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104-10123-10286 JFK Assassination Records Archives 1 (5/23/1962)

handle is hein.jfk/jfkarch11184 and id is 1 raw text is: 4104- 286 SECRET (When Filled in) RE ESI-FOR PERSONNEL ACTION DATE PREPARED Q3 aw 1( 1. SE R 2. NAME (Last-First -Middle) 1071O3I44. P. ar. 3. NATURE OF PERSONNEL ACTION 4.EFFECTIVE DATE REUESTED 5. CATEGORY OF EMPLOYMENT and 2ran:r to C u d A MON DAY YEAR 6. FUNDS V V TO CF 7 CST CENTER NO. CHARGE- 8. LEGAL AUTHORITY (Completed by CF TO V CF TO CF 9. ORGANIZATIONAL DESIGNATIONS 10. LOCATION OF OFFICIAL STATION 11. POSITION TITLE 12. POSITION NUMCER G* . CAREER SERVICE DESIGNATION BOOM-1mat.. 0MIN@*3381< a M 1 S 319aS a* 14. CLASSIFICATION SCHEDULE (GS, LB, etc.) 15. OCCUPATIONAL SERIES 16. GRADE AND STEP 17. SALARY OR RATE 0315 3 1.see. CO B~athlTh**** I8. REMARKS ***s ft W3 z alanalb-41wir the/88 t/WOOf Security Approval has been gt$4Wed fc the use contemplated b this request Is o fto det 6 a a 96 03 Chief. Personel Security Diviqio( Alill 41Glattain 39M n 3R R .503 ag g * ***** 2= searet 18A* SIGNATURE OF REQUESTING OFFICIAL DATE SIGNED I85. SIGNATURE OF CAREER SERVICE APPROVING DATE SIGNED OFFICER no. SteC e SPACE BELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL 19. ACTION 20. EMPLOY. 21. OFFICE CODING R2STATION 23. ITECREE 21. HDOTRS 25.DATE OF BIRTH ?E.DATE OF CRADE 27.DATE OF LI CODE CODE CODE CODE CODE I NMERIC ALPHABETIC J0. DA. YR. MOD. DA. TO. MO. DA. YR. 28.NTE EXPIRES 29. SPECIAL 30. RETIREMENT DATA 31. SEPARATION 32. CORRECTIOI/CANCELLAT IO1 DATA 33.SECURITY 3%.SES MO. DA. YR. REFERENCE - CSC COE MIA CODE T *(0. . DA. Yr. E RED. 1o. MO. i. Y. 3a FICA T 5 - HONE 35. VET. PREFERENCE 36.SERV. COMP. DATE 37. LONG. COWP. DATE 31LNIL.SER. CREDITILCD 39. FECLI / HEALTH INSURANCE 40.SCIAL SECURITY 0. CODE N lEONE Mo. DA. YR. MO. DA. YR. I YES CODE CODE o - WAIVER HEALTH lNS. CODE - 10 PT. 2-mo 41. PREVIOUS COVERNMENT SERVICE DATA 12.LEAVE CAT. 43. FEDERAL TAX DATA STATE TAX DATA CODE CODE 0l No PREVIOUS SERVICE FDaR EXECUTED CODE 40. TA EXEMPTIONS FORM EXECUTED CODE V0.7a STATE CODE 1 - meno onK sON c VC - YES 1 - YES ExtP* 2 - BREAK IN SERVICE (LESS THAN 12 MDS 2 * No 2 - MD 3 - BREAK Ia SERVICE (MoRE THAN 12 1os 1 45. POSITION CONTROL CERTIFICATION 46. O.P. APPROVAL DATE APPROVED a. 1 1152 Use PREVIOUS EDITION. 14) SECRET 7 A..RAt%;; k.. 1 JUN trai

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