RESPONSE TO GREEN LIST REQUEST.
Agency: CIA
Originator: CIA
Document date: 03/25/1960
Document type: PAPER-TEXTUAL DOCUMENT

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104-10180-10152

SECRET

041

3. BIRTM DATE

A. BIRIN PLACE

S. CITIZENSMIP

PRESENT ACTI USA (Natator

TONTE UTTUTRETTEUA LUVLATTUR

RESPONSE TO GREEN LIST

REQUEST N? 99739

RATE OF FERUIST.

16 HArON 1262

REQUEST FROA

NAME OF ORIGIGATINO SFISER

oFFIcE aloReRS. Plecalo

POOM, GUILDING

EXTE#SION

2211 PEN

2972

14. WAS CONTIMUING SEARE- GESUESTED?

ES. TYPE OF RECUEST

2ISI TINE SUOMITTE

- ADDITIONAL DAT

_COVER

16. INTEREST IN SUBJECT

__ ESPIONAGE OR CE ACTIVITY

. OPERATIONAL CLEARANGE

17. INFORMATION REQUIRED

LOCATION

DATES

Primarys)

8. MILITARY SERVICE

SERVICE ARM. COUNTRY

, Not Known

PAST OCCUPATIONS

ACTIVITY

SPECIALTY

As Stated In Part 6 since 1954

Prios to 1954 held varlous od Jobs while attending

school.

LOCATION

24715

10. DESCRIPTION

(HEIGHT)

(WEIGHT)

11, SPOUSE (IF WIFE, GIVE MAIDEN RAME)

12. OTHER MEMBERS OF IMMEDIATE FAMILY, AND ASSOCIATES

(FYES)

(MA19)

(RACE)

(OTHER)

13. OTHER SIGHIFICANS DATA SPOLITICS, RELIGION, FTES

ATTACH ENTRA SAIETS DOLO MEDES

dil - 201 (274509)

INSTRUCTIONS:

INSERT CARBON: FiLL OUT FORMS COMPLETELY.

SEND 80TH SHEETS TO FI/D.

SEE CS1-10-7

SECRET

i 01

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