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104-10128-10027 JFK Assassination Records Archives 1 (2/8/1960)

handle is hein.jfk/jfkarch11381 and id is 1 raw text is: 104 28-10027


A


  SECRET
(When Filled In)


REQUEST FOR SECURITY CLEARANCE


N`ME (LAST . FIRST - MIDDLE)                                        (12Y28)  Y
   PHIILIPS,  DAVID  ATLEE
POSITION TITLE                         OITION NUMBER (31 - 36) OCCUP. CODE (37 - 42) G
   OPS  OFFICER                                               0136.01
LOCATION (CITY. STATE. COUNTRY)       ASSIGNMENT (OFFICE, DIVISION, BRANCH)
   Washington,  DC                    DD    BDivision    CS/CS Dev Coup
                 REGULAR   CONSULTANT CONVERSION ACTION    IF OTHER, SPECIPYe
TYPE OF APPLICANT CONTRACT  MILITARY                CONTRaCT  to SE
                        TYPEAC                    OFASIGMET  NDFUDSI


KXJ HQS I I S  I  I F' I  I V zu


NO. ~'es/cs


R


              PROVISIONAL FOR (INDICATE NAME OF POOL OR GROUP)I        SECRET CLEARANCE (S)
   CLEARANCE                                                          ----
   REQUIRED                                                                     .  .
                PERSONAL HISTORY STATEMENT  APPENDIX I  REQUEST FOR WAIVER   RECRUIT. CODE (52-84)
                PHOTOGRAPH(S)           APPENDIX II     REPORT OF INTERVIEW
                MALE - VETERAN          FEMALE - VETERAN                     VET PREP. & SEX (3)
VETERANS STATUS - _______  _______
                MALE - NON-VETERAN      FEMALE - NON-VETERAN


   PLEASE  EXPEDITE


   Mr             WH  Division,  advises that Mr.  Osborne  (Office of Security)  has
   indicad that subject would be granted imediate see              clear     , subject
   to poly.

   Former  Staff Employee.   Your  Case  40696.

   Presently  Contract  Agent.


   HAND  CARRY

   0   o
   O  OTL

                            SPACE   B) LOW   FOR   OS  USE  ONL


  RETURN  TO  CIA
Background Use Onl
  Do Not Reproduce


Pe


FORM NO.*
1 SEP. 5637


(9)


USE PREVIOUS EDITIONS     SECRET


NAME OF REQUESTER (OR OFFICIAL)
   G.M.  Stewart/hec


REQUEST NO. (1-sc
-E-8573  Dev Cot
(EQUEST DATE (6-Il)
8  Feb 1960
EAR OF BIRTH (29-30)
1922
GRADE (48*44)
GS-16
ORGN. CODE (45-48)
460
TYPE OF APPL. (40)
7
HDQTRS & FUND (50)
'1


I


(9)

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