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Released under the John F. Kennedy

Assassination Records Collection Act of

1992 (44 USC 2107 Note]. Case#:NW

B8613 Date: 03.18-2025

Date

Page

:

01/20/98

1

JFK ASSASSINATION SYSTEM

IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : INSCOM/CSF

RECORD NUMBER

: 194-10004-10145

RECORDS SERIES

: DOD-AFFILIATED PERSONNEL INCIDENT INVESTIGATIONS

AGENCY FILE NUMBER

: PAGE 387

DOCUMENT INFORMATION

ORIGINATOR : USA

FROM : DCOFS, OPER HQS USAINTC

TO

:

TITLE

: [ RESTRICTED ]

DATE

: 03/15/67

PAGES

: 1

SUBJECTS

: FROMER, DAVID R

NATIONAL AGENCY CHECK

DOCUMENT TYPE : PAPER, TEXTUAL DOCUMENT

CLASSIFICATION : UNCLASSIFIED

RESTRICTIONS

: 3

CURRENT STATUS

: RELEASED WITH DELETIONS

DATE OF LAST REVIEW : 03/07/95

OPENING CRITERIA

COMMENTS :

NW 83613 Docld:34523586 Page 1

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## Page 2

-US-ARM

DOD NAC CENTER

REQUL..

FOR NATIQNALAGSNOYICHECK

CAR 381-130% 21

1. DATE OF REQUEST

V5 Men.

1967

NAME - ALIASIES) • NICKA

FROMER,

David Reed

DAY, MONTH. YEAR OF BIRTH

21 Jul 1942

i. B.i RELATIVE'S NAMES

PATHER

Irving Fromer

MOTHER (maiden nomo).

Katherine Rhodes

sPousE (maiden namo)

564-58-8137

6.. PLACE OF BIRTH

Chicago, Ill

14

7. SERVICE NUMDEA

e. DATE AND PLACE OF BIRTH

I2 Jun 1913

Cincinnati,

id. PRESENT ADDRESS

13 Rhondg

M111 Vals

731 D20.1909

Estherville, Iowa

As above

11. CHTIZENSHIN

US

FROM

& FROM

12. RESIDENcES (List all from 16th. birthday or during last 15 years, whichever is shorter)

b. TO

C. NUMBER AND STREET

d. CiTY

NAC COMPLETED

773

dateWAR 2-8190%

FOR THE DIRECTOR"

кси.

15.

EMPLOYMENT

(List all fror/loth birthday or during last 15 years, whichever is shorter)

b. то

C. EMPLOYER

d. PLACE.

e.

STATE

WITH SUB.

NO DATA

HAAST

REQUEST COPY OF BESiES

FROM

5. 57

b.

TO.

3960

1A. LAST CIVILIAN SCHOOL

CO) C. NAME,

d. PLACE

YES;

NO

b.

d.

1S. ITEM ("Yes" answers are expanded in Remarks)

ECT AN ALIEN OR A NATURALZED CITIZEN OF THE UNITED STATES?

OREIGN CONNÉ-TIONS, INTEREST EMPLOYMENT OR MILITA

OVERNMEN

RAVI SA CLASSIPIED US GOVERNA

NT. CONTRACT?

TI

OF DO PORN SRA OR DO PORM 98?

=P. ANY ARREST OR COURT RECORD?

iG, REMARKS

¡fIF-additional spaco is needad, conthus an plati paper):

reserence,

and I-F-ll-58433-22991/9

Spake,

17.1

CONTROL OFFICE. USE

6353/6004

•AFORM 3027

Promer,

18. FROM:

DCofS, Operations

Headquarters, USAINTC

ATTN: ICOP III

Fort Holebird, Maryland 21219

19. THRU:

387

MAR 1 7 1967

0903-51

FINGERPRINT CARD FD 258 MUST BE ATTACHED

REPLACUS DA FORM 340. 1 DEC 50. WHICH 18

OBROLETE

NW 88613 Docld:34528586 Page 2

248

76-1239

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