:, tse poticers salectid to randie sould de ratue, to aracience

in 900318 107

he scher than site

It is icizored that

nexerienced forale crue

visor ne tor sporarinate are could es do vell, te net lotter, than a rio cose

DATE

10 Outta 116%

SECRET

juRE or

ATE SEMIOR OFFICE

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