PERSONAL HISTORY STATEMENT.
Agency: CIA
Originator: CIA
Document date: 10/22/1953
Document type: PAPER - TEXTUAL DOCUMENT

## Page 1

JEK ASSASSINATION SYSTEM

IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : CIA

RECORD NUMBER

RECORD

SERIES

104-10121-10159

: JEK

AGENCY FILE

NUMBER

80T01357A

DOCUMENT INFORMATION

AGENCY ORIGINATOR

PERSONAL HISTORY STATEMENT.

10/22/1953

SUBJECTS

JEK ASSASSINATION

MORALES D

DOCUMENT TYPE

CLASSIFICATION : UNCLASSIFTET

RESTRICTIONS .

DATE OF LAST REVIEW

: RELEASED IN PART PUBLIC - RELEASED WITH DELETIONS

: 05/26/04

JEK44: E23: 20040225-1048985

IRI - ITEM IS

RESTRICTED

104-10121-10159

174 53294

DocId: 32362504

Page 1

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PERSONAL HISTORY STATEMENT

Instructions: 1. Answer all questions completely. If question is not applicable write "NA." Write

"unknown" only if you do not know the answer and cannot obtain the answer from

personal records. Use the blank pages at the end of this form for extra details on

any question or questions for which you do not have sufficient room.

2. Type, print, or write carefully; illegible or incomplete forms will not receive consid-

eration.

HAVE YOU READ AND DO YOU UNDERSTAND THE INSTRUCTIONS?

(Yes or No)

SEC. 1. PERSONAL BACKGROUND

Telephone:

Miss-

A. FULL NAME Mr.

(Use No

Initials)

Mrs.

David

* (First)

Office -

Sanchez

(Middle)

Morales l

biotica

1 Newtone ster.)

PRESENT ADDRESS

32 vanet Road

(St. and Number)

Ehoenize

Nass

(City)

(State)

PERMANENI ADDRESS 2021 Fun defferson Sta: Phoenix, Arizona U,s,A.

B. NICKNAME

"Didi"

- WHAT OTHER NAMES HAVE YOU USED?. None

- UNDER WHAT CIRCUMSTANCES HAVE YOU EVER USED THESE

NAMES? Famili and friends

HOW LONG?

_ IF A LEGAL CHANGE, GIVE PARTICULARS ..

None

(Where?)

(By what authority)

C. DATE OF BIRTH 2É AUG 125 PLACE OF BIRTH Phoenix

Arizona

(State)

D. PRESENT CITIZENSHIP ESA

- BY BIRTH?

Yes

(Country)

BY MARRIAGE?

BY NATURALIZATION CERTIFICATE NO.

N/A

_ ISSUED ...

N/L

(Date)

USA

(Country

N/A

- BY WA

(Court)

AT

(State)

(Country)

HAVE YOU HAD A PREVIOUS NATIONALITY?

-No.

(Yes or No)

(Country)

HELD BETWEEN WHAT DATES? NA TO

ANY OTHER NATIONALITY? (Country)

GIVE PARTICULARS

SOP™ NS: 38-1

HAVE YOU TAKEN STEPS TO CHANGE PRESENT CITIZENSHIP? _

No

. GIVE PARTICULARS:

M/A

(1)

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(2)

E. IF BORN OUTSIDE U. S. WHEN DID YOU FIRST ARRIVE IN THIS COUNTRY? /A

PORT OF ENTRY? /A

_ ON PASSPORT OF WHAT COUNTRY?.

N/A

LAST U.S. VISA..

Numbers

(Type)

(Place of Issue)

(Date of Issue)

SEC. 2. PHYSICAL DESCRIPTION

AGE

30

SEX

Hale

HEIGHT - E' 19"

WEIGHT

200

EYES

HAIR - BLaCK

COMPLEXION- Dari:

SCARS. Agne

BUILD... lieavy

OTHER DISTINGUISHING FEATURES irtu park oo left side

of waist

SEC. 3. MARITAL STATUS

A. SINGLE

MARRIED

27 DIVORCED

STATE DATE, PLACE, AND REASON FOR ALL SEPARATIONS, DIVORCES OR ANNULMENTS

WIDOWED

N/A

B. WIFE OR HUSBAND (IF YOU HAVE BEEN MARRIED MORE THAN ONCE-INCLUDING ANNUL-

MENTS-USE A SEPARATE SHEET FOR FORMER WIFE OR HUSBAND GIVING DATA REQUIRED

BELOW FOR ALL PREVIOUS MARRIAGES.)

3:1

10875

NAME OF SPOUSE

Joan

(First)

PLACE AND DATE OF MARRIAGE

None

(Middle)

Munich,

Germans

_ errizan

Forales

(Maiden)

(Last)

31

- herch 1253

HIS (OR HER) ADDRESS BEFORE MARRIAGE

Janet Ra,

fiSt. and Number)

Newton Center, Lass US:

(City)

LIVING OR DECEASED LiVing. DATE OF DECEASE

CAUSE __

PRESENT, OR LAST, ADDRESS -

33 Janet Rd, liewton

Center

Mass

(St. and Number)

DATE OF BIRTH30/3/26

PLACE OF BIRTH

Brookline,

Mass

(City)

(State)

USA

(Country)

USA

(Country)

IF BORN OUTSIDE U. S. INDICATE DATE AND PLACE OF ENTRY

N/A

CITIZENSHIP. USA

WHEN ACQUIRED? Birth

- WHERE? Cy)

(State)

(Country)

OCCUPATION Houserife

LAST EMPLOYER U. S. Government (CIA)

EMPLOYER'S OR BUSINESS ADDRESS

None

(Date)

2130 Ee Stre Mei, Washington, DeC

(Country)

MILITARY SERVICE FROM

TO

BRANCH OF SERVICE

COUNTRY

(Date)

DETAILS OF OTHER GOVT. SERVICE, U. S. OR FOREIGN

18-62855-1

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SEC. 4. CHILDREN OR DEPENDENTS (Include partial dependents) :

1. NAME Juanite Kerie Lor les

CITIZENSHIP USA

2. NAME

Martha Janet Horales

CITIZENSHIP

3. NAME

It's vuenita 5. Morales

CITIZENSHIP

-_ RELATIONSHIP laughter

- AGE _2 JES

ADDRESS 32 Genet Re, Keron Center,

(St. and Number)

- RELATIONSHIP daughter

(Country)

AGE _2 T0S

ADDRESS _33

Janet Rd, Merton Center,

(St. and Number)

Hass USA

(Country)

- RELATIONSHIP. Lotzer

- AGE - 20

ADDRESS 2021 I defierson St. Phoenix, uriz is:

(St. and Number)

SEC.

5. FATHER (Give the same information for stepfather and/or guardian on a separate sheet)

FULL NAME... Eedro

(First)

None

(Middle)

norales

Intensi

(Last)

LIVING OR DECEASED Living : DATE OF DECEASE . - - =

CAUSE

PRESENT, OR LAST, ADDRESS

1009 Missouri St.,

(St. and Number)

E1 Faso, Texas

DATE OF BIRTH

_ PLACE OF BIRTH

Sinoloya,

Sonora, bexico

IF BORN OUTSIDE U. S. INDICATE DATE AND PLACE OF ENTRY -

Unknown

CITIZENSHIP

USA

- WHEN ACQUIRED? Unimoin

OCCUPATION ...

Selesman

EMPLOYER'S OR OWN BUSINESS ADDRESS

- WHERE? ...

Unionown

(City)

(State)

(Country)

LAST EMPLOYER -

Fargs Bottling Company

Missouri St., El Fase,

Texas

(St. and Number)

(State)

USA

(Country)

MILITARY SERVICE FROM

None

(Date)

TO

-_ BRANCH OF SERVICE

COUNTRY

(Date)

DETAILS OF OTHER GOVT. SERVICE, U. S. OR FOREIGN

SEC. 6. MOTHER (Give the same information for stepmother on a separate sheet)

FULL NAME

Juanita

Sanchez

(First)

(Middle)

Morales

(Last)

LIVING OR DECEASED living

DATE OF DECEASE

CAUSE

PRESENT, OR LAST, ADDRESS 2021 Bast defferson Stee PhoeniX

Arize

DATE OF BIRTH 23/11/04

(State)

PLACE OF BIRTH Tempe, Arizona

USA

CITIZENSHIP USA

.. WHEN ACQUIRED? Birth

_ WHERE?

(City) (State)

IF BORN OUTSIDE U.S. INDICATE DATE AND PLACE OF ENTRY

(3)

(Country)

1...

9-53711

1637628361

+.

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(4)

OCCUPATION ArmY

LAST EMPLOYER. S. Governnent

EMPLOYER'S OR OWN BUSINESS ADDRESS

MILITARY SERVICE FROM

3315 ApF1146PF270ct53

(St. and Number)

(City)

(State)

BRANCH OF SERVICE -

Army

(Country)

COUNTRY U,S

DETAILS OF OTHER GOVT. SERVICE, U. S. OR FOREIGN

7. BROTHERS AND SISTERS (including half, step, and adopted brothers and sisters) :

1. FULL NAME ...

Raymond

Buenaventura

Morales

(First)

(Middle)

150 and Tumber

Sunland

Phoenix

Arizona

2. FULL NAME

Carmen

(First)

PRESENT ADDRESS 701 Tucker St.

Francis

lorales

Fronteras.

AGE 35

(Last)

"US

ne

(citizenshye

AGE - 33

Arvin.

California

USA

3. FULL NAME

Morales

Saguio

-US

(Citizenship)

.. Last)

AGE - 31

PRESENT ADDRESS

4. FULL NAME

robert

(St. and Number

Box 759,.

Aryin, Califo

Sanchez

Liarales_

AGE 29.

PRESENT ADDRESS 252 and Buchanan y

(St. and Number)

- Phoenix.

(State)

5. FULL NAME

Arizona tryi

(Citizenship)

(First)

(Middle)

AGE

(Last)

PRESENT ADDRESS

(St. and Number)

(City)

(State)

(Country)

(Citizenship)

SEC. 8. FATHER-IN-LAW

FULL NAME

James

Francis

(First)

(Middle)

F'errigan Lat)

LIVING OR DECEASED Living

DATE OF DECEASE --

CAUSE

PRESENT, OR LAST, ADDRESS 33 Janet Road, Newton Center, lass.

(St. and Number)

DATE OF BIRTH 11/9/91

PLACE OF BIRTH Boston, Massachusetts, USA

IF BORN OUTSIDE U. S. INDICATE DATE AND PLACE OF ENTRY

CITIZENSHIP

US

OCCUPATION Proprietor

- WHEN ACQUIRED?.

LAST EMPLOYER

Birth WHERE? (CY" (State)

"(Country)

16--62855-1

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SEC.

9. MOTHER-IN-LAW

FULL NAME

liary

(First)

recionald

(Middle)

LIVING OR DECEASED LirAgE

.. DATE OF DECEASE

PRESENT, OR LAST, ADDRESS 33 vanet fid, Newton Center, lass

(St. and Number)

DATE OF BIRTH 8/5/95

PLACE OF BIRTH -

Newton Center, lass.

Aerrigan

(Last)

CAUSE --

Via country)

USA

IF BORN OUTSIDE U. S. INDICATE DATE AND PLACE OF ENTRY

CITIZENSHIP

USA

WHEN ACQUIRED? -

(Country)

OCCUPATION ....

Housewife

LAST EMPLOYER

SEC.

10. RELATIVES BY BLOOD, MARRIAGE OR ADOPTION, WHO EITHER LIVE ABROAD

OR WHO ARE NOT CITIZENS OF THE UNITED STATES:

NOT AFFLICABLE

1. NAME

RELATIONSHIP

AGE

CITIZENSHIP

ADDRESS

2. NAME

(St. and Number)

RELATIONSHIP

(City)

(State)

(Country)

- AGE _

CITIZENSHIP

ADDRESS

3. NAME

(St. and Number)

RELATIONSHIP

(City)

(State)

(Country)

AGE.

CITIZENSHIP

ADDRESS

(St. and Number)

(City)

(State)

(Country)

SEC.

11. RELATIVES BY BLOOD OR MARRIAGE IN THE MILITARY OR CIVIL SERVICE OF

THE U.S. OR OF A FOREIGN GOVERNMENT:

1. NAME Ist Its Harmond Ee Morales.

- RELATIONSHIP... Brother

AGE - 35

CITIZENSHIP

US

ADDRESS 16QE Sunland Phoen arizona

TYPE AND LOCATION OF SERVICE (IF KNOWN) AF Jet Filot- Williams Field, Ariz

2. NAME

RELATIONSHIP

AGE -

CITIZENSHIP

ADDRESS

(St. and Number)

(City)

(State)

(Country)

TYPE AND LOCATION OF SERVICE (IF KNOWN)

3. NAME

RELATIONSHIP

AGE -

CITIZENSHIP

ADDRESS

(St. and Number)

(City)

(State)

(Country)

TYPE AND LOCATION OF SERVICE (IF KNOWN)

(5)

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(6)

SEC.

12. POSITION DATA

A. KIND OF POSITION APPLIED FOR Administrative

B. WHAT IS THE LOWEST ANNUAL ENTRANCE SALARY YOU WILL ACCEPT? $ 5,060.00

(You Will Not Be Considered For Any Position With A Lower Entrance Salary.)

C. IF YOU ARE WILLING TO TRAVEL, SPECIFY: OCCASIONALLY

xx

FREQUENTLY

, CONSTANTLY

D. CHECK IF YOU WILL ACCEPT APPOINTMENT, IF OFFERED: IN WASHINGTON, D. C. Yes.

ANYWHERE IN THE UNITED STATES YeS

-.., OUTSIDE THE UNITED STATES YeS

E. IF YOU WILL ACCEPT APPOINTMENT IN CERTAIN LOCATIONS ONLY, SPECIFY LOCATIONS:

Europe or South America

SEC. 13. EDUCATION

ELEMENTARY SCHOOL Monroe School ADDRESS Phoenix, Arizona

(City)

(State)

DATES ATTENDED 1936 - 40

GRADUATE? - yes

HIGH SCHOOL Phoenix Union

ADDRESS

(City)

Phoenixe Arizona

_ GRADUATE? - yeS

USA

(Country)

USA

(Country)

DATES ATTENDED. 1940-1944

COLLEGE

Arizona

State College

ADDRESS - City)

lempe, Arizona.

USA

(Country)

MAJOR AND SPECIALTY Pre-Legal

DATES ATTENDED 1944- 1945

COLLEGE Univ. Southern Calif

YEARS COMPLETED _ 1 Yr

DEGREE nO

ADDRESS LOs Angeles, Calf

- YEARS COMPLETED _ 1/3

_ USA

(Country)

MAJOR AND SPECIALTY Pre-Legal

DATES ATTENDED

1945-1946

DEGREE nO

CHIEF UNDERGRADUATE COLLEGE SUBJECTS Political Science and History

CHIEF GRADUATE COLLEGE SUBIECTS

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SEC.

14. ACTIVE U. S. OR FOREIGN MILITARY SERVICE

United States

(Country)

(Service)

208.

Suesort Grs.

2706 AAt, Masha,DO RA19242309

(Last Station)

(Serial Number)

REMARKS: -

'one

SELECTIVE SERVICE BOARD NUMBER 5

SFC

(Rank)

15 bpr 46 - 270c8

(Dates of Service)

Hocoracle

(Type of Discharge)

- ADDRESS

645 W. 'efferson St,

Phoenix

Arizona

IF DEFERRED GIVE REASON..

INDICATE MEMBERSHIP IN MILITARY RESERVE ORGANIZATIONS

Active Reserve

SEC. 15. CHRONOLOGICAL HISTORY OF EMPLOYMENT FOR PAST 15 YEARS.

ACCOUNT

FOR ALL PERIODS. INCLUDE CASUAL EMPLOYMENT. INCLUDE ALSO PERIODS

OF UNEMPLOYMENT. GIVE ADDRESSES AND STATE WHAT YOU DID DURING

PERIODS OF UNEMPLOYMENT. LIST LAST POSITION FIRST. (List all civilian em-

ployment by a foreign government, regardless of dates.)

FROM April 1943

TO June 1943

CLASSIFICATION GRADE

- (IF IN FEDERAL SERVICE) -

EMPLOYING FIRM OR AGENCY

Arizona Star Flour Compandi

ADDRESS

901 E. Jackson St...

Fnoerixe Arizona

USA

(St. and Number)

(Country)

KIND OF BUSINESS

Flour 1311

... NAME OF SUPERVISOR IT. Cruz

TITLE OF JOB Part Time

- SALARY $ •50

- PER _ HOur.

YOUR DUTIES utilities

REASONS FOR LEAVING...

FROM July 1944

School

CLASSIFICATION GRADE

TO September 1954. (IF IN FEDERAL SERVICE)

EMPLOYING FIRM OR AGENCY Contractors & Ensineers, Inc.

Morrison & Knutson Comp.

ADDRESS Foise,

Laaho

(St. and Number)

(City)

(State)

(Country)

KIND OF BUSINESS. Building

NAME OF SUPERVISOR _Unknown

TITLE OF JOB -

Ensineer Assistant

-. SALARY $ 1.10

- PER hour

To set up and operate plane line and locate topographic

taue surets:

symbols,

et see ot destin an convention esters on plane.

sketches, and contours indicated by elevations; Virectioning

of rodmen b; verbal instructions or conventional arm er hand signals;

To hold stadia or level rods and range poles at designated points; The

EASONs n i herent leva vertical control area by taped or stadia

establishing

(7)

School

16-62855-1

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(8)

FROM October 1944

•CLASSIFICATION GRADE

TO MEN 1945

- (IF IN FEDERAL SERVICE)

EMPLOYING FIRM OR AGENCY Ia aculate Heart School

ADDRESS 909 1

• washington Ste Fhoenix, Arizone

(St. and Nunber)

USA

(Country)

KIND OF BUSINESS Catk. Gramar SCAPORE OF SUPERVISOR Sister Hary WAKe Rose

& Teacher

TITLE OF JOB F6 E. Instructor

.. SALARY $ 35.00

PER weeK

YOUR DUTIES

Coach and Physical Education Instructor

and taught class.

in history and Literature.

REASONS FOR LEAVINOS8h001 (Transferred from Arizona State College to USC

FROM October 1945

- TOF ebruary 1946

CLASSIFICATION GRADE

- (IF IN FEDERAL SERVICE)

EMPLOYING FIRM OR AGENCY Soledad Catholic Grammar School

ADDRESS

4548 Dozier St., Los ingeles 33 Sut

(St. and Number)

California

(Country)

KIND OF BUSINESS

... NAME OF SUPERVISOR

TITLE OF JOB F. E. Instructor

-_ SALARY S 35.00

- PER -

_week

YOUR DUTIES Coach for Grammar School

REASONS FOR LEAVING Unlisted in US Army

FROM

TO

EMPLOYING FIRM OR AGENCY

ADDRESS

(St. and Number)

KIND OF BUSINESS

TITLE OF JOB

YOUR DUTIES

CLASSIFICATION GRADE

- (IF IN FEDERAL SERVICE)

(City)

(State)

.. NAME OF SUPERVISOR

_ SALARY $..

(Country)

PER

REASONS FOR LEAVING

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SEC. • 16. HAVE YOU EVER BEEN DISCHARGED OR ASKED TO RESIGN FROM ANY POSI-

TION? HAVE YOU LEFT A POSITION UNDER CIRCUMSTANCES WHICH YOU

DESIRE TO EXPLAIN? GIVE DETAILS:

NO

SEC. 17. GENERAL QUALIFICATIONS

A. FOREIGN LANGUAGES (STATE DEGREE OR PROFICIENCY AS "SLIGHT," "FAIR," OR

"FLUENT")

LANGUAGE Spanish

- SPEAK fLuent

- READ fluent WRITE fluent

LANGUAGE German

- SPEAK fluent.

READ fluent

- WRITE fair

LANGUAGE Portugese

- SPEAK fair.

READ fair

WRITE fair

B. LIST ALL SPORTS AND HOBBIES WHICH INTEREST YOU: INDICATE DEGREE OF PROFI-

CIENCY IN EACH:

All sports - average

C. HAVE YOU ANY QUALIFICATIONS, AS A RESULT OF TRAINING OR EXPERIENCE, WHICH

MIGHT FIT YOU FOR A PARTICULAR POSITION?

Administrative work, agent training operational duties, editorial

(03 for Air and Military) registry, "trouble shooter", liason duties. •

D. LIST ANY SPECIAL SKILLS YOU POSSESS AND MACHINES AND EQUIPMENT YOU CAN USE,

SUCH AS OPERATION OF SHORT-WAVE RADIO, MULTILITH, COMPTOMETER, KEY PUNCH,

TURRET LATHE, SCIENTIFIC OR PROFESSIONAL DEVICES:

None

APPROXIMATE NUMBER OF WORDS PER MINUTE IN TYPING

- SHORTHAND

(9)

10-82855-1

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(10)

E. ARE YOU NOW OR HAVE YOU EVER BEEN A LICENSED OR CERTIFIED MEMBER OF ANY

TRADE OR PROFESSION, SUCH AS PILOT, ELECTRICIAN, RADIO OPERATOR, TEACHER,

LANTER, CPA, ETC. No

IF YES, INDICATE KIND OF LICENSE AND STATE

FIRST LIC. OR CERTIFICATE (YR)

_ LATEST LIC. OR CERTIFICATE (YR)

F. GIVE ANY SPECIAL QUALIFICATIONS NOT COVERED ELSEWHERE IN YOUR APPLICATION

SUCH AS:

(1) YOUR MORE IMPORTANT PUBLICATIONS (DO NOT SUBMIT COPIES UNLESS REQUESTED)

(2) YOUR PATENTS OR INVENTIONS

(3) PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE

(4) HONORS AND FELLOWSHIPS RECEIVED

(3) two years study

(4) Outstanding senior boy of my high school class; Annual kiwanis.

Club Award; Outstanding athlete Award.

G. HAVE YOU A PHYSICAL HANDICAP, DISEASE, OR OTHER DISABILITY WHICH SHOULD BE

CONSIDERED IN ASSIGNING YOU TO WORK? IF ANSWER IS "YES," EXPLAIN:

No

H. DO YOU RECEIVE AN ANNUITY FROM THE UNITED STATES OR DISTRICT OF COLUMBIA

GOVERNMENT UNDER ANY RETIREMENT ACT OR ANY PENSION OR OTHER COMPENSATION

FOR MILITARY OR NAVAL SERVICE? IF ANSWER IS "YES," GIVE COMPLETE DETAILS:

No

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18. GIVE FIVE CHARACTER REFERENCES-IN THE U. S.-WHO KNOW YOU INTI-

MATELY — (Give residence and business addresses where possible.)

1 gil: 1:17. Frather (Deen of Boys).

Street and Number

BUS. ADD. Phoeni' High

City

Fhoenix,

State

Ariz,

RES. ADD. -

Unknown

Ak. tr. Russel Lackson.

i a tir. Joe Carbaial

BUS. ADD. Unkn

RES. ADD. 611 Horth 19th Ave, Phoenix Ariz

BUS. ADD. Unta

RES. ADD. 121 S

.. St St Phoenix

BUS. ADDIri-ingle Froduce Ga} Phoenix Ariz

RES. ADD. Unkn

NeAR's. Mr. Raymond Martinez

BUS. ADD. American Legion Fost 41

thoenix, Ariz

RES. ADD

SEC. 19. NAMES OF FIVE PERSONS WHO KNOW YOU SOCIALLY IN THE UNITED STATES-

NOT REFERENCES, RELATIVES, SUPERVISORS, OR EMPLOYERS- (Give residence

and business addresses where possible.)

Mr. Mike Baca

Street and Number

City

BUS. ADD. 404 2

-. Wahhington Phoenix

RES. ADD. unkn

State

Arizona

2. Mr. Ted Olea

BUS. ADD. Fire Station #1, Phoenix

RES. ADD.

Arizona.

3. Sir. Robert P. Stimpson.

4. Mr. Donald Hefner

BUS. ADD. CIA

RES. ADD. 9420 01d brandenburg Rd Silver Springs, ha.

BUS. ADD. CIA

RES. ADD. Unkn

5. _ Sister Mary Rose.

BUS. ADD. Imnaculate Heart School Phoenix Arizona

RES. ADD. _Unkno

SEC.

20. GIVE THREE NEIGHBORS AT YOUR LAST NORMAL RESIDENCE IN THE U. S.-

• (Give residence and business addresses where possible.)

Street and Number

1. Mr, Joe Carbajal

.. City

State

and

112 lirs, Sierra.

3.

BUS. ADD. Unknown

RES. ADD.-121 S, 22nd-St Phoenix

BUS. ADD.

Arizasa..

- Unknown

RES. ADD. -1905 k, Ladison Phoenix

Arizona..

BUS. ADD.

RES. ADD.

SEC. 21. FINANCIAL BACKGROUND

A. ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY?... yES... IF NOT, STATE SOURCES

OF OTHER INCOME

alley

Bank, main branch,

Phoenix, Arizona

(11)

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(12)

C. HAVE YOU EVER BEEN IN, OR PETITIONED FOR, BANKRUPTCY?

GIVE PARTICULARS, INCLUDING COURT:

NO

D. GIVE

THREE CREDIT REFERENCES-IN THE U.S.

1. NAME

Valley National Bank

ADDRESS

2. NAME

(st and ember razordy)

Phoenix

ADDRESS

3. NAME

(St. and Number)

(City)

ADDRESS

(St. and Number)

(City)

(State)

(State)

(State)

SEC. 22. RESIDENCES FOR THE PAST 15 YEARS

FROM 1940

TO ...

Present

FROM 1929

TO 1940

and mast descenson Stripenixy dont USA

1150 East Washington St., Phoenix, ariz Usi

(St. and number)

(City)

(State)

(Country)

FROM

TO

(St. and number)

(Cits)

(State)

(Country)

FROM

TO

(St. and number)

(City)

FROM

(State)

TO

(Country)

(St. and number)

(Cits)

(State)

(Country)

FROM

TO

(St. and number)

(City)

FROM

(State)

(Country)

(St. and number)

(City)

(State)

(Country)

FROM

TO

(St. and Number)

(City)

(State)

(Country)

SEC. 23. RESIDENCE OR TRAVEL OUTSIDE OF THE UNITED STATES

A. FROM Feb '49

- TO 14 September 1953

Munich

(City or section)

Germany

FROM

(Country')

US Army

TO

(Purpose)

(City or section)

FROM

(Country)

TO

(Purpose)

FROM

TO

(City or section)

(Country)

(Purpose)

(City or section)

FROM

(Country)

TO

(Purpose)

(City or section)

(Country)

(Purpose)

SEC. 24. CLUBS, SOCIETIES, AND OTHER ORGANIZATIONS

LIST NAMES AND ADDRESSES OF ALL CLUBS, SOCIETIES, PROFESSIONAL SOCIETIES, EM-

PLOYEE GROUPS, ORGANIZATIONS OF ANY KIND (INCLUDE MEMBERSHIP IN, OR SUPPORT

OF, ANY ORGANIZATION HAVING HEADQUARTERS OR BRANCH IN A FOREIGN COUNTRY) TO

WHICH YOU BELONG OR HAVE BELONGED:

1.

American Legion Post 41

Phoenix Arizona

USA

(Name and Chapter)

(St. and Number)

(City)

DATES OF MEMBERSHIP:

(State)

1946

(Country)

to Present

2. Los Conquistadores

*(Name and Chanter)

Arizona State College, Tempe, ARizona

USA

(St. and Number)

(Country)

DATES OF MEMBERSHIP

1944-1945

3. Newman Catholic Club

(Name and Chapter)

University of Southern Cal. 1945, 1.A. Calife, USA

(St. and Number)

"(City)"

DATES OF MEMBERSHIP:

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4. ÷

(Name and Chapter)

DATES OF MEMBERSHIP:

5.

(Name and Chapter)

DATES OF MEMBERSHIP:

6.

(Name and Chapter)

DATES OF MEMBERSHIP:

7.

(St. and Number)

(St. and Number)

(St. and Number)

(City)

(City)

(City)

(State)

(State)

(State)

(Country)

(Country)

(Country)

(Name and Chapter)

(St. and Number)

(City)

(State)

(Country)

DATES OF MEMBERSHIP:

SEC. 25. MISCELLANEOUS

A. DO YOU ADVOCATE OR HAVE YOU EVER ADVOCATED; OR ARE YOU NOW OR HAVE YOU

EVER BEEN A MEMBER OF, OR HAVE YOU SUPPORTED, ANY POLITICAL PARTY OR ORGANI

ZATION WHICH ADVOCATES THE OVERTHROW OF OUR CONSTITUTIONAL FORM OF GOV-

ERNMENT IN THE UNITED STATES?

IF "YES," EXPLAIN:

No

B. DO YOU USE, OR HAVE YOU USED, INTOXICANTS?

Yes

IF SO, TO WHAT

EXTENT? Moderation

C. HAVE YOU EVER BEEN ARRESTED, INDICTED OR CONVICTED FOR ANY VIOLATION OF

LAW OTHER THAN A MINOR TRAFFIC VIOLATION? IF SO, STATE NAME OF COURT, CITY,

STATE, COUNTRY, NATURE OF OFFENSE AND DISPOSITION OF CASE:

No.

D. HAVE YOU EVER BEEN COURT-MARTIALED WHILE A MEMBER OF THE ARMED FORCES?

IF ANSWER IS "YES," GIVE DETAILS BELOW:

No

E. LIST BELOW THE NAMES OF GOVERNMENT DEPARTMENTS, AGENCIES OR OFFICES TO

WHICH YOU HAVE APPLIED FOR EMPLOYMENT SINCE 1940:

U. S. Army

(13)

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(14)

F. IF, TO YOUR KNOWLEDGE, ANY OF THE ABOVE HAS CONDUCTED AN INVESTIGATION OF

YOU, INDICATE BELOW THE NAME OF THAT AGENCY AND THE APPROXIMATE DATE

THE INVESTIGATION:

U. S.

Army. Reason:

sensitive Fosition hanaline classized material

Type: Complete bachground. Date completed: 28 july 1947; Report faled

Read uarters Sixth Army

CIA - 30 January 1950 - Limited Frovisional Clearance

•CIA; Full Security end Crupto Clearance completed 29 June 1950.

SEC.

26. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY:

NAME

Ars, Joan K, Horales

ADDRESS 33 vanet id, Newton Center, lass..

(City)

RELATIONSHIP Wife

(State)

(Country)

SEC. 27. YOU ARE INFORMED THAT THE CORRECTNESS OF ALL STATEMENTS MADE

HEREIN WILL BE INVESTIGATED. Yes

ARE THERE ANY UNFAVORABLE INCIDENTS IN YOUR LIFE NOT MENTIONED ABOVE WHICH

MAY BE DISCOVERED IN SUBSEQUENT INVESTIGATION, WHETHER YOU WERE DIRECTLY

INVOLVED OR NOT, WHICH MIGHT REQUIRE EXPLANATION? IF SO, DESCRIBE. IF NOT,

NO

SEC. 28. I CERTIFY THAT THE FOREGOING ANSWERS ARE TRUE AND CORRECT TO THE

BEST OF MY KNOWLEDGE AND BELIEF, AND I AGREE THAT ANY MISSTATEMENT

OR OMISSION AS TO A MATERIAL FACT WILL CONSTITUTE GROUNDS FOR IM-

MEDIATE DISMISSAL OR REJECTION OF MY APPLICATION.

SIGNED AT - Washington, D

PaY and State)

DATE - 22 October 1953-

Coleue D.

(Witness)

Byd

Lanet

(Signature

scorales

Applicant)

USE THE FOLLOWING PAGES FOR EXTRA DETAILS. NUMBER ACCORDING TO THE NUM-

BER OF THE QUESTION TO WHICH THEY RELATE. SIGN YOUR NAME AT THE END OF

THE ADDED MATERIAL. IF ADDITIONAL SPACE IS REQUIRED USE EXTRA PAGES THE

SAME SIZE AS THESE AND SIGN EACH SUCH PAGE.

U. S. GOVERNMENT PRINTING OFFICE

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SEC. 13.

College:

College:

EDUCATION

University of California at Los Angeles (UCLA). at ended:

Summer

Session 1945

University of Maryland, European Extension Courses.

Attended: October 1949 to Spring of 1953

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