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Heleased under the John F. Kennedy

Accassination Records Collection Act of

1992 (44 USC 2107 Note). Case#:NW

38613 Date: 03-18-2025

Date

Page

: 01/20/98

JFK ASSASSINATION SYSTEM

IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : INSCOM/CSF

RECORD NUMBER

: 194-10004-10139

RECORDS SERIES : DOD-AFFILIATED PERSONNEL INCIDENT INVESTIGATIONS

AGENCY FILE NUMBER : PAGE 372-373

DOCUMENT

INFORMATION

ORIGINATOR : USA

FROM : HAYASHIDA, MYRON K.

TO : USA INTELLIGENCE CMD

TITLE

: ( RESTRICTED ]

DATE : 11/25/66

PAGES

: 2

SUBJECTS : FROMER, DAVID R.

INDUCTION

DOCUMENT TYPE : PAPER, TEXTUAL DOCUMENT

CLASSIFICATION

: UNCLASSIFIED

RESTRICTIONS

: 3

CURRENT STATUS

: RELEASED WITH DELETIONS

DATE OF LAST REVIEW : 03/07/95

OPENING CRITERIA :

COMMENTS : RECORD REGRADED UNCLASSIFIED ON 2 SEP

94. INCLOSURES

NOT INCLUDED.

NW 88613_Docld:34528580 .Page 1- - - -

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REQUEST FOR AND RESUL IS OF PERS

(AR 381-130)

A ACTION

TE

25 November 1966

THRU:

FROM: (Requesting Agency)

USA Intelligence Cmc

CG, USAREC

CO, AFEES

ATTN: ACOFS, CONOPS

ATTN: Security

Offacer

1515 Clay Street

PO Box 398

Hampton, Va

23369

Fort Holabird, Md 21219

7 DEC 1976k1and, California

faqueatene and addross of tha ACTION AGENCY lo which resules are co de sone, il knoun by

CONTROL OFFICE USE ONLY

REQUIREMENT

TREQUEST NO.

CHIEF, USAPSG

ATTN:

Adjudication Branch

Fort Holabird, Md 21219

DOSSIER NO.

OPENING DATE

REMARKS

L

1. SUBJECT (Last name in

capitals, first and

middle names)

FROMER, Dawid Reed

a Day, 1

OF

Mona, Fear

21 July 1942

7. REQUESTED ACTION

8. TYPE OF INVESTIGATION:

_ NAC

L NACI

O BI

10. TO DETERMINE SUITABILITY FOR:

INDUCTION

SECTION I - REQUESTER TO CONTROL OFFICE

2. ALIASIES, YH4Y44EY

None

5. PLACE OF BIRTH (City, State and country)

3. SEYYYE/SOCIAL SECURITY NO.

564-58-8137

6. GRADE AND POSITION

N/A

Chicago, Illinois

XJ INVESTIGATION

]VALIDATION

JOTHER (Explain in Item 15)

RECORDS CHECK

9.

a. FOR CLEARANCE AND/OR ACCESS TO:

I TOp sECRET

• SECRET

I CONFIDENTIAL

в.. |

FOR LIMITED ACCESS AUTHORIZATION

11. JUSTIFICATION

C.

_ INTERIM CLEARANCE DESIRED

PAR 18, AR- 604-10

d. [XXOTHER (Explain in Item 15)

12. REVIEW OF FILES REQUIRED BY PARAGRAPH

AR 604-5, COMPLETED ON

REVEALED:

NO UNFAVORABLE INFORMATION

UNFAVORABLE INFORMATION DE TERMINED NOT TO BE A BAR TO ACTIUN

CONTEMPLATED

[J INFORMATION SUMMARIZED IN ITEM 15

13. LATEST INVESTIGATION/ CLEARANCE (Type, when, by whom)

14. NO BREAK IN FEDERAL SERVICE

N/A

EXCEEDING SIX MONTHS SINCE

15. REMARKS (If unfavorable information entered, transmit in sealed envelope thru intelligence channels,).

Request investigation of regiatrant it view of remarks made by registrant in remarks

8a 618: 26DP-Form 99i and Doterm 399. SS N: 4-42-x2-204

=CUiTO

annulatio

Headquartond

US Army Recruiting Communil

Hampton, Virginia 23369

INCLS

16.

INCLS

TYPED NAME AND TITLE

SIGNAT

MYRON KO HAYASHIDA

1/LT, AGC

372

SECTION II - CONTROL OFFICE TO REQUESTER

DATE

_ NEW FINGERPRINT CARD REQUIRED

DITEMS

ON SPH (PSOI REQUIRE CORRECTION AND/OR COMPLETION.

_J INTERIM REPORT FORWARDED, REQUEST REPORT OF ACTION TAKEN AND RETURN OF INCLOSURES UPON COMPLETION.

TYPED NAME AND TITLE

SIGNATURE

FORM

DA, APR 2784

NW 88613 Docld:34528580 Page 2

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SECTION III - REQUE-

17. REPORT OF ACTION

DJINFORMATION NOTED

SUBJECT REMARTE TAMONA

ENSITIVE QUIES INVESTIGÁTIO

MAY BE CANCELED. "

18. SUBJECT WAS TRANSFERRED

TO

HEADQUARTERS

19. REMARKS (Il retuming corrected forms, stâte here)

PER

J INFORMATION CONSIDERED NO BAR TO

CLEARANCE. REQUEST COMPLETION

OF INVESTIGATION.

DATED

INCLS

TYPED NAME AND TITLE.

SIGNATURE

SECTION IV - CONTROL OFFICE TO ACTION AGENCY

DATE

80 MAR 1967

20. RESULTS OF PERSONNEL SECURITY ACTION

_ NO RECORD

_ FAVORABLE

→ MINOR UNFAVORABLE INFORMATION RECORDED IN ITEM 21

• PRIOR INVESTIGATION INSUFFICIENT FOR ACTION CONTEMPLATED

X FORWARDED FOR SECURITY DETER-

IF NEEDED, INITIATE REQUEST FOR INVESTIGATION.

MINATION BY CLEARING AUTHORITY

TYPE OF INVESTIGATION

COMPLETED BY

UNAC

XI OTHER

USAINTC

DATE

29 Mar 1967

DOSSIER NUMBER

AA 81 40 20

21. REMARKS

a.. THIS FORM, TOGETHER WITH ANY INCLOSURES, REPORT OF ACTION TAKEN AND USACRE COPY OF DA FORM 873

(il appropriate) WILL BE RETURNED TO THE CONTROL OFFICE WITHIN_

→ DAYS AFTER RECEIPT.

B.. IN THE EVENT SUBJECT HAS BEEN TRANSFERRED FROM YOUR COMMAND, THIS FORM AND INCLOSURES WILL BE

RETURNED IMMEDIATELY WITH ITEM 23 COMPLETED.

C.. ATTENTION IS INVITED TO: PARAGRAPHS_

AR 604-5; PARAGRAPH_-AR 604-11; PARAGRAPH-

AR 640-98; AND PARAGRAPH _ AR 381-130, AS APPLICABLE.

INCLS SUBJECT'S DOS-

TYPED NAME AND TITLE DAN H. DIETRICH

sier and that of HIs

father - D8 03 23 86

707

Lt Col

AIS

Chief of Operations IlI

SECTION V - ACTION AGENCYTO CONTROL OFFICE

22. REPORT OF ACTION

FAVORABLE DETERMINATION, USACRE

COPY DA FORM 873 ATTACHED

UNFAVORABLE DETERMINATION.

RECOMMENDED ACTION IN ITEM 24

23.

SUBJECT WAS TRANSFERRED

TO

HEADQUARTERS

SIGNATURE

S.3. Butte

DATE

RESCINDED PER DA MESSAGE

DA 16ST75, DATED TO MAY 56

GATION AS INDICATED IN ITEM 24

Regraded tardar: car than Sparated

di,:

24. REMARKS

37"BOR DA

P. 6. 0.11

-

this eer.sctive

Termination"

INCLS

TYRED NAME AND TITLE

SIGNATURE

NW 88613 Docld:34528580 Page 3

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