“14-00000 b'1 1 • . • 8/44 1. SIFICATION ARD PERSONNEL DATA :‘ FOR EMPLOYMENT CF untrzo STATEs CITzaN 1iNStrLGTuNS.—Tierare in guadfupt up-date Ali sections must be completed Write‘ "when 9; plcable. Type’s print anteety| - 20 space not adequate for rociplesth answris cont”
“3 OR DEPT. COI’MN AGENCY COLUMN ITHIS FORM MUST BE RETURNED No 1 5071 YR i Mt. , YA .. ENTER .... NA.) CO t *0 31 342 35 34, 1219-4 eiAt 7W.W _C.------ WHETHER YOU HAVE HAD OVER 310 Territory of —Hawa 11------ 1 51451014512 US Marine Corp:1 540 SEAS SERVICE OR NOT. 1 I”
“IGAL-HESIDENCE (Caty ancastare or country) 16 CURRENT RESIDENCE (GEeF and ataro or country. Wilshire Blvds, Loe Angeles, California 17 MARITAL S ATUS (Chock as appropriate) i SINGLE op-.manien Ceroeo AmBULLED. sceseargo. T Jotvoscso 18.: NUMBER OF DEPENDENTS (Not including ”
“SUBMIT FORM 1322 Fov ANY: CHANGE-AFFECTING •,6 vivo THIS sip , * X -***- COVER. (HU 2,6026)1 udrinK lILL SUBMIT FORM 1323 FOR TRANSFERRING COVER RESPONSIBILITY?. (HR 240-20) X FAA. CATEGORY 1 CATEGORY II X x. x SUBMIT FORM 2698 FOR_AGEHOSPITALIZATION CARD R VA*<S AND”
“14-00000 FOR# OSP-39 ' - DEPARTMEN STATE. BU buzsAu NO. 47-2074,8 APPEL ‘. EXPIRES AUGUST 31, 1959 FORMERLY F5-372 APPLICATION F EMPLOYMENT . IN.THE FOREIGN SERVICE OF THE-UNITEDSTATES . THIS SPACE FOR OFFICE USE oyLr. aIESTRUCTlONS—Aaswers to all questions mast be typed o”
“1 4-00000 SECRET /‘• ..... Fille- In) tis nate PERI IC SUPPLEMENT PERSONAL HISTORY STATEMENT 21 January 1959 INntatCTIONs if, wilt he lent < rent Even though it uplecates This form provides the infecestion You need complete • sherehi boer official personnel see ou ”
“14-00000 1 CONFIDENTIAL fr.tto.t h>i ~platei "• derecorded on ! % fore 1% essential in de mlcing travel evceeses allomrble in con- aspente, 0/094093 duty, toturn to residence urne seppretior, and for providing current residence an d sereedenc, information remiited In the”
“Military 27/12/74.08760 Service. L. Scottula SETA sure or Siployee Date Signed Address (Street, City, Suite, 012 Code) 4314 BIRCHLAKE CT. ALEXANDRIA, VA. 22309 VINT 7 Overt 7 ivers 2 la 9 2 1 1 I! 8 9, a ) is g i $ 7 8 (”
“14-00000 DECLARATION OF APPOINTEE I This form is to be completed before entrance on duty. Answer all questions. Any false statement in this declaration will be grounds for cancellation of application or dismissal ater appointment. Impersonation is a criminal offense and will”
“-00000 roam osP-js edeet Persee Re. ev-899t.4 9-1-93 MMlfMir of Start Approve Repicen June so, toon 7.8. SAW((Print) SUPPLEMENT TO STANDARD FORM 57 ge morespoco je required, poo edditicesl beota of paper. Write Robert Tyler Shaw OB each sheet your semo, M4r»i» and date of ”
“14-00000 4 CONFIDENTIAL (iMen Filled In), 3 Complete in duplicate. The ostu recorded on thee fern nessential in determining travel expenses allowable in connection with leave - . al gortrnmient exper se, over seas duty,rotuin to residence upon separation, and for providing”
“14-00000 SECRET (enen Pilled In) JUN. PERIODIC SUPPLEMENT * PERSONAL HISTORY STATEMENT INSTRUCTIONS- re50 aotam! This form provides the ovano whereby your official personnel records watl he Even though st duplicates inforeation-you have furnished previously, it well be”
“PERIODIC SUPPLEMENT -- SECRET (WNen Filled Zer THIS DATE Mar 61. PERSONAL HISTORY STATEMENT 6, INSTRUCTIONS This fore provides the means whereby your official personnel gec de •: t be kept current. Even though or duplicates information you have furnished previously, it w”
“kubderrinainoisingdebinieirses.j *rs 1 "dwu osr-3s 3-26-91 C69A9T :oF state • car DURBAU NO, 47-norz.s AprzovAt gxrinus Audobe 91, teso APPLICATION F OR FOREIGN SERVICE AND DEPARTMENTAL EMPLOYMENT 1. a. MAMI (Print) (Use with Standard Form 57) Robert Tyler: SAW It mor”
“0 PERSONAL HISTORY STATEMENT INSTRUCTIONS: ■ ANSWER ALL QUESTIONS COMPLETELY. IF QUESTION DOES NOT APPLE WRITE "NOT APPLICABLE". WHITE "UNKNOWN" ONLY IF YOU DO NOT KNOW THE ANSWER AND CANNOT OBTAIN THE ANSWER FROM PERSONAL RECORDS. USE A ST PARATE SHEET OF PAPER FOR EXTRA DE”
“14-00000 5,/ DASeceemI 8 snet FaElodhid) 1 th DEC THIS DATE PERIODIC SUPPLEMENT 109734 PERSONAL HISTORY STATERENT? / \ Q • Thia form provaden the means whereby your ofi inforoation you have furnished previously, i 160 Cutie current. Even though it duplicates to Section”
“14-00000 fl. 24 SUl *$% Let shres toledee hiring in the United States or Territories <4 the United States who are NOT related for you and who have definite knowledge of 5for con - M-e and Nirsese t># the position for which you are are errlying epplying Do not repeat Do no”
“3. HOME ADDRESS (No., Street, Citr. Zone, State, Country). 6300 St. Charles Ave., New Orleans 18, La. 4. BUSINESS ADDRESS (Vo.. Street, City, Zone, State, Country). INDICATE NAME OF FIRM on EMPLOYER, IF APPLICABLE rone 5- HOME TELEPHONE NUMBER 6- BUSINESS TELEPHONE NUMBER 7 B”
“14-00000 PERSONAL HISTORY STATEMENT INSTRUCTIONS: QUSTllks COMPLETELY ANSWER ALL QUESTIONS COMPLETELY. I QUESTION OCES * IF QUESTION APPLY WRITE NOT APPUlcs (%, WRITE UNKNOWN ONLY IF YOU 00 NOT’ANOW TE AS=E9 AND CANNOT’CETAIN T € ANSWER FROM PERSONAL £39795.9 USE A SEPARAT”
“14-00000 CONFIDENTIAL (When Filled In) Complete in duplicate, The data recraded on this form is essential in deter mining travel expenses allowable in Connection myth leave of government expense, overseas doty,retu‘n to residence upon separation, and for providing currentre”
“14-00000 SECRET (When Filled In) 1Htg barg PERIODIC SUPPLEMENT PERSONAL RISTORY STATEMENT INTIEECTIGNs This fora provides NA ep-na wNDrahy sour official personnel recordo will he seel curtent. K.’n thoeth if duplicetes official pessonno infarnetien you have furnished ”
“FORM OSP-34 • DEPARTME* ‘STATE .. of - • BUREAU No. 0y-2o?s,s 9-1-V8 APrku i EXPIRES AVOUST 91,1990 FORMERLY F5-372 APPLICATION- Fun EMPLOYMENT IN THE FOREIGNESERVICE OF THE UNITED STATES THIS SPACE FOR OFFICE USE ONLY ISTRUCTIOXS—Assvers to all questions most be typed or pr”
“14-00000 CONFIDENTIAL plinen rated In) Coeclete in original. The dets recorded on this fore iS essential in dotereining traver scenses bllo-ztla in Con- - section with levost goverreent expense, overseas duty, return to residence-upon see."pr ion,.... and for providing cur”
“1 4-00000 DECLARATION OF APPOINTEE 6 tJax This form is to be completed before entrance on duty. Answer nil questions. Any false st. vent in this declaration will lie grounds for cancellation of application or dismissal after appointment. Impe cation is a criminal offense and”
“14-00000 4 28 AI;to:a* % Line three seat ring is* the !’•*>!• 1 S’atee ore Teresf-msen of (7.e United Gratee ‘‘‘ NOT ** rr eriire hevo definite knowledge of eteor • unto **>‘M and Niness for the prestinn fir orlasa h yore m ising pre at fires. 14 EXPERIENCE) {C.ve complete ”
“14-00000 . DECLARATION OF APPOINTEE . This form is to be completed before entrance on duty. Answer all questions. Any false statement in this declaration will be grounds for cancellation of application or dismissal after appointment. Impersonation is a criminal offense and w”
“14-00000 / 24 DEFFMT* - Let three perw-is living in the United States • Ferritenies et the t’nite- States who are rara isteif to you and who has • deneite knowledge cl vis and fi’ness free the prertion Feer which yens nre apt 3sipg Do not repeat names of sopervieore : 4 unde”
“14-00000 SECRE 17 ; % (WNen Pillen'Iny wis Oars PERIODIC SUPPLEMENT PERSONAL HISTORY STATEMENT ISTECTIONS el records walt This fota provides the dehoe ebeeoby your official personnel wilt No hept eweront. Even rhougo it duplicates information you have furnished previou”
“Bertha G. Wyatt, 6633 Soacly Road, Manassas, Va. 22110 MAVE vou r*fcutro * Ponta or aftouarv I— - Vis I----- I vo. (7) e* * peseene the povrr of attorney?) Dy Wife. 6. ADDITIONAL DATA AND/ OR CONTINATiCA OF PRECEDING ITEMS 7. RESIDENCE DATA - TO BE COMPLETED ONLY St DPLOYEES”
“14-00000. (WNer SECRET Fitted In) LY THIS 0AT[ PERIODIC SUPPLEMENT PERSONAL HISTORY STATEMENT 9 February 195 ‘i INSTRUCTIONS This form provides the means whereby yeur official personnel pers ei records will be kept current. Even though st duplicates information you h”
“14-00000 . :, DECLARATION OF APPOINTEE . - - This form is to be completed before entrance ou duty. Answer all questions. Admitted unfavorable inform aticn a Lout such matters as arre sts or discharges wil I be considered fogether with the favorablc information in your record”
“14-00000 I CONFIDENTIAL 5 THR J am es CAln FIlloitn) Complete in duplicate. 1 he data reroded 4,77 the % form it essential in determining travel capenses allowable in connection with lenve ol government expense, over segs duty, return t residence upon separation, and f”
“14-00000 DECLARATION OF APPOINTEE This form is to be compacted before entrance on duty. Answer all questions. A fmitted unfavorable information .. about such matters as arrests or discharges will be considered together with the favorable information in your record in determ”
“14-00000 60 056: 1-26-51: DEPARTMENT v: STATE BUDC BUPEAU NO.47-R0?1.9 APPROVAL EXPIRES August J1, t9se APPLICATION F OR FOREIGN SERVICE AND DEPARTMENTAL EMPLOYMENT !. a. GAVE (Print) (Use with Standard Form 57) "Earl J. Williamson It more space is required, use addition”
“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 d”
“h ie FCRW 05P-54 3-26-51 - DEPARTMENT v ATE BUDG .EAU NO. 47-2072.3 APPRO..L EXPIRES August 31. 1*56 APPLICATION. F OR FOREIGN SERVICE AND DEPARTMENTAL EMPLOYMENT !. a. NAME (Print) (Use with Standard Form 57J If more space is required.. use additional sheets of paper, d.”
“PERMANENT ADDRESS (No., Street, City, Zone, State and Country) AHO PHONE NO.: Toluca Highway - Kim 19-1/2 10 El Magueyito, Cuajilnalpa __ J Same 3S (12)- Mexico, DF Mexico 14, CURRENT PHONE NO. 20-77-47 08 Phone20-77-47) 8______ :6. LEGAL RESIDENCE (State, Territory or Co”
“PERSONAL HISTORY STATEMENT INSTRUCTIONS: A*S*£6 ALL QUESTIONS COMPLETELY. IF CUES71C9 A*Sw[6 QueSTice DOES NOT APPLY WRITE "PCT ACT. APPLICABLE". WRITE UNKNOWN" 0NLY-1F 100 00 NOT KNOW THE ANSWER AND CAREC” OBTAIN THE ANSWER FROM PERSONAL RECORDS. USE A SEPARATE SHEET CE PAP”
“14-00000 / ronu osp-30 9-3-98 Di PARTEE yA STATE I vr peessu so. er-edtt. 1 APPLICATION. EMPLOYMENT APPR . EXPIRES Avcusr 91, 1930 FORMERLY FS-372 1% THE FOREIGN SERVICE OF THE UNITED STATES ruts sracs’ros orrtcs tsu ovlr JASTRUCT1O%S—4s-vere so all questions must b ty”
“14-00000 ar. DECLARATION OF APPOINTEE This form is to be completed before entrance on duty. Answer nil questions. Any false statement in this declaration will be grounds for cancellation of application or dismissal after appointment. Impersonation in a criminal offense and w”
“14-00 00 2onu/010-3y 9-1-92 rase y gu. RELATIVES By 01000 00 waegaGE now RESIDING 11 rongace COUETRIES . WANT Nyarigysaip apngas Mad F. P. Shaw, JTa. Brother Tokyo, Japan 19. LIST PRESET On Fonuta Fonticu CONNECTIONS! A. Business . 0. turcorugnt 16. 00Es youn FINANCIA”
“14-00000 Form 13 Wrenen attwove Feliruory 1946 UNITED STATES CIVIL SERVICE COMMISSION Dwbpit Bureau Number 50-R050 PROOF OF RESIDENCE, Arsstcotiens for ergusnitment in the oit-teeetiorm-3 detvsrtmentisl enevire most !• eevethepenenry toy a co-til -sle slewing legal or wretr”
“14-00000 DECLARATION OF APPOINTEE This form is to be completed before entrance on duty. Answer all questions. Admitted unfavorable information about such matters as arrests or discharges will be considered together with the favorable information in your record in determining”
“14-00000 4 SECTION 23. GENERAL QUALIFIC-O gi :h0l"4‘ ast $PrCi8; Nu#lto+t• 1181NO et.d Aart, 8L90, Li zootr A NT .t ‘ I CAT 0% 9 is a "isu: •* ‘mailing 04 tariiwf, WHICH MiGh’ 71! rOU fC9 a PSBTICULAR 0il11n%, Football Track Swimming SECTION 2%. SPORTS AND H0881ES Baske”
“14-00000 DECLARATION OF APPOINTEE This form is to be completed before entrance on duty. Answer all questions. Admitted unfavorable information about such matters as arrests or discharges will be considered together with the favorable information in your record in determining”
“1 4-00000 CONFIDENTIAL fuhen Fillo In) Complete in duplicate. The data recorded on this form is essential in determining travel expenses allowable in connection with’legyo ETTR at government expense, ever seas duty,return to residence upon separation, and for providing curr”
“14-00000 SECRET (+Neh Filter Ie) 9. PHYSICAL Defllivn PLACE (rer-anent Place of Keestence € GtnF> Piste •tCe5760 I Requested Per ent Finco of Kontesa address in stee s 19 approved in lieu thereof) Futt ADDRESS Rensdongo ol different f-ox iteo 3) FULL AD:133 8151 LARK”
“14-00000 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”
“14-00000 j N EVUONO .) CONFIDENTIAL s (when Fitted In) Complete in duplicate. The doto recorded on this form is essential in determining travel expenses ollewable in connection with leave at government expense, over seas duty,return to residence upon separation, and for”
“14-00000 DECLARATION OF APPOINTEE This form is to be completed before entrance on duty. Answer all questions. Any false statement in this 1 declaration will be grounds for cancellation of application or dismissal after appointment. Impersonation is a criminal offense andwin”