FORM:PERSONAL RECORD QUESTIONNAIRE PART II-OPERATIONAL INFORMATION:AMMUG/1
Originator: CIA
Document date: 11/02/1964
Document type: PAPER - TEXTUAL DOCUMENT

## Page 1

4-00000

104-10225-10036

H4nn4.w1904054e

2022 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992

anoite como

SECRET

PERSONAL RECORD QUESTIONHAIRE

PART 11 = OPERATIONAL INFORMATION

SUSTRICTIOUS SO CASE ORTICRE

PRQ NO.

DISPAICH NO.

TAiN

öe. cön.

TF/d

SECTION

CONTACT ANO CEVILSPHENT

IMDICATE MOD.

мнен.

onene, ano, ano dr auna suaster nas ara;a conracreo of ocurenero.

ipaps/51 In Ottara on 23 acril 1964

Wnuorch test the dim

of dro Sitiato

INDICARE OCINEA SUBIREI COLLO OR PUANCO OUCA QUICALE ARS CO A SECURE MANNER TO ANS RIGRUNGIDLE CASE OPRICCA TOR

MANOLADE. lE SO.

INDICATE to anca.

List.

DIRER CASE OFFICENT

BEEN

0r.*

11cg

Fio

1119ges

MANOLED

SUAJECT iN

172 M70T1 3.

Kity."

trickir ar do.r

apetala dias?

0:.4?:7

I: 5.1:1.

ali

trl: o3

E.!"

ü rios

409"

11en

0. 012008.

GIVE NAMES Or MICH

19n :hіC1:

irake

iichatto du Sarcis xxxrg

Lucenier to Hiere ar Horace

1:::07:0100210 491:0

1050a

18-201

SECRET

1900

---

## Page 2

SECT

1 ON

SECKET

ANÜ C

Lineatisfaction nith prason rutinco

2.

INDICATE MAT COMPÃOL. DO ANT. GRIDRO ONCE ME DUELECT, 18l nO conteol or arenas

•пріолn.).

lindur enoneors du or rieroy an ulo countr tinanciul, logo toi fanily'e

malitare.

SECTION

:COVER

COVRA USCO OY SUOSACI ANO CASA:OFPICER-IN PARIA MERTINOS.

Honc

•noeded.

COVEN USCO ErI

Celan Intolliunor (101)

8. INDICATE SCAVICE POR AMICH SURECT THINDO ME (MILI MORG; iSO

Mità asa

SECTION IV:

• CAPLAIN SUDILCI

SUCH.CONNICIION

INTELLIGENCE CONMECTIONS ANG TRAIMING

OOM-PASI DA PRESINT CGRMACTION MITM ANE DIMEN INTELLIGENCE

LANON OVERTET.

venter of Cuban Intelligunce.

INDIVIQUALS: pARente.

повіно хніза зі зівлесь у.

FALSENT: INTERLIGENCE ACTIVITIES.

PUNGIERY the ICI:

S. CAPLAIN ANT IRAINING SURJICE-MAS MAD IN CLANDESTINE OPERATIONS..

SECTION V

COLLAGORATION POTENTIAL

PODICATE OTHER FORAICA PODCA SUBICI BOULO DE MUST CINELÍ TO COLLADORATE MIIM ALCAUSE DE MIS COCOLOGE OR PAST

ASSOCI

TiONS..

triture cort of his onn country

SECRET

---

## Page 3

SECTION Y

SFCRET

OPERATIONAL

USE - CONTACT

dRi ANICH NO MAS INGAGEO AND PUP iNPI O!

IMOICATE ANAT. HAS BEEN. 1010

OF

INTORMATIDeS ME FURNISHES.

ULTAIL JUDITI

SEU

To be used in recrilent atunts agaret Cilan Intelligerce.

•DESAIL SUBJECT•S PRUPOSIS PP-DO PIPE USE ON GUTIES.

None at into die.

Z PROPOSE LIAISON OR: OPEMATIONA ACTIVITY

.. "HERE SUBIÈCI

19 IN ORRECIAL USUREA DR A ERREICA GONERNMENT 24

Di WHERE SUBIICE

1g/ an

DUrORE. AGENCY:

SECTION VIII

AGENCY RELATIONSHIP WITH SUBJECT

PERSONNEL ANDAN TO

EXPLAIM MATURE OF AGENCY RELATIDASMIR DIPM SUBJECT, D.E, TRAINEE, OPPOSILE MUMBER: REMUMERATION, IF AMY, AGENCY

SUBARCE.

Cortract Eginto

(ise curation a for anencs persorel inor: io his:

SECRET

3/900

---

## Page 4

14-00000

SECTION IX

SECRET

JUALIFICATIUNS FOR GTHER OPERATIONS

TALENTS.. OR QUALIRICARIIS

POSLESJCO DI SUDITCT, AMICH CJULO CONCEIUITE: IL GE. NALUE

1anet4T4/191

FOR DTHER ORERATIONS.

Nuorlodço of vertoual tatiore une cont: of luban inbdligince.

SECTION X

CUMMI TMENTS

1F.1T1S PROPOSIO IO.PAY BURICCT, @REGULAN

SALARY.

• RRUICATE: 9HE

coNNDo1rILS.

suasipr.

ON 'OPMER MCTHÃO, SPECIAN AND CIVe ORSAILS.

PAYMINT. IO BE MADT

•LNCHANGE

£300.02 sorittio

oTkt,

Lubyeet me vralin3

•DTHÉRDISE:NOS CUVLREO HEREIO, MAUE SÓ SUBIEET, (ExanalO: Commilmendo reddrBeud aracualton

$3,000.00 to apoüre 1f dles in line of duty.

$1,000:00 bonus as diterminod by azeros.

•CE:AND SECURITY

MHICN

KN:CHECICD AND THE: HESLTS.

SECTION

XI

ISDICATL TNE FIELO ÁGENCIES

ANO FILLD FILLS

Allo

OTHER

ISURES TAKEM. TO 'YERIE

DIOGGAPHICAL: INIORNATION JURMISHED DY SURSICE.

INDICATE

INETHER

OR NOT.PROVISIONAL

TTONAL

RATIONAL AP:

PUANLL

•POR SUQLECT'S USE MAS BECA PRCVIOUSLY ONTA

« EO.

Pod obtalnod, nl suy 190u

EVALUATE SUBIECT'S'CHARAGIER.

RECiAOILITY AND SECURITE, CUCAÇG EVIOENCE OMCRE POSSIBLR

M.¡D'ATE APPROVAL TSFAIBED"

20 July igt'i

All Informatlon riven by bin has toen corrocorated as far ao poscizie um

has ciecked outo

Ho has prorec his rliitrinees to copperito by Mlrc

his entrty and kell being ar veil de wa of hlc faally 1n overseae

colloboration iitn thls egarc:o

•.1tPLCIn

ANY

SITUATION.OR

CE'OPERATIONAL

SECUNIT:VIl

iaPOINT.

INDISCARTIDO DN MMICN SUGDECO MẠE MAVE GEEN INVOLUED UNICH MUST DE EVALLA-RS AR'IN A

liono to. dato.

SECTION XIL

SUBJECT'S PERSONAL: MADITS

USE OF LIOUOR, ORUGSI GAMBLING. PARAVOUAS:

Irinka nodoritiey, euaires, no drugs or gunblingo No permanont extrzarit:1

Effairs lno-no

---

## Page 5

af:.

SECTION X100

1:: INDICATE SUB

SECRET

AVOCATIONAL INTERESTS

SPORTS.

NUSIC.

. 86

donce biJuball, atto fin.

SECTION: XIY

GEAERAL

INDICATE METHER SUBSECT'S LANGUAGE ABILITIES

AND OTHER CHARACICRISTICS, ARE SUCH AS ME COULD PASS AS A NATIVE

OF A COUNTRY OR RIGION OTHER THAN MIS OUT.

iXPLAIN.

contral mordonne

INDICATE WMEINCA INFORMATION IN PRO PARTS I AND 11 MAS OBTAINCO BY RESCARCH, CLANDESPINE ASSESSMENT.

CORRESPONDENCE OR OTNER MEANS.

Personal debriefings.

THAN ROUTINE

REUUIREO.,

IF AND THEN

TERMINATION DE SUBJECY IS REFECTIO, PLEASC EXPLAIN.

1A1 10

N/A

SECTION XV

EMERGENCY CONDITIONS RECONTÄCT ARRANGEMENTS

GIVE FULA DETAILS

:: MAXING CONTACT USES

PiE, RECOGNITION DICHALS, SIMI AMEAL COULO CONTACT DE MADE.

THAT DONA FIDES COULO INDIVILUAL

Under control of IN WI.VE stition it present.

IF needed naues of langosch, Luzier, Treciles could te used.

SECTION

MISCELLAMEOUS OPERATIONAL DATA AND REMARKS

None•

DATE

2 Nov 64

---