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![handle is hein.jfk/jfkarch39865 and id is 1 raw text is:
104-103-07
STANDARD FORM 52
?MLGATED BY THE
A5- 0.cIVI SEri'cmmissaR
JANUIARlY 15o-VfrERiAi PERSOMNl1
MANUALWJ A17 O RPT
REQUEST FOR PERSONNEL ACTION
voa1Mm
REQUESTING OFFICE: Fill in items I through 12 and A through D except 6B and 7 unless otherwise instructed.
If applicable, obtain resignation and fil in separation data on reverse.
L NAME (Mr.-Miss-Mrs.-One given name, initial(s), and surname) 2. DATE Of BIRTH X REQUEST NO. 4 DATE OF REQUEST
TAAn3ty, Boris Dimitri nowm. 2, 18 a AC 9
& NATURE OF ACTION REQUESTED: -. EFFECTIVE DATE 7, C. S. OR OTHER
A. PERSONNEL (Specify whether appointment, promotion, separation, etc.) A. PROPOSED: LEGAL AUTHOR-
IXCIYTE AM rfW W TY
B. POSITION (Specify whether establish, change grade or title, etc.)
B. APPROVED:
FROM- L POSITION TITLE AND TO-
NUMBER B & caw) BVsO741
. SERVICE GRADE, AND
SALARY
IL ORGANIZATIONAL DPf n Stof
- DESIGNATIONS D D fj.et
Otn of an cha
11. HEADQUARTERS frA 2 Swum 9
leAbe tens D. C;
_] FIELD ED DEPARTMENTAL 12. FIELD OR DEPARTMENTAL [D FIELD DEPARTMENTAL DI
A. REMARKS (Use reverse if necessary)
B REQUESTED BY (Name and title) D. REQUEST APPROVED BY
Signature:
C, sIng J111031141 IIJfRMIOM i511 (Us e and telephone extension)
-9w *i~5Title:
13. VETERAN PREFERENCE 14. POSITION CLASSIFICATION ACTION
NONE WWII OTHER 5-PT. IG-POINT NEW VICE L A. REAL.
DISAB. jOTHER_________ ______________________
15. 16. 17. APPROPRIATION 18. SUBJECT TO C. S. 19. DATE OF APPOINT. 20. LEGAL RESIDENCE
SEX RACE RETIREMENT ACT MENT AFFIDAVITS
FROM: (YES--NO) (ACCESSIONS ONLY) CLAIMED PROVED
I 1 TO: 30620 STATE:
21. STANDARD FORM 50 REMARKS
22. CLEARANCES INITIAL OR SIGNATURE DATE REMARKS
A.
B. CElL. OR POS. CONTROL
C. CLASSIFICATION
D. PLACEMENT OR EMPL
E.
F. APPROVED BY
16-57832A](ViewImageLocal?handle=hein.jfk/jfkarch39865&div=1&collection=&method=preview&ext=.png&size=3)