Agency: FBI
Originator: FBI
From: SAC, CG
To: BLOOM, EDWARD F.
Document date: 11/27/1963
Document type: PAPER, TEXTUAL DOCUMENT

## Page 1

JFK ASSASSINATION SYSTEM

IDENTIFICATION FORM

AGENCY INFORMATION

Released under the

John F.

Kennedy

Assassination Records

Collection Act of

1992 144

USC

2107 Notel.

Case# :NU 53130

ate: 06-01-2017

AGENCY: FBI

RECORD NUMBER: 124-10239-10343

RECORD SERIES: CG

AGENCY FILE NUMBER: 62-6115-D-21

DOCUMENT INFORMATION

ORIGINATOR: FBI

FROM: BLOOM. EDWARD F.

TO: SAC. CG

TITLE:

DATE: 11/27/1963

PAGES: 2

SUBJECT: JR, INFORMANT, CONTACT, ASSOC, NEG

DOCUMENT TYPE:

PAPER. TEXTUAL DOCUMENT

ORIGINAL

Unclassified

CLASSIFICATION:

REVIEW DATE:

STATUS

09/24/1996

Redact

NEW

CLASSIFICATION:

UPDATE DATE:

02/14/2001

RESTRICTIONS:

JFK Act 6 (4)

COMMENTS:

NW 53130 DocId:32184133 Page 1

---

## Page 2

FD-209 (Rev. 3-9-62)

OPTIONAL FORM NO. 10

UNITED STATES GOVERNMENT

Memorandum

TO

: SAC CHICAGO (137-4446)

DATE: 11/27/63

FROM : SA EDWARD F. BLOOM

CJ PSI

SUBJECT: CG 6642-C

Dates of Contact

11/27/63

Titles and File #s on which contacted

Assassination of President

JOHN F. KENNEDY

JACK RUBY, Aka., ET AL

CIVIL RIGHTS

62-6115

44-645

Purpose and results of contact

NEGATIVE

POSITIVE

Informant will not testify to

the

attached.

ALI INFORMATION CONTAINED

HEREIN IS UNCLASSIFIED

DATE

12-8•93 Bx 9803-Rad/ nde

X Informant certified that he has

furnished all information obtained

by him since last contact.

Personal Data

Rating

Excellent

- 137-4446

(D

62-6115

1 - 44-645

EFB: bjz

(3)

H# 53130 DooId:32184133 Page 2

Redral

thy

Coverage

Same

1162-6115-21

SEARCHED _

SERIALIZED.

_FILED

NOV 2/7 1963

---