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

handle is hein.jfk/jfkarch47048 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           Lt Clark AFB in Philippines 1952-54) J                       INDIVIDUAL NO.




                                                                               ORGANIZATION NO.


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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