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104-10250-10035

2025 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992

SECRET

"NETURN TO CIA

NAME- (Last, First, Middle)

2. DATE OF BIRTH.

Background Use. Onbe

•HICK'S, CALVIN W.

_Do No Reproduce

& NOV 1924

GS-13

A. OFFICE, DIVISION.

BRANCH for overseas station and

5. PRESENT POSITION

6. EMPLOYEE EXTENSION

existing cover if lateral assignment)

DDP/WH/CS/CS Dev Comp

7. PROPOSED STATION

OPS OFFICER

681.5

8. PROPOSED POSITION (title, number.

grade)

16-16

9.

P13, BOLIVIA)

TYPE OF COVER AT NEW STATION

STATE

32

12. NAME OF

DEPENDENT TO ACCOMPANY

OPS OFFICER -

10.

0977 - GS-13

ESTIMATED DATE OF

NO.

OF DEPENDENTS TO

DEPARTURE

ACCOMPANY

SEPT 66

13. RELATIONSHIP

14. DATE

MONTH

BIRTH

HiST.EPSRT 885 MFP:

CATHERINE L.

THERESA L.

MICHAFL C.

MARY C.

LISA ANNE

DANIEL C.

PATRICIA E.

16. COMMENTS

WIFE

MAY

1925

DAU

JAN

1953

SON

DAU

DAU

SON

DAU

JULY

1954

DEC

1955

OCT

1957

FEB

1959

MAR

1960

FORM 89 ATTACHED IN DUPLICATE. PLESE SCHEDULE MEDICAL AS SOON

AS POSSIBLE.

17. DATE OF REQUEST

18.

SIGNATURE

OF REQUESTING OFFICIAL

, 19. ROOM NUMBER AND

BUILDING

10 HAY 1966

Kenneth Le Wambold

EVALUATION AND SIGNATURE OF APPROVING OFFICIAL

CH 56 Eqs

Date:

2 JUN 1966

Security Approval has been granted for

the use contemplace by this request

Chief inner Bely Division

retin

20. EXTENSION

6815

3/18

FORM

6-65

259a

REQUEST FOR PCS OVERSEAS EVALUATION

SECRET

GROUP T

Eschuded from outomatic

ungrading and der bossificorice

(4)

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