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104-10255-10011 JFK Assassination Records Archives 1 (3/25/1977)

handle is hein.jfk/jfkarch18314 and id is 1 raw text is: 1O4.iO255~1OO11


                                   (When Filled In)


DOMESTIC  COLLECTION  DIVISION REQUEST  FCR NAME  CHECKS
                                                  NC  DCD/  5


TO     Industrial &  Certification Branch, Clearance Division, Office of Security

                                                                                DATE
FROM:   Domestic Collection Division, FO: San Francisco (DABartlett:mm)    25 March 1977

SUBJECT'S FULL NAME Last                       rst                Middle
                                                                                  US CITIZEN  ALIEN
               SHERMIAN                   Adrian              Fisher            _S
OTHER NAMES USED INCLUDING MAIDEN, ALIASES, ETC.

SEX           DATE AND PLACE OF BIRTH                                           SOCIAL SECURITY NUMBER
      M         31  July 1918,  Chicago,  Illinois                                     I   I
 CITIZENSHIP (Country)     NATURALIZATION NUMBER, PLACE AND DATE          ALIEN REGISTRATION NO.


                FULL NAME                        DATE AND PLACE OF BIRTH              CITIZENSHIP
SPOUSE
FATHER
MOTHER
    FROM          TO                      RESIDENCES - COMPLETE ADDRESS (Current and last 5 years)

June  1976     Present      655  John Muir  Drive  #406, San  Francisco,  CA  94132
Apr  1976      May 1976     1593  Haight  St., San  Francisco,  -CA
Jan  197.6     Apr 1976      (son's residence)  Clayton  St.,  San  Francisco,  CA
1974           1976         Bradenton,   Florida
From  1972  t  1974  subje t suffered   two heart  attacks  and was  hospitalized  a great  deal.
                                    EMPLOYMENTS (Current and last 5 years)
    FROM          TO                  EMPLOYER'S NAME                           ADDRESS

1970           1972         State  Attorney's  Office             Miami,  Florida

1972           Present      Retired





                                     EDUCATION (Colleg, Graduate Work)
    FROM          TO                  .      NAME OF SCHOOL                       DEGREE AND MAJOR

1935           1939         Stanford  University,   Stanford,  CA                 BA, Economics






PRIOR US GOVERNMENT SERVICE INCLUDING MILITARY
US Army  1940-46,  US Army  Nov  1948-56
OTHER GOVERNMENT  AGENCY CLEARANCES HELD                        kxl NEW REQUEST   RECHECK
1948-56   US Army  Top  Secret  clearance                        OS NUMBER AND DATE (Ifa recheck)

REMARKS                                                          -                 DCD HQ. USE ONLY
Subject                    it Clark  AFB in  Philippines  1952-54)  J           INDIVIDUAL NO.




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FORM 2941  OBSOLETE PREVIOUS
   7-73         EDITIONS


E-2, IMPDET CL. BY: 007622


1 - OS/CO
    MFG. 10-73


OS FILE NO.

  054  621
      (OS Use Only)


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