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104-10110-10651 JFK Assassination Records Archives 1 (6/9/1975)

handle is hein.jfk/jfkarch38707 and id is 1 raw text is: 
10-010105


FOR OFFICIAL  USE ONLY


PERSONNEL  SECURITY  PLEDGE AND
NAME CHECK  INFORMATON  RELEASE


I

I


K~1


       U
Checks were


FBI  ON I ACS I  STATE   PASSPORT   CSC [HCUA  OSII 051/4    &  G  OC .~

            ___            __           __________L


P - POSITIVE


     As a duly  accredited representative  of the Requesting  Agency named above,  I
understand  that all personnel  security information released  to me concerning  the
Subject by  review of his file, by  memoranda, by copies  of reports, or by any  other
means is furnished  in strict confidence  in connection with  my official duties.
Accordingly,  I hereby pledge the  following:

     1.   The information is for  official United States  Government use only  and
         will  be handled in accordance  with its classification.

     2.   The information, the  source thereof, the  identity of informants, and
          the collection methods  will not be divulged  nor disseminated to anyone,
          except officials of  the Requesting Agency named  above on a strict  need-
          to-know basis.

      3.  The information will  not be divulged in any  hearing or board action
         without  the prior written  consent of the Releasing  Agency.


DATE


  FORM 2689
10   IS9


ust PREVIOUS EDITION


(4.12.43)


FOR OFFICIAL USE  ONLY


NAME OF SUBJECT (Last, First. Middle)        REQUESTING AGENCY       DATE


DATE OF BIRTH       PLACE OF BIRTH                                   DATE F REQUEST
                                     I/_


     0                             v
       In                        __19,       National Agency  Name
on the Subject with  the following  results:


conducted


I


4,3 IF '7 ,


INEGATIVI E


IS

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