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

handle is hein.jfk/jfkarch39479 and id is 1 raw text is: 4104- 286 SECRET (then 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 trande to C u d A MON DAY YEAR S V X7V TO CF . COST CENTER NO. CHARGE* 8. LEGAL AUTHORITY (Completed by CFABLE Office of Personnel) 9. ORGANIZATIONAL DESIGNATIONS 10. LOCATION OF OFFICIAL STATION it. POSITION TITLE 12. POSITION NUMBER 13. CAREER SERVICE DESIGNATION OM- &S 316 asS * 14. CLASSIFICATION SCHEDULE (GS, LB, etc.) 15. OCCUPATIONAL SERIES 16. GRADE AND STEP 17. SALARY OR RATE 0315 3 e. CO B~athlTh**** I8. REMARKS ***R ftm W39 OW z amab-%uer Dhe/88 R/W /Of Security Approval has been gt$4Wed fc the use contemplated b this request lagne fto deo 4t a amn 9 0 , hif Personnel Security Diviziq 9 5 9o r a n n a t i n , a y a s o ffn K y- W ea n e t o e los * - EIL4. '01ma X m 18A* SIGNATURE OF REQUESTING OFFICIAL DATE SIGNED I85. SIGNATURE OF CAREER SERVICE APPROVING DATE SIGNED OFFICER no. Stae C SPACE BELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL 19.ACTION 20.EMPLOY. 21. OFFICE CODING R2,STATION 23. ITECREE 2N. HDOTRS 25. DATE OF BIRTH ?E. DATE OF CRADE 27.DATE OF Ll CODE CODE CODE CODE CODE NMERIC ALPHABETIC JD. DA. YR. MO. DA. To. MO. DA. YR. 28.HTE EXPIRES 29. SPECIAL 30. RETIREMENT DATA 31. SEPARATION 32. CORRECTIOI/CANCELLAT IO1 DATA 33.SECURITY 13.SES REFERENCE DATA CODE RED. NO. I- CSC CODE T YPE 140. DA. TR. RD M. D. R.3 - FICA E ODAA 5 - NONE 35. VET. PREFERENCE 36.SERV. COMP. DATE 37. LONG. COWP. DATE 3XLNIL.SER. CREDITILCD 39. FECLI / HEALTH INSURANCE %0.SCIAL SECURITY N0. CODE r ONE M. DA. YR. MO. DA. YR. YES CODE CODE 0 - waIVR HEALTH INS. CODE - 10 P. I-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 P0. TAX EXEMPTIONS FORM EXECUTED CODE ND.Ta4 STATE CODE 1 - meno onK sON c VC - WES 1 - VIES ExtP* 2 - BREAK IN SERVICE (LESS THAN 12 MODS 2 * No 2 - MD 3 - BREAK Oa sEaVIcE (MORE THAN 12 HosI 45. POSITION CONTROL CERTIFICATION 46. O.P. APPROVAL DATE APPROVED a. 1 1152 Use PREVIOUS EDITION. 14) SECRET y A..RAt%;; k.. 1 JUN trai

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