## Page 1

Date

Page

: 01/13/98

:

1

JFK ASSASSINATION SYSTEM

IDENTIFICATION FORM

-..-

AGENCY INFORMATION

AGENCY : INSCOM/CSF

RECORD NUMBER: 194-10004-10135

RECORDS SERIES : DOD-AFFILIATED PERSONNEL INCIDENT INVESTIGATIONS

AGENCY FILE NUMBER

PAGES 14-14A

DOCUMENT INFORMATION

ORIGINATOR : USA

FROM : USAPSG

TO : DCS-OPS USAINTC

TITLE : I RESTRICTED]

DATE: 05/05/67

PAGES : 2

SUBJECTS : FROMER, DAVID REED

REQUEST FOR AND RESULTS OF PERSONNEL SECURITY ACTION

DOCUMENT TYPE : PAPER, TEXTUAL DOCUMENT

CLASSIFICATION : CONFIDENTIAL

RESTRICTIONS : 3

CURRENT STATUS : RELEASED WITH DELETIONS

DATE OF LAST REVIEW : 03/07/95

OPENING CRITERIA :

COMMENTS : RECORD REGRADED UNCLASSIFIED ON 2 SEP 94.

hai destat

NW 88613 Docld:34528544 Page 1

---

## Page 2

REQUEST FOR AND RESULTS OF PERSONNEL SECURITY ACTION

(AR 381-130)

THRU:

TO: (Control Office)

DCS-OPS

USAINTC

ATTN: OPS III (MI. Burwasser)

Fort Holabird,

Md.

(Enter name and address of the ACTION AGENCY to which results are to be sent, it known by

requester)

U.S, Army Farsonnel Security Group

Fort Mulabird, Masylanú 21219

ATIN: Adjudications Division

DATE

5 May 1967

FROM: (Requesting Agency)

USAPSG

CONTROL OFFICE USE ONLY

REQUIREMENT

REQUEST NO.

DOSSIER.NO.

OPENiNG DATE

REMARKS

L

1. SUBJECT (Last name in capitals, first and

middle names)

SECTION I - REQUESTER TO CONTROL OFFICE

2. ALIAS(ES), MAIDEN NAME

3. SERVICE/SOCIAL SECURITY NO.

PROMER,

David Rood

• DATE

OF BIRTH

Day,

Month, Year)

None

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

564-58-8137

6. GRADE AND POSITION

21 July 1942

7. REQUESTED ACTION

Chicago, Illinois

#INVESTIGATION

IVALIDATION

8. TYPE OF INVESTIGATION:

NAC INACI DEI I

XOTHER(Explain in Item 15)

10. TO DETERMINE SUITABILITY FOR:

Rogistrant

RECORDS CHECK

a. FOR CLEARANCE AND/OR ACCESS TO:

I TOP SECRET

• SECRET

O CONFIDENTIAL

b. I] FOR LIMITED ACCESS AUTHORIZATION

11. JUSTIFICATION

c.

INTERIM CLEARANCE DESIRED

d. XI OTHER (Explain in Item 15)

12. REVIEW OF FILES REQUIRED BY PARAGRAPH

! NO UNFAVORABLE INFORMATION

AR 604-5, COMPLETED ON

REVEALED:

CON EMER YE INFORMATION DETERMINED NOT TO BE A BAR TO ACTION

J TION SUMMARIZED IN ITEM 18

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

114. NO BREAK IN FEDERAL SERVICE

EXCEEDING SIX MONTHS SINCE

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

Request that Headquarters and Local FBI (S) file checks be conducted on SUBJECT's

parents.

"Request this investigation be expeditod as determination under AR 604-10 1s

boing delayed at Department of the Army pending results".

DiZsepay

CLIFIED

BY COPE

: ГО1/РО

AUTH Pala i-des BOD 5200.1R

INCLS

Dossior 564588137

re SUBJECT

TYPED NAME FERNECAN

COL

AIS

14

SIGNATURE

SECTION II - CONTROL OFFICE TO REQUESTER

DATE

is.

# NEW FINGERPRINT CARD REQUIRED

IRR COPY

ITEMS

ON SPH (PSQ) REQUIRE CORRECTION AND/OR COMPLETION.

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

INCLS

TYPED NAME AND TITLE

Regraded UNSiGNATURE

when separtied fromm

classified inflosures

FORM

DA, FORM. 2784

NW 88613 Docld:34528544 Page 2

---

## Page 3

SECTION III - REQUESTER TO CONTROL OFFICE

17. REPORT OF ACTION.

I INFORMATION NOTED

18.

SUBJECT WAS TRANSFERRED

TO

-2o0gt

Han.

| SUBJECT REASSIGNED TO NON-.

INFORMATION CONSIDERED NO BAR TO

SENSITIVE DUTIES, INVESTIGATION

CLEARANCE, REQUEST COMPLETION

MAY BE CANCELED.

OF INVESTIGATION.

HEADQUARTERS

PER

DATED

785 30x

19. REMARKS (If retuming corrected forms, state here)

INCLS

TYPED NAME AND TITLE

SIGNATURE

SECTION IV - CONTROL OFFICE TO ACTION AGENCY

DATE

20. RESULTS OF PERSONNEL SECURITY ACTION

_ NO RECORD

_FAVORABLE

] MINOR' UNFAVORABLE INFORMATION RECORDED IN ITEM 21

# PRIOR INVESTIGATION INSUFFICIENT FOR ACTION CONTEMPLATED

I FORWARDED FOR SECURITY DETER-

IF NEEDED, INITIATE REQUEST FOR INVESTIGATION.

MINATION BY CLEARING AUTHORITY

TYPE OF INVESTIGATION

-COMPLETED BY.

DATE

DOSSIER NUMBER

DINAC

ENACI

OTHER

21. REMARKS

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

(if 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 610-98; AND PARAGRAPH_ AR 381-130, AS APPLICABLE.

INCLS

TYPED NAME AND TITLE

SIGNATURE

SECTION V - ACTION AGENCY TO CONTROL OFFICE

22. REPORT OF ACTION

I FAVORABLE DETERMINATION, USACRE

COPY DA FORM 873 ATTACHED

23. SUBJECT WAS TRANSFERRED

DATE

UNFAVORABLE DETERMINATION.

RECOMMENDED ACTION IN ITEM 24

_ REQUEST ADDITIONAL INVESTI-

= GATION AS INDICATED IN ITEM 24

TO

HEADQUARTERS

PER

DATED

24. REMARKS

TEERAL.

n2 sepqy

SIFIED

BY CUR

: ГО1/РО

AUTH Pala 1-6t3 BOD 5200.1R

INCLS

TYBED NAME AND TITLE.

SIGNATURE

14

NW 88613 Docld:34528544 Page 3

---