FORM:PERSONAL RECORD QUESTIONNAIRE PART II/AMMUG/1
Agency: CIA
Originator: CIA
Document date: 01/01/0000
Document type: PAPER-TEXTUAL DOCUMENT

## Page 1

104-10225-10034

RETURN TO CIA

Backgrourd Use Only

Do Not Reproduce

SECRET

PERSONAL RECORD QUESTIONNAIRE

PART 11 - OPERATIONAL INFORMATION

SUSTRUCTIONS DU CASE OFFICEN

This lora muel no

fedded

1n By

:PH2.N0.

BISBAPCA NO.

Banda al the

pproval aay be obtained hi

Thepaafter

handoodlina. ll por

docenent

and. 8u0 1 88 criar.

•MA.

ll aldollinal apaco

CANO TONTM

SECTION

INUICATE NON, BACH. MNERE, MNO, ANO O MUOM

гLU8H

CONTACT AND GEVELOPMENT

itrari

inentent

Statos

torenter

Purpire

1151025

11.5

Poster teca

41:

702.94.2612:4

Prima cert.

residera.

INDICATE PILTHER SUBJECT COULO OS TURNIO OVER QUICHLY ARD' I4 A

MANOLING.

1N 80, INDICATE iN THOM.

to muy

t1m:

ver]

TO:ANY HISOUASIBLE CASE OFFICEN FOR

nocide

altoria

sieron de ney opero de Line sois

LIST. OTHER CASE DEFICEAS INO HAVE MANDLEO SUBJECI

BEEN ANONA.

OR MAS PUDON; GIVE MANES DY MICH THEY MAVE

3001601

moon thet taerticios?

WUN 819HrH6E

copor prtscherit) tayr

sint

1h16::24: 1. 61e29000e

1050a

SECRET

16 - 801

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## Page 2

SECTION

SECRET

IVATION AND

CONTROL

Ml0141

*412

Subduct

Culia.

ПІʼС

Subjocd'e landis

noronteel.or

1s e lorid of poet

control

-;:.

titten

..; :

tha:

"..::

SECTION

COVER

COVER USEO BY

SUBJECT AND CASE OFFICER IN THEIR MEETINGS.

Mooteres wit:

OT

Subject

greatlaty:

satchonge

up i adverte

COVER USEO: BY

SUBJECT IN OBTAINING MIS INTORMATION AND' IN CONTACING. MIS INFURNANTS,.

INDICATE SERVICE FOA SNICH SUBJECT THINKS HE (Will Work) (as workine).

Sanject is

aware. ta

SECTION. IM

ELLIGENCE CONNECTIONS AND TRAINING

ENTLAIN SUBJECTIS'ANO

•SUCH COPNECTIOM IS KNO

PRESENT CONNECTION WITH ANY OTHCH

OVERTLY.

INTELLIGEACE SERVICE, INDICATE TUE LATERS.

tell once servier

Prior to his deractten Kubtoch had tass sealer of tie Submitate

It the

16%

Scotine fry a porcos

At the time of tis defection Sundece ear anivacadad dart offic

torithe ict

LIST DIMLA: INDIVIDUALS (AgARES.

relativag.

Since 116 detectio:

fRieNdO) ANO RADe OF SUBJECT'S PRESCAR PAPELLIGINCE ACTIVERiES.

Subject la moon peod 1.

pitcles te several tarants of interest

Hestern Europe.

knowledre

neiro activities

that Smoject is cocoratin

 potos

Tite

tith the in dosertant it

Nots

CAPLAIN ANY TRAINING SUBJECT MAS MAD IN CLANDESTINE OPERATIONS.

SECTION M

COLLABORATION POTENTIAL

INDiCATE

OTHER FOREICA ROBER SUBJECT ODULO AL MUST CIRELY TO COLLABORATE BITH RECALSE DE SIS POLOLOGE UR PAST.

MMMONS.

EXPLAIN.

?? Morgect Pure To Charachcht 118111

11t: 11e

from tas

ritude confined pries

anill no inerted

Malibuter #to4

mid drinking do the catisit resid

i:

Hur0y110a

SECRET

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## Page 3

AATION

SECRET

OPERATI ONAL

USE

USIO DE CONTALIS BROORE.

TomEt A1

M9& &1M001 93488

L::

"civilin,

:::

P117;

fon la died idee

quint: .

Atentri

INDICARE NUA NOU INUM MON SUBSECI OBPAINS INFURMATION.

#HAT HAS

INDICALE 5N 29S OE1A

TOLO SUBISCE AS TO TRE DISPOSTIION DE IMORMATION ME LUANISNES.

chat. any

mistersund

10 100,0./6r9

rancide.

DEFAIL SUBJECT"S PAOPOSEO FI ONCI

TYPE USE OR DUTIES.

Subjoct mill conttrie

coricornire the Cis,

tie orpaniratino

tnc.acorialtio..of.infucmatiar

of

ine .C15.

tre Trentadicalcon on

CI

monbers, and wil!

conttuue to le used in attennteo recruitaectet

Cis agerts outside of cuSa.

DETAIL

MOGICITY4

NA

TYPE USE DA DUTIES.

24

SECTION

24 PROPOSED LIA: SON OR OPEHATIONAL ACTIVITY

PADROSCO LUNISON TUPE SCARACI OR OPLRATIONAL USSI

A. UNERE SUBJECT IS AN OFFICIAL

THERE SUBJECT 15

AN

OFFICIAL

ODYORE AGENCE:

SECTION VIGI

AGENCY RELATIONSHIP WITH SUBJECT:

AGENCY

PERSONAEL ANDRA TO SUBJECI.

RELATIONSMLA DIPA SUOJEÇTO ¡.E. TRAINLE: OPPOSITE NUMBLRI GENUNCRATION. !! ANT:

AGENCY

Arency cointionano fit: 50l000t 1211

alose

pannerapis.

Subuoet is raCrivIr!

cialy di esproxinatéi:

€00.

morti.

No ipercy perco:ael are treme to

SECRET

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## Page 4

SECTION.

# C88

SECRET

UALIFICATIONS FOR CHER OPERATIONS

¿CALIFICATIONS POODLISEO DO SERIES SNICA SOLE CONCERNABLY DE OF

case dares,

SECTICH A

SUOSIOY DA ORNER MESS, SRECIET

"UPHI THEATS

PADICATE PHE MREALE DUDUADA DE PAONIUP TO BE MADE PN EXCHANGE

DETAIL'S.

LAPLAID,

!! traits

dilate ti

proved bombaed un

110: 101

Shock

.2206

materactin

C:: 111

41: 9. 01 duty his 12354

188EX3869

die chort ni

is First!

Supert's

Menti

SECTION XI

accented dep dua Prest of 50.000.00

INDICATE: TAR FIELD AGENCIES AND

CE AND SECURITY:::

riel! ::::

FILES BITE

national

MICH SUBJECT: S MANI MAS ALIN CHECKLO 24D THE RESULTS.

INDICATE:

IOVESTIGAYIVE MEASLOIS PARES TO VERIFY BIOGRAPHICAL

189ORMAT00N FURRISED AT SUBJECT.

Subleet was giver an tart

furnishes, results

CATER SURE NOT PROS SON MINO SARCOAL OR ORCRATIONAL ARO

SUBJECT'S USE MAS BEEN PRIXIOUSLN

Pain Con

.. DATE APPROVAL OBTAINLO

EVALUATE-SUBJECI•S CHARACTER, AILIA8:E:5

AND SECURITY

PersonDit,

1191916 to

"HINE POSSIBLE.

41:6

has provon binsold do in anite sali contideri

recrultrent attendis

Torass excelionly icant costs

Mri.

6:6

7::

curiosis

11: 11a

fe quicirinking and tax pore

948161233

B-EXPLAIN

CE/OPERATIONAL

BAY SITUATION O# INDISCHEPIT IS MICH SUBIILI MAY MAVE BEEN INVOLGED AHICH MUST BE EVALUATED FROM A

SECURITY VIL#POINT.

surfaced

ti,r

indors

near litard carleet

suit inc

AMMAYE

providing dotese

:::020

this

coinected

6:1:2

wi?!:

or die sores panted, ir seei

SECTION XIL

SUBJECT'S PERSONAL MADITS

1. USE OF GIQUOR. DRUGS: GAMBLING, PARAMI eS.

wineer me

60015:0 .

He is

A.GMe5 C19915 1

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## Page 5

SECRET

SECTICN XI!

AVOCATIONAL.

INTERESTS

INDICATE SUBJECT'S HOUDIES OR INTEREST 14 SOGUES, MUSIC: ÈIE..

Wily

SECTION. XIV

CENERAL

COUNTRY ON

BEGION OTHER THAN HIS 094.

ABILITIES AND OTHER CHANACTERISTICS. ANI SUCA AS ME COULD..

ESPLAIN.

Sanjocils constele:

Phonis

1::

inition country providen

Mr not

• could pacently

tackins.

couptry but of

INDICATE WHEPMEN

•lA PRO PARTS I AND

CORRESPONDINCE ON

Inforcation contaired More: 59g

cortact

niet, subject.

CL.6958. $81998.

SWING, PILES

para. 83b,

THAN ROUTINE, ACTION IS MCQUIRED, 1O AND PHEN TERMINATION OF

se torminated.

PLEASE CAPLAIN. (AlI

SECTION XY

KIN?

EMERGENCY CONDITIONS RECONTACT ARRANCEMENTS

FULL

BARING CONTACT USÉY

DETAILS 1C, RECOGNITION SIGNALS, S/EL AMCRE COULO CONTACT BE MADES MAY: OGDA RIDLE COULO INDIVIDUAL

Subject could in corticted

reterent the nade of dormarco

111aT}

Sata Y0gsar

SECTION XVI

tore.

EGUS OFERATIONA: DATA AND REMARKS

DATE

SIGNATURE

Of

APPAUPHIATE SENIOR OFFICER

5

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## Page 6

Separato Cover Attachment to

UFGA- 19738

Bection I. *S

Iden A: Daniel Flores

Iden B: Joseph Vidal

Iden C: Joseph Placolo

Iden D: Balses Hidalgo.

Iden I: Karold Senson

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