DOCUMENT REQUEST FORM JOSEPH STEPHEN PICCOLO.
Originator: CIA
Document date: 01/01/0000
Document type: PAPER - TEXTUAL DOCUMENT

## Page 1

-Q000o

104-10161-10120

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

Cace Na:

- Roquestor.

Dato Dox:

True Macne: • Jopopà Stophen-P18991e

Extension:

Address to be unadi le Ge ATPS

Betrate

-91229

Wedght. 198

Hats-Boome

Maars planes?. He

- Marrieds lo

Occupation

Birth date 811309 bar 1935

_ Place Tontact, de Ja

Countrtos ubero documentation will be wood: Saint and Be tea Ile 8a

DATA FOR BIRTH CIRTIFICATI, AS OF TIME OF BIRTH

Father's sense 29995h

rOB:

Maples, Itely

Arro

a stre tenderdale, the

Number al ebildrea bors to parents prior to tata birts:

• Documentation regianiad: (Bootal Bacchty Geol) 31

Arts Ine Good

- Age 53

_ Occupation: lennesten

Doctor's some: tr, asshon

Home.

Imal paghat 21189r

sacartty elesterice

D-104

Te 3+05-9906

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## Page 2

IDEN!

IDENTITY SHEET

Joseph S. PICCOLO

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