“4Cernt (/) ,4. !. 7 rensALD; rete; (J) relationship; >!•/?•<!> and (9) kind M7 19. YOU now, on HAVE You 9V95 mam • wyytB MAPASCITTOPEJ9 2% %. X SPECIAL INSTRUCTIONS FOR CLAPPING VETERAN PREFERENCE- seafsen 7 ARE sou now (221 JA IF. YOU FV*2 ecse 4 v• *A**0*CA*t29 Tir,10, ”
“vidaton ■. 0 the no tie and location id the cutirt (4) th. tensity C. G., etc.) trpo d, i any, the < th.or dliat actin ol the c-tni, U apraunted your lr-ge-yea ‘s will Bo tikon. ′ 29. Have you over been discharged or forced ho rusign for nus- IF YOUR ANSWERS TO THIS QUESTION ”
“Lose • re in ac-on $.22 ‘ the dat, Q the nostere cl t • ottetio Army Navy M C., |t.ine vol mor-rdtsan ) or widatiin, .7 the min 1 von C4 the court ‘$) the, pot. 129 ii.pai J cry se ctner Ga *».wxa ct the cose Lt «P5 4410 tod U an*-' rout angerun: s »C tv to. USMCR 013458 Maj”
“ARMED FORCES SECURITY QUESTIONNAIRE I__ EXPLANATION 1. The interests of National Security require that all persons compelled to furnish any statements which you may reasonably being considered for membership or retention in the Armed believe may lead to your prosecution for a ”
“none, give grade ce rating at low Give in such cuse (1) the’dal’ i.i the nature of the cerise\ (Army, Navy M. C. : tune ct soparaton.) ‘ or violation (30 the name and location of the court (4° the por-alty' V C. G., eto.) .j ; , ** imgr/eed. il any or other disposition ol the ”
“AClvl PntlARr PlliPl”, PAT /Lor Ncl th. ACTIVI Civbi V A Firoon C° Retired :--------- ——-—EG715 □ es: 9.2 .:. NO D. DISABILITY INFORMATION Only applicants for total disability retirement will { t wieeni (st res f tati 1 C.AtHf ficoin yenj complete Part D. J** fC1S RIPF T.”
“ronglty C. G. eto.) -.**9*1 i." I "ether det-eitiun u tie 0190, " upsetrite. army 32289456 29. dlive yots went bonf -hie henrejent or brood to resign for mis X IF YOUR ANSWERS TO T911°1 CUKSTION (23., 3rl) INDICATE THAT YOU APE ENTII! M1) [ , VFFPA’ I+HII+I! F * C11 PFIFFVENC”
“separation.' or violation ( it the name andthe losofires court, (4) the penalty C. G.. etc.) Iinpri it any or other Bistoaiton fhvee case. If appealed your tirgerprinte will be taken 29. Have you over lean dischorjo) 4 jorewd to resin for D.l- IF YOUR ANSWERS TO THIS QUURTO”
“red X ,t. colutrin , TES I NO It your answer is ’ Yes, give in Itvern 3s ie for retirement ‘ theat ia carter eig-ficoticil dim-ak bity co by recai .: volinhafy u> afi- 37. ('it J you servetiti the I: ′; M h’s'. cor Nervral Sons vace i'it- voluntary antmatcal'ati after ', years”
“sheet.).............................................................................................................................................. X 35. Do you live with, or within the past 12 months have you lived with, any of these relatives who are employed in a civilian c”
“natum € *hser otters ! .(Arn r Navy, M G. '4 Gefairra-1 or violation 1393 the home catui k- iiii.ut .4 the curt :4 them pawiiity : Ic G sc ) irpeomw* 40 any for other fiazmiaation of the .• your hiruerprints will tay taken It titqaarenj 1 Navy Ensign 1445046 1 USHR 20. Hav”
“force to resign kie ns- IF YOLY AN’WFV’: TO THAT’. G*!v „* «N, ‘969) JPJTNTC -ATP THAT Y09 ron-fuct or wheat 1 I tory oor de n b'do any jasition?. .. __ __ AM I’Clh ET) TO YFIIKAN Pk-PPvet * 3" II IVU FWIN K WILL Ft CMM.RHJI THE F.XA14.11A1108 F APB-1NT1.D, 19/1) WII I Dr PRCCl”
“)4-00000 21. MILITARY STATUS A. IF YO‘1 WAVE REE • 1V Fitf APer" FORCES OR IN fHf miCkANT A- b. SERVICE OR SERIAL NUMBER DINF IN mitaT FPVICF sup 35A400 Dit 100 5ERVE7 (e.a. v.s. Army: Piold Artillery) sim ene 6. CATL OF (9797 00 adt 70 bor? f. VAT OWHANE Af fimt of - n. D”
“DPN 101H1D P 290 99 If you are a WAR-TIME VETERAN not claiming disability preference, THEIN piGer: ,9 • ‘at M^MUHiGN of Tur UNITED STATPsrM’A sr e. you ahevuate NOT submit your dierharge with this epplication - Preference will he tentatively credited to wort orid if appointed,”
“SUBMIT P.COF OF DISCHARGE OR SEPARATION 30. Do you revel so an annuity from the U. S. or D C. Government WITH THIS APPLICATION under any eireent actor any pension or other compensation y. ke miliar, or moral tree?........................................ ...-., Indicate "Yoe" o”
“.......... - 2............ . 1 1.• -x -rim e n -F^ff.^Kp^T*.^ - *p- , F ». t.. 1 . 1. .. 12.. a INDICATE “YES" OR "NO" ANSWER BY PLACING "g" W. SPACE FOR DETAILED ANSWERS 70 OTHER QUESTIONS __ IN PROPER COLUMN YES NO ITEM WRITE IN LG: COLUMN RUMBTRS or ircks to Wa”
“in each case 28 your answer is “ Yos,” give dates of and reasons for such debarment in item 13. 12. SPACE son M TAILED ANSWERS 10 01 HER QUESTIONS (le dicale itotn Aumbsea to which answers apply) ITEM NO. / Ns NO a 22 14 TEXT INSTRUCTIONS TO APPOINTING OFFICER.—You mus”
“ennsuifaraton can be given to your physical fitness for the job. The information contained to the answers to Questim 37 Dinive list been vest- fed by comparison with the diselsarge certificate on ...__ , ....... 19 34 ro wo. PECNIVE A* sum007 Puna tus i wr© gTarFe on rortpice ”
“fremn us for FACH such ro'a- liver €22 full none (21 present adkirece, (to reiuonshtfr, (4) do- partrzent or agency by whom employers, on i (5) k.nu of appoint- mient. • THIS SPACE FOR USE OF APPOINTING OFFICE ONLY The information contained in the answers to Question 33 above”
“z ...... a f. ...... z___ 1 I______ ._ 1 INDICATE “YES” OR “NO” ANSWER BY PLACING "X” 10. SPACE FOR DETAILED ANSWERS TO OTHER QUESTIONS____ IN PROPER COLUMN YES NO ITEM WRITE IN UFT COLUMN NUMBERS OF ITEMS TO WHICH DETAILED ANSWERS APPLY NO. y 1 ON TT FCITMP-SM----”
“for such deny other pro x United States,o the United Soni: ot X 32. A. Have ven ever been discharged from employment because: 1/ , 12) 104, conduct was not satisfactory? u/ ship: .X 125 You, werk was not satisfactory? X ip or L B. Hzv we ever resignel after efheisl non”
“14-00000 21. RI I I A I NCF % —List t’oree prmes living per the t’oned Sraten eve Territories of the twh-d Rates who ore NOT RELATED T0 You AND Win HAVE D911N1EF KNOW 111k.! of your qualifications and fitness for the ProrHu hor ott tva are applying. INt nut repest naies of sur”
“e td a s a e s t sA#. _ 6. DO YOU HAVE A HISTORY OF MENTAL 08 DESVOUS DISORDERS? Lyes KXro ARE YOU NOW OR HAVE YOU EVER DESH ADDICTEO TO THE USE OF HABIT FORNEHG CAUGS SUCH As wancortNS On ARBITURATES? • YES LX NO ARE YOU sw OR HAVE YOU EvEA BEEN A CHRONIC USER TO EXCESS or A”
“apronrucut IF OFFERED, ron 1 70 I MONTHS 1 to • MGNTis tth € TO 12 WORTHS DIF YOU WILL ACCEPT APPOINT MERT IN CERTAIN LOCATIONS ONLY, GIVE ACCEPTABLE LOCATIONS. NOTE, Acceptance or refusal of a temporary short-term appointment will not affect your opportunity to obtain a prob”
“yes-evet has tuberculosis? If your miiser in jn. 2’), or 30 above it "Yes," give oletsarli in Item $9. 9 1. Hheve yord gyrt hern barred by the |.' S Civil Service berseovsavar,” fvesten taking gndefservati etring crvil service appointment? (Ij your anivor it "We," give od.ste”
“PLACING "K" I YES NO ITE IN PROPER COLUMN * werttfe UTT COLU9N NUMDER3 OF ITEMS TO WHICH NTAILCO ANSeTrS APPLY 6. AnE YOU A CI nu Of on 00 iou on € ALL Giant TO fyt iartes srator. . C, ADU. YOU UNOFFICIAL on EMPLOYEE or ally STATE. 70 R>;torcr, CrANT7, CR : X MOHICIPALHI Y”
“perloite <4 uneingloytent. (a) It-ygas were evereanplarred in any position under a name different from Experience gained more than 15 years ago which is not perartit *p the wort that ahrore _o Item 5 ot those application, give under “Drsption of your ras for which yond nie appl”
“adjudicated in a juvenile court or under a Youth Offender law.).................. •........................................... •.- 33. While in the military service were you ever convicted by general court-martial?.................................................................”
“2. 1. I....................... 1 2..................... IIDICATE “YES” OR ‘NO" ANSWER BY PLACING "X” 10. SPACE FOR DETAILED ANSWERS TO OTHER QUESTIONS____ IN PROPER COLUMN YCS NO ITIM NO wane * LEFT COLOMN NumerKS OF ITEMS To WHck DrimiD ANSWERS APPLY $ %ARE YOU A CI”
“complete under Itom to. rost ornct ADDRESS POSITION () TEMPORARY on NOT MAR- RELATION MANS (Give otroot number, if any) DEPARTMENT ON AGENCY IN WHICH RICO StcLE EMPLOYED SHIP (Chook one). 1------- -2 a %- 1. 1 1. I.- a - INDICATE “YES” OR "NO" ANSWER BY PLACING e”
“yosra' norvie • ciat of retirement trua posrelise ONLY, 'IH f'. . pornc.pate in a com try and under •‘** tel rotent 'ii'i, utui reftirg it roared from poign or erpedition and rer.en f* s raznpeiegti badge ‘it intlitory or naval raryice servicerikamil 04 Are you <3 disabled v”
“WITH WHOM YOU LIVE ya WAsE LvEO WITHIN THE PART UMONfHB?................................................ 27 APE You wry on WAVE YOU,T VF N rrw A MI MDER or THE COMMUNIST t/ your answer is "Yeo,”" show in Item 39 for EACH such PARTY U S A ANY COM VUN131 OBCANIATHONT - , solativ”
“TOGETHER WITH THE NLCESSA£Y :8OO SPeCikiti THKMUN. It your answer is ′ Yea,” show in ltom 3:8 I r EAc II auch rolls i hire 11 till note, (1) prosant address (.0 f vostic-ahitis (:) de- portuent or agency by whom en ployed and (32) kind ft apromt THIS SPACE FOR USE or APPOINTI”
“14-00000.1 <rawpep rows 57- Nov 1947 US CTYtL StpVIcE COMMISSION CATION FOR FEDERAL EMPLOYN. IN 97 P UCTION3 In order to prevent delay in eenrentermti-n of your arel instructions on the vrmeewren eerd regariling disposition of this application, to’rn, mower ‘ ey-ey quretian ”
“this’catlieride (Army; Novy, M. C., time ol spurution) ’r on violation, (3) the name and kontion ul the Court, (4/Cth-d srervalty. C. G., 66.) - .lingneed, if Any, or other.,disponttion ol the case, il ripptuted noir lingarpsints will ttokaui - "- % OSS Chief of Station . 29.”
“"No" answer by placing, X in proper oofimn YES ro 15. (c) U you will Goceil appointment in consain locations ONLY, give acceptable locations. 19. (a) Would you accept short-term appoinment d cHered he— 1%3a 3 *6 conta?.... 6to 12 mceasa?___X the Would you accept appointmen”
“prints wil/be toben X Army ER-17 214 704■ 34 AI ir You B*VtD IN Tiff unrre States vilstany OR NAVEL SERVICE 3*0 31 HAVE YOu QAN pirn pivent y, OR MDRED 70 PSu, OR MISCON DURING PEACETIME ONLY »D 7, fI»f<,pr( IN A CAMPAIGN OR EXPCDI CA/CT OR UNSATISFACTORY ARAVICE FROM Any M**”
“sheelta_be attas bed. lo and sale a part of tbit I application the names of till fifth vegwszlatswies, 411P( iatiows, -. (2) Your work was not satisfactory? . -mosemnents, groubi, or combination el Persons and dates af.mem- Iberibip. Cit e snmplete elet@ils of that efiidin the”
“ALLOW 69071 or 1 X TOUEVER net % O4DRt n to PVT RaIZ for CINLATES L res Th+f vox A. D: LATE OF ENTIV OH LhINILi INTO StHuICL CATE OF SI,PARAIION OR DAPAHARKOS ThA or ANT LAW. POLICE RTGUUATLW OR JCW4N2 CLeerad ***** TRAFFIC MICLATIONSFOR WHICH A FINE on FiR/it 4 CF 09 4 LI ss ”
“t8e job. The information contained in the answers to Queetin-s 37 shove has been veri- hied by comparison with the discharge certificate on ______ 6 C. 1 .. .... 19.4 3to Teo RECEIVE AN ANNUITY FROM THE UNITED STATES OR DISTRICT co co. vhra GOVERNMENT UNSER ANY RLTIRI 'UAl ac”
“in each case (D> ARE YOU A CISABLED VETERAN?........... X 12 HAVE You EVER BEEN BRRR n AY THE e % CviL MRVR’F COMrom It so, and you have not listed your disability in answer to FROM **ING I AWINA9* OR Arc PTING c • St REICE APRUNTYE NTS . Item 33, at plain in Itom 39 below. I”
“I a......... a INDICATE “YES” OR “NO” ANSWER BY PLACING “X” 10 SPACE FOR DETAILED ANSWERS TO OTHER QUESTIONS IN PROPER COLUMN YES NO ITEM unite in um COLUMN NUMBERS or ITEMS to winch DETAGID ANSWERS APPLY 13. 1 ARE YOUA CITIZEN OF OR DO YOU Ow ALLEGIANCE TO THE UNITED STAT”
“14-00000 STANDARD FOR 57 Nov. 1947 US CIVIC SERVICE COMMISSION /UCATION FOR FEDERAL EMPLOYE 9 INSTRUCTIONS In.ocilee to prevent delay .. se/tees-ee ‘4y+mitor- 1/3, afro- NUNwe g.pe-tvng Aingwoniticn on this application. ration, ansmef every guestiret *** the fow is clearly ”
“in Itern 19 so THIS SPACE FOR USE OF APPOINTING OFFICER ONLY thet conmdassiion son be given to your physical Atnese for the job. X The information contained in the answers to Question 37 above has beva veri- 14 to eras onrssrt p.90 ANNUITY FROM THE UNITED STATES OR SASTAKCT B”
“necessary, complete under Item 10. POSITW C) TEMPORARY OR NOT MAR - POST OFFICE ADDRESS RLATION RILD. SINGLE NAME (Give street number, 4f any) ELFARYMENT OR AGENCY IN WHICH sinp EMPLOYED, (Chook one)‘ %. a %. a. X %___ 2______ 3 INDICATE “YES” OR "NO" ANSWER BY ”
“willing to travel? ( Ch not affect your consideration —1 to 4 months? X __ Any place in the United States. for other appointments.) to 12 months? x Outside of the United States. _Only in (spify): metro area NO SOM X 19. VETERAN PREFERENCE. Artswer all parts. If a part does”
“intonation dated he below in sufficient desni to anct.e the Civil Service Commierton and the arroineng otticses, * agencies to determine your quolt cator 1 tre -* wewten tea in dpisying for which you are ditsying in the sow coonde tel sw describe EVERY portion too have hard U”
“type of appointment action, please submit to this office within three working days after the appointee enters on duty (1) application, (2) file covering any in vestigation or inquiry conducted by your agency on • preappointment basis, and (3) Standard Form 87 (fingerprint cha”
“or-gantettin that Service durila time of War? advoco’ye the overthrow of the Gorrene setet ca the United States bj were or violence? (b) lo the word "honorable” or the word “satielcctory” used in your diwhiiis or secanihe n popeta th show the type If your answer is “Yrs,” giv”
“9048L. DEVICE i . * w. * Pf °C TINE ONLY, 0/0 eo. PCI AT IN A zves:t OR ICC Det Ve UASAHSE CICRY StftViCk FROM Aten Po’lfidn! ........ ............ Le your answer in ""Yoe," dive in Item 3°9 the name uticf No tiGN AND LC4IVE A CAMPAIGN CADGL 0.1 SER.JCL RItacal...............”