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104-10115-10144 JFK Assassination Records Archives 1 (06/28/1973)

handle is hein.jfk/jfkarch72464 and id is 1 raw text is: 104-10115-10144 2022 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992 ( hen Filed In) DATE PREPARED . S REQUEST FOR PERSONNEL ACTION - 2.8June 1973 1. SERIAL NUMBER 2. NAME (Last-First-Middle) 057- GODPASTSRE; Ann T... - 3. NATURE OF PERSONNEL ACTION Disabiity Ret i renen 4. EFFECTIVE DATE REQUESTED 5. CATEGORY OF EMPLOYMENT Under CIA Retirement $ Disability MONTH DAY YEAR System _6iOL27 Rhigl 1r V TO CF7. FAN AND NSCA S. LEGAL AUTHORITY (Completed by Office of V TO VfVTOCF Personnel) F CTO V CF TO CF 3227-0183 0000 9. ORGANIZATIONAL DESIGNATIONS 10. LOCATION OF OFFICIAL STATION DDO/CI Staff Development Coplenent Washington, D.C. 11. POSITION TITLE 12. POSITION NUMBER 13. CAREER SERVICE DESIGNATION Ops Officer 9997 D 14. CLASSIFICATION SCHEDULE (GS. LB. etc.) 15. OCCUPATIONAL SERIES 16. GRADE AND STEP 17. SALARY OR RATE GS 0136.01 13 7 $ 23,642 18. REMARKS Subject has been on Extended sick leave & Disability retirenent since 14 June 1972 r cc: Finance and Security 1By SIGNATURE OF REQU OFFICIAL DATE SIGNED 188. SIGNATURE OF CAREER SERVICE APPROVING OFFICER DATE SIGNED M. D. McCa lu, CI Staff 6/28/73 SPACE BELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL . 19. ACTION 20. EMPLOY. 21. OFIICE CODING 22. STATION 23. INTEGREE 24. HDQTRS. 25. DATE OF BIRTH 26. DATE OF GRADE 27. DATE OF LEI CODE CODE NUMERIC ALPHABETIC CODE CODE CODE MO. DA. YR. MO. DA. YR. MO. DA. YR. 28. NTE EXPIRES 29. SPECIAL 30. RETIREMENT DATA 31. SEPARATION 32. CORRECTION/CANCELLATION DATA 33. SECURITY 34. SEX MO. DA. YR. E -CSC CODE DATA CODE TYPE MO. DA. YR. EOD DATA REQ. 0. MO. D. YR.2-0RGN NONE - 35. YET. PREFERENCE 36. SERV. COMP. DATE 37. LONG. COMP. DATE 38. CAREER CATEGORY 39. FEGLI/HEALTH INSURANCE 40. SOCIAL SECURITY NO. CODE 0-NONE MO. DA. YR. MO. DA. YR. CAR/RESV CODE CODE 0WAIVER HEALTH INS. CODE i-5 PT. I PROV/TEMP 2-R PT 2-10 PT. I ______ 3-INELIGBE ___________ _____________ 41. PREVIOUS CIVILIAN GOVERNMENT SERVICE 42. LEAVE CAT. 43. FEDERAL TAX DATA 44. STATE TAX DATA --E -CEOD ,f-R.M EXECUTED CODE NO. TAX EXEMPTIONS FORM EXECUTED CODE NO. TAX STATE CODE 0-NO FEVIOIJS SERVICE CD -E XM.CD 1-NO BREAK IN SERVICE 1-YES 2-REAK IN SERVICE (LESS THAN 3 YEARS) 2-NO 2-NO 3-BREAK IN SERVICE (MORE THAN 3 TEARS) 45. POSITION CONTROL CERTIFICATION 46. O.P. APPROVAL DATE APPROVED if' . A B2 1152 USE PREVIOUS EDITION U SECRET CLASSIFIED BY:_ 01-0332 [X-21 (Vi _ - r ~ A i - d s 'r ye. r'. r.i y.. O.X' 3 s eti yr).. Y . IJ UV®U U Ulv roduc9 h~. _ 9

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