About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline

104-10121-10213 JFK Assassination Records Archives 1 (10/19/1972)

handle is hein.jfk/jfkarch39310 and id is 1 raw text is: 104-10121-10213
  ase  No.-
  NDo not write.in this space)


Requesting


Backstopped


b tu ft I


Date: 19  Oct  72


U.S.   DOCUMENT REQUEST FORM


          REQUESTS   FOR  U.S. ALIAS DOCUM1%ENTS  FOR USE  IN U.S.
               REQUIRE   APPROVA    OF  OFFICE OF  SECURITY

Office:   FR/SG              Et    1T             ocuments are required: ASAP

     Registered Alias:
                                        -Wrte  out middle name, if any)

 address, if anv


If address is to be selected by TSD, list state and cities with which you are familiar in order of preference:

   First choice:                    filaryland Driver's   License

                                           0oI


econd  choic

Third choice:


Height:  5 ' 11 Weight: 198     Hair: Brown     Eres: Brown     Blood Type: A     Married? Yes

Glasses while driving? No - Birth date:_ 26                    Place: CPhoenix29  Arizona


Occupation:
           (Engineer, Intelligence Officer, Government Official, etc.)


Mexican


(White, Negro, Yellow)


Specify country where documentation will be used:

Documentation requested:  ry   nd) License   and   ocial
                        Itter   pertinent to


Seuri ard.
Clubs
    't -14


As a guide for issuance of appropriate documents, list hobbies, i.e., photography, bowling, shooting, stamps, etc.,

special interests, social clubs, athletic and cultural associations, or professional societies or institutions with which

you are familiar:


Signature exemplar in alias:
(Write name three times)


Supply proper photo or negative for identity document request if required.


    ~,
............


I


e:


,drs ifay


Mexican


non.


*

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.



Contact us for annual subscription options:

Already a HeinOnline Subscriber?

profiles profiles most