Transcript of 104-10175-10179.pdf
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14-Q0000 104-10175-10179] 2025 RELEASE UNDER THE PRESIDENT JOHN F_ KENNEDY ASSASSINATION RECORDS ACT OF 1992
Cargfcton PROCESSIN; DISPATCH
SECRE?
KC-v Prf Nctijr A'Sed
To entis 6J intuiKG
Chief; WI Divisicn 06 i(lxc CQHiIID
GYro Un' DZUfjc0 XX M4cAMrs USB
Liq J.OI inCEKInt
TrOM 4bl-0
Chief_o_Station Lexico Cisy Biir'U
SuejeC7
iuEF_
NilnrQu3) . RIFTRINOTS
REFERENCE: A. HMMW -1l321, 13 Feb 1963
B_ HMMA-20931, 22 Mar 1963
1 Trangmitted under separare cover trwename attachments are the
following form8 t0 complete Headquarters" records on subject:
a Personal History Statezent
b Personai histry S_te_-8_: {ifzzndix I)
C, Report of Medical History
2_ Subject wa8 originally recruited a8 a cutout for the LIHUFT/2
organization. However , nis actual 'duzies for KUBARK entail far more :hhan
coatact and communication with LIHCFF/2_ He is an outside agent. 'Ic
addition to acting a8 the contact between the Mexico Station and thc LIHUFF /2
Institute, LIHUFF/l i8 respongible for organizing and directirg the KOWOLF
stuzent groups in the LIHUFF/2 project; printing &nd distributing o bropzganda;
planning and initiating student harrassn-ent activities. Since LirUFF ,!'&
duties are thoge of an outside agent, 4is salary was established t0 reicburse
him for the amount of tin:e it is necessary for bim to spend on LJHUFF
actvitieg. In this regard_it_is felt_Aeat_the_sum %f 5500. monthlx is Pot an
ercessive amount Headquafters is requestca t process 2 contract {0z
subject in this amount-
3.
Subject'g social security number ie2255-58-5889
RuteacG&z
Enclosure8:
22
a8 gtated above (UNDER SEPARATF; COVER)
x
21-6.117
DATI TyFu 37 [rmtoadd
Distribution:
WH, w/ende 29 Apr, 63 30 Apr 63
Oran7oh57uX Momik5
HMMA-ZUc6
CS Hudannto Ssiumnndt Copk
~4SFZTA
SECRET
201-60j993 221
? /Rc
'An3t
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SECRET
PaRT
KOTE: DETACH THIS_PORTIOM 0F FORM_AND_DLSTR UBUTE SEPARATELY
6741
SECUR I TY wo If Sxii secuR iTY 4. is not AvailabLe . #ave Form Mj. 85-5, 20 . Fb4;esxt
AppLicetiow FoR SCCI4L SEcur iTY acc:_HTS; cohpletes AS
Prov |DeJ 10 detailed Prccedukes. Qg
aocres3 0f REcEE) (Im U.S.) ADORIS$ 4n nono Kortoo
{6;
DIstptr'tton' SIGNTD OR[G AND Copr To FINKYCE: CoPT To CFNTPAL COveR; copr To FILE
313a Oosol{T{ J{viqus {0iti0um' SECRET
6
Ips"
2spoy =
58857
krloo
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Do Not Ure this Space Twis caTe (P llb)
Tssue5 @y Personal history Statememt
INSTRUCTIONS
1 Answer all questions completely or check #Ppropriale bor; Uf question i8 pot applicable, Frite 'NA Write ~Uo-
known" oaly if you do not know the as5er aad it cannot be obtained {r03 personal records: Use blak space at
end of fOrn lor extra delails 0 ay quesuz or which you have insuluciect space.
2. Print % write carefully; illegible or tncomplete fors will not teceive consideralion
3 Consides yoar answers carefully- Yojr siqjature at the ead o this fom 7ll certily t0 tbeir correclness: Carelul
completica ol all applicable questions 5J pemit {eview of your quallb ations to the best advantage.
secTiON GENERAL PERSOMAL AMD physical Data
FuLlnaE @"-ficst- Vidala) 2 ^ge seX Swichtrich_Alfonso Rudolph 47 iX i~ALe FemiLe
Iuletght Jeight Colortf EYES coLor Of Mrir Type complexiom Type Build
6'3" 185 Brow Browis Lig Med
10 Scars Ind Locallon)
None
6. Otmea distingushing paTsicAL Fe7TUREs
None
1i. CurrEmT ADdress {No., Su6rt Cuy. Zont Sut6 Ind Counit) 1J. permaMENT Redress (.Nj-, Stc63 Ctty. Zono. Seate
Counio) And Pmone NO: Toluca Highway Kim 19-1/2
(0 (EL Migueyito, Cuajitnalpa Same ?s (12-
Mexico DE Meric Phone7ZZA2 O8
current phone NG. 15- Office phore Nc, ExT . 76. LegAL Resicence (Siaro. Tettatoty 0+ Caniry)
2-77-470 6X 85-96-53 2k Mexico
I7 NICKmaMss 16. Other MaMES You HIvE use5
SPancho A! Ok None
19. indicTz ciacumstances Tirrhdina L7nzy M/TE,5} UndER Dhick You Mave EVeG Used THESE #ibes:
(Pancha through clege Nillcor & Tucson Ariz A-Usedtodace
TF LEGIz CHANGE: GIVE P^t7iculars777567 04 B Wto[ Autnarist}
SECTIOM II Position DATA
Ixoicate TMe Type 07 Dork Or Positiom FoR Jhich You ^rE KpplYinG
WcicatE The Lowest ANndAL CMTraNCe SalAry You QICL DatE AvailaBLe For Emplotwent accePT iu Mii 0ot 60 cocotdgtod (O5 HT Pillian Mth loet Inttanco +91att): $
inceate Your Killingness To Travel
locc4wo4LLy Fr{QuehtlY CcnstanTly Dtmer;
6. indicate Your #illikgness To ACcept Assigmmemt im Tme OlLoing Locations (Chocs Y) sch (t861 applicablo}i
#asinatoh O.c Antemere Ih u.8 :ratiin Locations Oml Y (Srrciiti
Ouidde {Oytinental V *
Inoicate GM^T acseavaTioms] You Gould PLace Om ^ssigtgenTs OutsideTMC Daghington Dc aaea
444 us pnevious Editiom:
Fes
Type,
TTt?
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2
Section Iii citizemskip
T;4TTe 07 0'ATA PLAf{ O7 0irtm s16. Comiit} preslm? citizensmip (Colaet}
D @c; 33, 1915} Chitzajua, ChbhZ Mexico_ U.S.A
Citizensk; KEquireo By Cate maturil ~iturjlitation Ceatiticate Mu. ized
0iath #aariaGE X 0imi7 "ereulr)derivirlve ANA NA
Court Tntuittg NatuatLizatizn Ce7ti7677€€ Ssued .T (C,67. 51018, Co.5im
NA NA
9.Have You MeLO previeus natiomality 10. if Yes, Gie Mave Of CeJntry
YES X No N A
Give prticular} comceanmg paevigus ~atignalitt
N.A_
I2 Mave Tcu Taken Steps 70 change Tc} 1j. GiJe particulaes
preeert citizenship X Ho N A
Ydu Have Applied f u.s. CiT zE oAID _ Cmat /5 paesent Status s Tour application(fini Pepto; EblJJ'
N A
OKte O. Arrival inus T6. port 67 €7TRT ON cassport O77 EM^T Cous,trv
1916 EL Puso, Texas Unklowi
To: Lagt U;5_ v1sa (No Troa Pltce 0l Lod4e) 09. Date VIs} ISsueo
NA NA
sectiok iv EDUCATIOM
Chece (K) Kighest LeVeL Of EducaTiom Attained
LEs} Thim High {CHool Ga ju4te Over To9 E*a5 O6 Collese No DegpeE
Migh {Gcool GraDuatE Xi BacMeLC? } Degree
Trade_ BlJyesd. Or Cdlyeaciil Jchool JaaduaTE Gracua?€ study Leadinc To Higher Dcgaee
770 Vn40} College 6e 68" Vist{o"} Oegofe Onctod" Deca[e
2 elementary SchooL
Mme ( 7 ElementaPT sfksol AcDrEss {€t57: sif0._Countm
Willcox Grammar School Willcox; Arizona 8
Ontes Af-erded (Fo05l8s7ei Graduate
1922-J930 Ik No
High SCHOOL
Nme Of Higm School 2.Adoaess FCity, 5toto, Couim)
Wlllcox _Union High School_ D Nillcox Arizona (0
DateS K7terdeo (Ftoa ond Graduste
1930-1934 xlres No
Name Of Migm scMool 2 . ^doress, City; Stto Counbr)
Dates ^tTENdeo (FomAndTj) gracuate
Te} No
ColLege 02 Umiversity Study
slbject CiTes ATTENdeo Cegree catt JE4 Ota Mame N location Op College Oa UniversitY Aec'D Rec'D Houa}
Uajoa Minoa "Rv To ISecettr} UillveFstry of ATlzona jRange Anmzl - Mez TU
Tucson Arizona Ecology_Hugb 34 39 pachelot 1939 Sem-
SfCTiot I cuITaLtd To #XGE
6'
% /es
(0it:
To}
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SECTION MV C(NTINUED FROU PACE
Graduate DegpcE B5871$ Beew Moted in Item Zmicm Required {UbhusiOm Of BrItten Thesis. {#ocate Tke Titl€ 06 TrE tmesis Amo Describ€ IT} CoktEmt .
N.A.
Trade, conikercikl And SPECUIZED SchOOLS
Mane Amo Addaess OF SCMOOL studt #r specializatich Teom Montms
N.A.
N.A
NA
1 LILIARY TrAinING (FuLL Tlhe Duty Im SpEciaLized ScHOOLs Suck ^s ORDNANCE, INTELL[Gence, collaukkcations.ETC)
Mane Nd Address Of SchOo study Ca Specializatisr Geom T0 Komtm;
Cav Szhool Basic Troop Ducy
Ec RgeilooKanza; Horse_& Mcchanized 1941 3
Cav _ Advanced
E_Riley_Kansas_ 1942 3
Sounad LeGegilbith_Kah
G-2 C&GS 1943 3
O7hER Educational Training Kot indicated Above:
War Dept. M:s-X Intelligence
Fort Hunt, Washingron, D.C. 1943 6 months
sectiom V Foreigm LAnguage Abiltties
Competence Ik Order Listed 1.Lguage Hoe AcOuaEd R-Reed, # Veite. sSpook
(Llst bolom ech lanqusje 6
shld You P3488j8 m> d26#v squiy- #luent
0i codtatanco - Indicps 1u alenT But Adejuate Adecuite Limited Pro ComtACT DE To ObyiQusL 39 80? KNog Gnive Longe? TSw
KS;;;
prolictonty {0 Road: Woue & Faeae, coneign reseircM TraveL Ledge aF RES" Spdek %7 Nocine rhott C) coumtry IDeYCE ~x; laooo}
In {6o Opardanlc Darte})
Spanish X Ix {X X X X
Tou Mave cmecked Academic sTudy UNDER Mob acquired Moic4tE Lerg Ano intensiveves} O7 Tuot -
years high school
2earscollege
Vou Hive inuic tE] Luenct Gor LanGUAGE Movin? Jigmificamt Ditcerences by ScokeN AND Jaittey /orl: EI-
Ai TOuA coetence Thereim:
NA_
otszride" vour7ol,t 7o Wo sotc nLuzed LaNgu Tz Gorr Trvoi7tS= Cocadularie} ANo TcrlNoloov 5 trI
iic. {Moineerisj. telecomuumications: Militar, 4Rd Mea specilized Fielzr
Business terminology wrlte _ speak read & translate-
Soclo-Economics write speak read & translate.
JOu Mave Note? paociciemct 1y Lanquaoe. GOvld Tou De Gillirg 7o use TMi} #bility iN Gmt Gonton,Qoa
Tou Mgmt 0e Jelected' TJ K0
TM
01
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Section Vi ceograpmic Area KNozLedge AnD Foreigm TRAVEL
List 0ELo? Eoreusr Eegiohs Or Coum7a-ES /7 "Mich Yeu Have TaaVelLed PrCaimep "Aarg8 0} RESULT Of
Resisedfe= StuDy 0r ~< AssicnuerT_ {bcATE TyFe 07 Khosiede sucm AS Teraain; HaRB Utilties, Aail- Roaos , insustries. Pblfical Rarties. ETc -
Krc#Ledge #covired 0y Dites Op Mame TTPE 0f Residerce Datz} 4nd #ork region Or counTrt {rCialized Krotleoge op Tr^VEL PLace o7 sTuDt Aes Assigm DErCr Traveli{Tudt MENT
Qastnal - Bs. 1949=
Mexicn Socio ~ Economia Presenc NA XL X LX KX Polities
0 Business
Pawama Terrain : RR 1945-1949 NA XLX
China FexBitZonditions in 1943-1945 NA XLxuxix_
Tezrain
Cencral Amer Local Condicions 1946-Present NA
Imdicate The Duapose c4 Visit_ Residevce OR TrateL i* EacM O7 Tme Regioms Or countries Listed ^Bove.
Mexico Business Work Assigment
[Panana} Business Work Assigament
China Arms
7. uniteg St^7E5 passpcat Mumber Amo E*rta^tion Date 16 issueD.
2i48036-Expired Augusr 20_1962
SECTION Vit Typing AMD STEmogrAPHiC Skills
1 Typikg(erou 2.shor T7A7G(Z6TV SA3Rtmb1?STSTEm Useo CPeck iXi Appropriste iTev
Unkow No Grege #p€edediTing Stenotype Othep (Seilp:
1 Jndicate Otrer busines #ACHINEs Dith ImicM You Mave HaD Operating Experience Or TraimiRG (Coavtozetor MieAoJERR Cin Purh Etlo -
None; =
97 L_
sectior Viii Special Qualifica Tioms
List ALL Mobbies AMD Sp*RTS in #M;ch Tou Baf ict J 3b Kiye 'ctiyely 6*87!828723. 2388472 Y3rr DRECE ZXCT Major Athletics Good
Horseback Good
Horse shoes Good
Gardening Fair
Brldge Fair
indicaTe avi special OlLifications Resulting Faom Expeaience Or Training #Mich Migmt Fit Tou #or particular Rosition On Tipe Of #crk:
{ICLuding Ootincss CQLDMENT Or Macrimes Gricm YOu #iY Mive Listed IN item?,scTion Vi' 4hy {pecial Tou pcssess ReLating To Oimer EolibreyT amd #Kchines Juch 49 Operation O7 Shdatoive Racio (H "ep{ol83485,854,VineNR.8 e8 } 5985 F3RAt?
LiTHE scientific Ard propessional devicesa
SECEClVic iTiaLed To PaGE
2/es
as
Riding
List
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:CTION Vjii COiTiiUED FRUv PAGF
RE 'Ol Nok Or Arve Tou E#e0 Bee , Licensed cR ceatipieo Membep 4ht Trade Or prcfession Sucm 4} pilot,
Electricinc, Radio Cperator TeA(c{r. Lagter. cpa, Vedica_ Tecamei UTC. Cres Xm
You MaVe ANs erEs PVes To AbOVE _ imdicate Kimo 07 Licemse AND $7,te isbuimg License (Ptvldo Lrendo RosoWy Nenbst; Enortu:
N.A_
Fiast LiceNse Or certimicate (Yer e Ento) Latest Licemse Or certipicate(Yow 0i [buw
N.A. N.A.
List Any sianific ^rij Rudlised VItedaljOf #Micm Tou Are The Autker (Do Not 3uni} Ccpied Snleu Rteniod' iNdicat
Tme Title_ Publicaticm Oate: ANc Ttpe Op. #riting (Notficiion 0 Serrrnr urtkckt; 087651 Intetott {lbjocus, Norlt Short
stortt: Ete)
N.A_
irdicate ^my Devices #Micm You Nve IMVENTEO AND Mtate CreTmer Or Not TreT ^Re Patenteo:
N.A
List Public Sdviking 0e 'AUt 5yps
Thraughout College and business career.
List 4nY professicyil Academic 03 Loorart Associations Or societies iN #rith Tou ARE Noe Or #ere Formerlt
Vekber: List Acacemic HoNors Tcl Aave Received_
Alpha Zeta Hojorary}
Bob Cats |University of Arizong
Scabbard & Blade 0&
sectiok iX EMPLOYMEmT History
Mote: (UST Last PosTaN FRST.) Indicure chranolog1co[ hi;lory 07 653lo5 at Ior p55t 15 yeart: Accormt Ior aIl periodu includine casus[ cmployanent and J perods 0l Oemployment. Give address and *tale shst you did during periodtel mnamploymtnt_ L3t ali civillan crzloymen by 0 larelen Govemalat,reqardlest 0( dslct. In campletu Ie 9, "D- scrtplia 0l Duties consider you (Ijnenco caretully and providc 07e4rrR- ob1ecllre sbtemenls.
ICLUsivE DATes tfr3 Ind To 8> Mc tuY{.) NME Of {Me_otimg Firm CR 4geRCT
LLLL63 Presenc American Camber of Commerce 2.7
J. adoress (No._ Stret, City: sut: Corntry}
Lucerna 78 Mexico D R
Kikg 0f dusiness Nawz Op supervisor
Promo:e trade & wil Exezutive Committee
OTitle Of Job Silart Or Eaanings 0.class: GraDE(I Faderal Sorvteo)
Execuclve_Vice Presideat 9680.
620 annum
descairTiom 0v Qu?e} Management & direction 60 Chamber P. RXDefend free enterprlse system. ] Ok
Coordinate committee work Promotc trade develo? will o8
10 Reatni Toa L {4V14G
N.A.
secTion [I CuTInUFd Tu PaGE
ees
ol,
god
good
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:sti0 tnLK? Froy ?AGE 5
inclusive CatES /f, Nua To 0 , *o anj *' } MaviCt Emploting Fiamor AgemC"
Seg5 .3949 Dc_3L_4962_ RC_Cola_Company 29
0o.S8nrt, Cily S5i, colnify
Colyrbus:
BuS,Le}s
Gergia
Mame Of supervisor
FSoft_DrWnk OS IH_Sranley
Gitle 0f Jo 1. Jeiiry 0r EAamings cLaSS,GraDE (Il Podorl Sovcr)
Gen; Mzr;_ Roval Cron SA
68
12.002 PEr yea-
Descriptidr cr Cu-ie; Directlo- 0f manufacturing concentrates Marketing. R dvertis
Developmenr Of sales. Franchising: Alexico and C. America.
Supergision %_2l-iranchisedorrlinz_plants_ OK
1J Ajoks For Le 1;#6
Transfer t0 Stares Preffered Mzxico.
ircLusive D4TES (fero ad To B, so ed Xr ) Mave Jf Employing Firm Or Ageme
Dec. 1946 1949 R.C Bottle of Panamal 29
Aooress(no_ Stra:. Culy: sme; Coonop
Panama Reo de Penam (0
Aimd Of buiness Xa0e Y} super' JR
'Boitling_& Sales -[Soft_drinks ex Boardof Directors
Title 67 JoB 1. SbLirt Cr Eaanings B. CLASS ORADE (7l Fedofel Servted)
49000 Per year
Description O7 cut ie5
Direction of Company.
1d- reasons Tor LeaVikg
Unfavorable climatic conditions.
inclusive 0a-e'fmr I To B> # and Yt ) MamE CF EmpLo irg Firm Or agerC
Doress Sertet, Swze; Ceunon}
Kind 0f @usincss Niue 0f Supertisor
Title Of Jod 7-SiLifY Or Earnirgs CLaSs GaadE(li Fadoral- Sonvdco_
Per
oescription OF duties
10. ReasoNs Dor Leaving
inclusive Dates (f767 ew4 8> %o ad Mave 07 mploying FifmOr Agency
^odress (Ro"87v7 S1r, Ctnay)
Kind 0F dusiness Have O7 supeavusor
TitLe 0 Jo0 0n ejaring} CLaSI: 0raor(1( Fodotol Socvcr)
780
SECTior LT continled Tu PaGE
ing.
Sezr; ing Co;
(o, Cur'
To . r}
cur:
4es
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Jzstiuv IX COt:Lzd Fkou PACE 6
Description Of 5u71E5
Re^s013 For Leavimg
ImcLuiE 047es(Fan maTo . Bv 5 4Y"-) rAT Of Ettployilg FiamoQ AerC
Adoress (3o Sut# Cry Mdc_ Com)
Rins OF 0UsINes5 11v2 07 svpervisor
Title O7Jod 1.Jalaay Or Earrivg} CL4 Cie (i 7oc0ioi
580tt^)
Pea
Cecrip71657 5u7161
J0 Reasok For Leavirg
TMCcusr57703577P777777776 Br *0 IyYo ) 1z 7TTT TTt676TG,1 Fiqv0r
Noores5 (7o 31cct. Cay: Storo, Cany)
Kind Of dusINEss 7of sUprrvgor
Tile O} OB S*LKrt CR Exrhixg} Elass: Grjze ( Fadari
Sanrko)
per
Oescriptio# Of Dutie3
ReasoNs7gR Cexming
4e Prior servKe Dith Twe FeDERAL Eoyeankent I5 NBIEABONE WbcaTe The
Kjwbea Of YeaRS caecitable 7o84p? U.3. Givhl Service Re7,a E7 [8Roott
Mave Tou Ever Been ciscmarGed cr AsKED To resign Fr7t I#t PosiTiOk Zres Cxo
Mave Tou Left Positiom UnOER cbeculstance] #mick Ou Desire To EXPLAIM' Coes Iho
Ip Youa Anster I0 Either Or Both Questiows (3 'Yes" _ Gtte Details
4"nxa
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Sectiom X Military SerVice
CurRert Draft STATUS X
^re Vou Qegisteped for TME :Patt Umder YeS SEl Ef1e service C_*;siFl selecfive service 49. TrE Umuveajal Lilitary Taaididg ANd Citro
Jeavice ACt 0f 1940 (40Gmdd mo
1p Deterred: Give Reasom Local Daaft Boaad 42-9r desigmatiot AND adoress
2 Wlttary Sebvice Record
current ^7sior Past Gps^iiatiomal MeSE ESskip
CmecK (Xi ^s Rarine Kir coaeT VermKm Matodilair Nat' Zrligm 8R945;;S Cr #il:
Mppropriate aaly mavt corps FBrce Guard marine Gur? quaro seavice
HIVE Jervedt XX
N6# {ErVing
2 Baanch Or Corps Of Above cmecKEd Orgamizatiomisi
Cavalry MIS_
J.Date separated Fpow Extemded Active Duty {Pad sordc$ {erchs-{ns'432.4,{NRE? ^CTI E duty in u.. Arred
(Poji 08Qnzoni {0iYic 6-46 6 years
DaTe Entered past Service current service {E5,2f71T0 TCTAL O8 Kctive duty iy *Jrekn military
'ctive Duty
Jan_ 194L_
Grade Or LPaST Service cuaremt {ervice sE3vice. Serial 0p File Numbea (U naw torvtnd: poriet € CoL 6< I0l 0Ld) LQ-3 7220 02
Yaay #xa Rt DccupatiowaL past service C#RRENT eavice specialty 0 Detignator) ANjtme MIS
18 PRSt service Curreht SeRVICE DEzarr&
0
CS54845.0545
8-?Czi
brief Descriptioy Of Military Duties (Ingedio ntdtr #Fellessld 6 138t 0r Dted Krd'Co} Past.
Troop duty troop and sqJadron horse and mechanized cavalry.
Mlitary Intelligence War Dept. Assiged CBI (MIS-X)
12 CHEEk (X1 TTpE Op SeparATiOn FRou ACTIE Buty
Monoradle DischarGE X Retirememt Toa {ervsce UrDue Ha Iships
Release To inactive dut * Retirenent For Ccmbat D'sibility ctner:
Retiremert #or AgE Retirement For phtsicil CsKBiUtY
1J. check (X1 Comporert in #Hich You serve?
REguLaR X RESERVE (Includmd tho Natloxol &nd Atf Nutiana 03a X ~Her (Includna k53) AUS
J. HltaRY Reserve; MaTional GuaRD And RoTC StATuS
Fes88*88F 4F Yes 2. 45 Vou nce Vevbea OsTpe Yes 43E You NoT & Erxaer Off 4IU ST I7 Grc: Or 4R #37'L. REfots; mo GRo: X no X 'm
L If You Hjve Ansvered "Yes" To iters 1, 2 Or } AbCye; CkEcK ColpceT Memberser BeLOw
Xrmy Harine corps NationalguaRO coaSTGWiPd navy 03-8 imdicat{ Rotc categort Du 0er Nav Mir Force "1R naT'L Gurrd 'RYt Rctc Si Gorce RotG
currem}-RaNK; gaADE Or PAXE OF Appointtent In CurReYT 7. Expiratizk DATE Of Cuboent Reserve Delgy
rate Lr CoLLOX_ 194 tioy
3. chECK +K+cuareht #ESERvE category ReaDT Reserye Stamdb(AGtr4 X Standbteectlvo} ReTta[)
Faimary Nilitary Occupational specialty (4o 6 Dalt I8. {Eeon?ary Wilitiet Occupationm specialty 01b 6eo Meot} Amd Title in,860) Ard Title
ML Lonown
Baief Descriptiom Of Military Reserve DutieS
N.A.
RE You curremtLy Assigned Or AttacMEd Ye} 1. Iv Yon mave Amsdered 'Tes? To itev 12 Gie umit Or AGICY
9 Reserve; RAT L: Guarg Or aotctraim: AMd ajores} WG Umit X Mo
Kave You Vilitaay Hobilizatiom Assign" Yes I6 Yov Mave Amsbered Tes To iteri4 GWe Uni= Om AGurCY
Wemt1 Ard Aejress Ho
'#dicate TOTaL YilitAry service Yeaps Months GMI9c Kr[ YOur SeevKt Recoros Krpt Ija Lohgevit purpcses imcLuD |
146 active Am) iyactive duty Jnknbxxl Unknown
2/es
~LL
Pof
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Sectinn Xi FiMANCIAL StatUS
Kae You Emtirely Debewoem? 30 YoL? Salary7 Yc} 63
Tour Arsgea 5 'No*To TME m3ove: StatE soupces Op Otmeq i E3Me
Investients .
banKING institutions Vith #hick Yau HaVE Accouts
462 30 Instit-Tion ADDaEM (Cmt: StMlo, counrt)
Falls Church Badk Falls_Church_Virginia_
Banco NacionaL de_Mexico Merico_DR
Mave You Ever Bee i. Or petiiOmed Foa, BKNKRuptcy_ Yes X 49
5. Ip Your AnSGea IS Tes"* To Twe ABove; Give Particulars, iNcluD,# couat AnD Da7e/s}
GNe Tkree crecit RevereNces /0 The Umited Stefes
#ie Rdoress Oo, Jtmat; Cuy: Sete)
Fails Church Bank_ Fauts Church_Krga
(6 RC__Bottling of Baltimcre= 21 9Eas;_30rh s| Baltimore _Md
Popular_Dept_Store ELPaso Texas
7. 90 You Receive Am AnmuIty FrCY The Umited StaTes Or district Cf CQluvbi^ GoneRnYEnt under An Retirewent
ACT , Pensioh: Or CCHPENsAtiot =3a VILItARY OR RaVAL Seavice' vE} X No
Ip Youa Answer 15 ~ Yes" To The ^bove Cuestion, GivE Complete EETNLS
32 e4e Any { inancial MMt{Re5t Ix_ OR QeeKiAL Connecti3 Yith Nortu:s Ccaporations Or bus messes; Or In Gith U S. Corpoaatisksor 8JsimEsses KavinG jubstartiaZ FoReigh interestS7
Yes wo m Mue} "TES%; bnrvahn detatl m Gplao? #oe-)
seCTiOM Xii MARITAL StaTUS
P=ese#T StaTUS (557816 %medl Bdoved, Stprrered; Olnorced, 0 Ankd Specift: Married
2State Date. FITCE. ^ng Re^sC > FcR ALL sepaaaTions , divorces 5R anRULmEnTS
N.A_
MFE. HLSRAND I sou hotc 8380 parricd corc thjn occe inclotitnr amulnxots 0 spaatc #tect {6r Ioruet Bile 0
O FW:CE: busband giriny dats rquired belov (6r aIl preriot martieges- U Euinge coalenplated, fiL in #Ppopriate
inotraduoa I& fubsc_
Kave (Figt (Midat) Madm) (Lart)
RacheL Esther Williams Wichtrich
p6
DATE 6f Rarri O€ B+E Of Vaariage (city: Stotc . careerT} (6
D2C23 1938 Tucson Arizona Pima StyLSA
8. His (CA Meri Asdress Berore Maainge (No_. Simte_ Cstr. Stt. Carrt}
3300 Hawthomne S: Tecson, Ariz 4SA
Livins C4T0 O5 ceata Cacrse Of Death
Yc 0)
10 cusrent Aozress lcoi 441",7igtogod)
Toluca Highway_Klo-49 V2 ELMgucyito_Quallmalpz] Mexico_DF Mexico_
11_ Datf Of Q4a 7 ".FLicE CF Biaty (Culy Stelt. IX citizership
213/1917 OT Myoca Texas U.S.A U.S A
(O SECTIAV IU COTAtED TQ PAGE 10
s(es
{Cjn
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Page 12
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14-00ooo
10
SECTio: II COITIALED FRow PXGE 9
gorr 'outside Uas 54Te =6 [+7Ry PlaCE Op Ent#t
NA NA
citizemsmiptsi Date u.s_ citizemship i0 HEFr acquired (Cmy.Jue, Coso) 28387
N.A_ ~A"R;D NA_
Occupatiom prEseNt Edplsver(ano (i5} (36noi gr1plorrt: M Pprro d9coc8ed
unorployed 0# 4oi (Yo GiPiormi
Housewife NA
77. Employer"s Or business Aodress /No strect Stato. Colmtsy}
NA
12 Dates Of Rilitaay service /7eom @nd @0 3," 074 %i )
#sizGcn =
Of service courtay #itm Wmicm #ilitary service Abeiliated
NA N
29. DetaLS O7 Otrer GoverMVE77 Service, U.5. Ga (oreigt
B N.A_
secTios Xiii Childrem AND Other DepeX DEnts
Provide The Followikg intobsation Tor ALL Children AYd Depemderts
NaVE pelatiomskip DATe Mo AUO 0@rt @TizEm Ship Address
3-T4-40 69i TNawyOCS
John Allen Wichtricq] 6 Son Tucsop Arizonal US A {aestWHex;
Janer Rae Wichtrich O6 Dughrer 3-5-1943 69 L.8A_ Els-"s46 M
Ellen Anne Daughter
{24+w9.E2 #usA
MexicoDR 833935
Nuiam Guske Son US A Mexico_DR
3
Perrcia Jean]( Daughter Mexioo_DF USA Merico DR
Cmildrev {tnelez6c nunber Op Jther 8568*28%t8 '3887e8885 3472e8, 9
adoprod Ghildren) who
# Pmig M0r? Ortd 388, r8 3P35+8a
475+8F58 Under 21 Yas; Of 43e, 8817887+2. 8
{5
#F 791.88F 5# 7yp,re5 ArE Not 5 Mot seLR-supporting_ SeLP-sigjating-
secTiCm Xiy Fatker (Give Nrc inloruauon br Staolnthe? #52 83 Gero = sepatale shoeij
KAME (U,ir7Iri-Mddel 2. Living J. DATE Of DE"Th CAUSE O7 Deatm Fchtich7G5sT
S6 Ye} X 4O
Feb. 19532 Pueumonia
Clare"T ^odress Gicim Nu5tu 11 @rcalge (3a , su0ol, City' Staro. conity)
WilIcox, Arizona (7
Date Of Biath placE Df B:RTh (City: Stlc; Cotty) CitizEmship
1864 Gezmany U.S:
Ip Oorn qutside U5. O4te 06 EnTrt Io. PLacE Of Entry
Unknown_ Unknowj Le
1. 23-58775,76
date U3. Citizenship 1 7kere ^cojired (citv; 73616 Country)
German 9-13"8 Tombstone, Cochise Co. Arizona
occupatiom S. present Enploer (Q5-bii #mplortt; 4 Fotof Io dceoud 075r5plor@
Qwner_Sheetmeral Shop N.A.
86. {uplotea's Business doress Dr Tather '] buslyes] Aoores} Selc-emploted:
Willcox Arizona ( 0
1rOTte} 0 Militaat Jervice (Fco #To) T6. BraMCM Ot service coltat
N.A_ N.A X A
1. Ceails O7 OTwea GoverMuert J{Rvice, U.I Or coreiom
N.A_
'(es -
Cm}_
4e-ie3,B A&4
For
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Page 13
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QoooQ
Section Xv Mother (Givg Mek "f *f4ncn lor Stepeeuer on sepanJ[6 skesl)
Iull RamE (Liippinpyddt) 2. Liming 3n7e Op Deatm ca s 08 Di4tm
rza_Fermina 0 6 #EJ X mo Feb:J951 Paeumonia
Quracmt ^Ocress Guvelrast ^doress, If] decetseeT7no:, 31577l, Cws: SWfo. Cotm(o)
Wiulcox_Arizona (8
Drte 0v biATr pice 67 Birtkt(ct) Jibt6. Counirt) citiereir
1874 SChihuahua] Mexico, DE US_A
Borr qutside U.3 date TTntRY (0 {d. FlACE Of Entay
Unknow El Paso, Texa
Bornee citizemshipis) Date u.5. citizenship 1 TGere ^equired (c,et. Sib76, 663I65
[Comtrtt] acquired Mexican 1L241944 Gi_ Bisbee Arizona
Occupatioy 'Mpresent Ewplgyer (Qitg 'd Erployers Ii Mohos M1 @coled 0 Vddouu)
Houseuife NA
J6 Emploter'9 business ALdress Or Mother's Blsiress Adores I6 SelF EmpLoted
NA_
Dates 07 Military service (FrogndTQ) 8raNCK Of Service coltat
NA VA
Fo. Detail] oF GTrer GovermmemT service U.s. BCreign
N.A.
section Xvi Brothers AND Sisters (Iniuzmne Half Stcp &d Adpled Brothen and Sus{ers)
T.7ulL Mare (Ldtf-FinIsMiddle} 2 RELATionship Ciazer{hip iCmam} Mrs_Margaret Andersoj OC Sister LS
CurrrrT ^odress (No : Stcott: Cn7; Zono; Seete Camtty) Living age
1037 Olson Sz; EL Paso, Texas (0 X Tes Ko 54
Tulc NamE (LSI WMidlt} 2 Relafionship Citizensaip (Cormity)
2
MraJCharlerte Edelmaue6 Siser LS
cuaertt ADoress (No: Suttt; Gtry, Zeno: Sule Canty} Living AGE N.A_
YeS X Ko
cull JAne (Luit-Flut{ndle} Relatioyship 1. citizesship (calnttv}
Mrs Mary Thama Pauer 06 Sister_ U.S_
curRErt ADOress (No Sutot, cTr} Zont: Suete: Camty) 9. Livitg 6. AGE 228 Nozales: Santa Barbara, Califoria (6 X ES Ho 52
Kull PAvE LobrFD-ldae) 2 Relationship citizership {couuy)
Mrs Sherman Dent 06 Sister_ LS
ScuaIRT ^obRess (Nor 57k86 City: Zens: St050, Cer uT) S. Liv;eg Age
B228 East Almeria Rd Phoanix Arizona (Q TES #0 LSL
TULL RAvE (Los-F mi-Nidcl Relatiomship Citizenmip (Colniry)
~rant IYichtrich_ 06 Brorher_ LS
CurrEnT ^jdress Stl City: Zono: suu6 Comttt) 9. Livi#g AGE
Los Angeles_Area_(Address Unknonm) TE5 40 50
FulZ Rave :Wrf|mt-Hiddi} Relationship Citizens ip (colnig}
Gus_Iichrrich 0 Rroher U.S
curaent Adzress (nest Strect, Citr: Zoncs St8t6 Camtty) 9. Living 6. AgE
V€ $ X 40
FuLL NaME (LatF uut-.tddle} ReLatiznship J- citizeysaie 'Countty)
cuareyt Aodress (Na} 3inet; clty: Zono: cani) 5. Living age
Yes Ho
FuLL Mane (Luit-Fmu Kidule) 4 @elaTiomsmip J. citizership (Corntt)
cuaaemt Kodqess (No' st0376. City; {onos S0e18 Canntty) Litimg age
Yes #0
FuLL Jame {LairFlni-"dddt Ceratiomskip '. cititemshi (Calnit}
CunGeCT ^coaess (No; 30346 Ciit: Eonos S0643 Canit) Livina Ngl
Tes X0
I/es
Espa
or
3t18t
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Page 14
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14-000QQ
12
SecTiOm Xvii Fatmer-iM-LAT
'ull 4Av{ i1rfostat:tdls } J.c"tE Op Death :iusE Of Destm
LWilliama JohnVeod 'L} X 4o 1944 Stroke
EuabemT 23 45, Accress {303 Skeci: Cily: S.0t8, Cami)
Demi-g_New Mexico
datE Of 3,T PLiCE 06 9/9}7 301. Connsv} citizemship
Uukaow Ronc Georgia LS
JorN 0J7MEE U.. Date 0f EmTR 10 PLAcE.)f @try
N.A. N.A.
Torver citizemsmipisi ate UJcitizewship ICQjired #ere Acjuined (CJy: 51018, Colntty)
[Couum(looB NA_ N
Occupntinm 1s. Pr _ 797P10777776,76 Taw Eploytt; Toihtt-I-Lit 10,.0008180 6 mamployed}
cotron_ginner sef
Section Xviii Mother-IR:LAG
EuLL mavE {LMI-FIfsf-Middlo) 2.Limf; Da? E J6 Death cause Of Death
Williams, Lucy CSC vE} ix 40 1918 Flu
JurrEXT CR Last Adores} INa: Siisot, ctty; 3016. Cannity)
Temre Arizona
Date 25 airt- 1.PLaCE Of 9iRt3 {ciy: S(01*, Colrsv} 6. citizenship
Unkno Virginia US
iF Borm0jfsiSe U.S. DITE Op Entry {o. PLcE 67 ETry
NA NA
M:Torker Citizenskipisi 12. Oate 4I citizensmip Acouireo Ij SreFe ^cquired (Cry: S{88e: Countoy)
[Canty(bw2 N
Occupatiom 15. PPESENT Employe7 'cin Moer employoi. [[ Mothtrm-Lav 00 @enddad &1 unemployed)
House_wiie V 4
SECTIOk Xix RELATNES By BLoOD MaRriage OR ADoption Who Either (1) Live ABROAD:
(Z) Are Not U.s. citizois Or (J) YorE For Foreigh gov Ernhent NA
FulL Njve (Lst-Furss-Middlo) Relaticnsmip ) KgE
Address Oa country in Bhich relative Resices 5. Emploved By
citizenship {Colntty) Freqdency Of ComtaCT 6. 67TE Of LAST ContaCT
FuLL MANE (Las-First-Mtdllo) Rel^tinnscip 1.^E
adoress Qr Country (RGmicm RelativE Rem3e3 Employed dy
citizensmif {Coenlay} Frequerct 56 Cohtac? Zag7 Cattast
ULL Nave (Last-F Int #utodle) Relationship 1. ^ge
Kodress OR Covntry in Ihich RelaTive Resises EmpLoyed By
citizership (colmitcy) 7. FReQUeNCy Of contaCt 8 O7TE Gp LasT comtaCT
FULL nawe (Laul-fusi-Middlo) Relatidnsmip ag
adoress Or Coumtry (M #mich Relative Resdes Employed By
Citiienship {Canity) 7. Frequevzt O6 contacT DATe Of Last comtact
ULL Nav€ (Lsu-f tos-Middb) 2. relationsmip
Aodaes} Oa counta im Imic relative Resioe} Emploted @y
citizemsmip 'colmicy) {requemct 06 comtact date Of Last contaCT
SFCTIOS IC contliled To PaGE [J
'cmy'
1les
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Page 15
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14- QoooQ
SEC? Iit CuntI:Led Froi PaG? n2
Special ReMAAKS; if Amy: comcerning aelat Ves Moted im Section Kix ^bove
relatlves [ might have in Mexico Jr Germany are unkowa.
secTion XX RELATIVES By BLooD, MARRIACE Or Adoptkon M* ARE Ik Tke MLitary Or CiML
SerMce 0f Tke United StateS
mne (Lrbkt 1bi-icalo) ReLatiomship J. Age citizemship
addaess (nom' {10306, citt} Suig; Counity) Type And Locatiom Of scrvice (1 Loew)
naME (LmtoP 58f Miadio) aeLationsmip AGE Citizemship
Adoress (Xa, 8t08t1, Cily: slto: Counltv) Type ^md LocaTOm @f Service (1/ Motw)
Mane (LoM; imoi-Mlcdlo) Relatiomsmip age Ci7izemsrip
^doress (Na 301079, citys Seato: Countoy) Type And Locatiom Of service (Ii Ooe
Section XXi ReferEces. AcquainTANCES, AND Neighbors
Lut Five CmaRACTer refe=dieEs_ not Relat es_ In{he U-5. Know YoU i#Tivately
Mane busimess Address Residence Address
(Lmutt lout-Xlodle) (So.. Sto0t_ Cuty and Sele) (19 Stteet end Strc}
501 Losk-Out Drive) l&
Sawley _ T Hiram G6 Colunsus_Ceorgia
SPranklin, William CO XOL East 3.h l6
Fallinore Mt
520 West Lewis) 7S
(Teeter__CarL7 OG Paoenix Arizona
Pres. Univ Of Arizona Or Warvil Richard 06
(O Tyn{loHfiz2ona
niv
Pistor, Williad 66 Animal Science
2. List Five peasons in THE U.s_ Ehd <42r You {ocially {LaTives_ SubervIoo} Cr {YpEC*EES
Sane businfss IQobess PesiDe*es 43*8e52 (Luet-Ptl-Middlo) (Vo Sbaol Cuy &nd Sete) (3a Strott Cuty Ind St6}
Bechtold Edward JoG
TTSIT Conrad Saueds (0
eusorpaTe8z
76 (Raven , William OG P.A.AL Miamt; Florida 'neeed
S N.
Elridz
UScott; Bil 06 LNNetio Bxrac88
Carlsbad Wax (0 (Pearson,_GeorgeJ26 Califorqja
lt, EdJ 06
dv;tsideRfdjoz.o
NestCaanan_Conn -
List ThRee meigmbors It Your Most Recent Norval aesidemce in THE N-S-
Mare business Aodaess Residence Aodress
(Loot-FersiMtddlo) (No-. Stntt; Cur Iad Stolo) (No Stratt_ cuiy GnJ sim)
06
18zi68 Gunston Ra Z7o
Pawler__Tedl Ilexaudria__Ya:
249 OrchaFd Drlvg (6
[Aurand_Perez) 26_ Fairfx_Ya_
64
24 (rJ
Any
JAO
cuy
Sc]
not
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Page 16
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14- QoooQ
secTiom Xxii cLubs, societies. AND Other Organizatioks
NOTE: Liti folet s8d eddtesss 0 #I1 clubo, soclelks. prolcsslonal scielies. emplotee rrolpt Or Orrmolulioab Of pny *icd
(Include menbetthip Ia. 6 blpott 01, DY MretnIIslion havins tradquarters 0 baxh I0 (oroien ounusy} {0 whicb Je
bciong 0r tsve belonged:
date} Of Memdertmip Name and cMapter (NNurbet, $tre0t, 2EREg/e.
Conu} Faom To
Sigma Chi Uiv of Tucson Ariz 1935 1239
Alpba Zeta
Bpb Cats
aEChb
Anerican Club Mexico D:R 1950 1955
Amerlcan Club 1963
merican Cnamler_of_Commercel 1950 1963
Knights of _Columbus_
SL_Paz's Cocil 1958_ 1963
sectiom Xxiii Residences FOR The past 15 YEARs
{240 4J1 Alj EncE irst 'cLusiT Dat
(Nunbrt. 56706, Cur: Stto. Camtov) Froy To
MxlcoDE Mexlco 3655 Sierra Leona (8 1949 1952
Mexico, D.F. Mexico -IToluca Highway Klm 19 +/28 (0
Cuajimaipas D.F
1952 1963
Panama Rd_P GoLf Heigbts: (0 1946 1949
des
Au-
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Page 17
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14-0000Q
Section Xxiv AdditioNAl INfozmaTion
88 7847988688 Or HAvE J JEYBeEAPY882"8FE Or ArE YC: Or W"8E7& ,Er%beEC MeYBER Of; cs [/Ea Suppce Beem AssoC Te? Tr &# iTical Ty O3ividuAl Oa Orgam iz4tior #Ah OvOcaEs Te4Cris Cyla 76ov Of Tce _ Verndzh 68 7{ UnTed Statzs OFCE Yiceemee 09 Otre #Ystit J5s & 4244s Or {07: 9y Force OR / 3Leree To Demy RersoNs Their Aigh Uoder TMe Cee;titution O7 TrE URITEDStA-I X
You MavE Amsgered YES To The Above Guestiom Explain
So. To what EKTeNt1 Po You Use Or wave
EVER Used ,8FoxzsN%h
#0
Modcrate
YES if S0_ To Wmat EITEMT) 98E78 You Use Oa Have You Used Kaacotics' I; ~0
Wave MouEver PeFt;irs BEEm Vevbeq Op or slppoated Or Mad Ary Comnectioms Bit0 ^ foreigm inTelLigence Orgam: ization ,Oa FtS Cves Owo INsvea I5 'Ves' give couplete Detrils:
Pe8 eFF; The Mares Of GovernmenT departmemts. ^geNcies Or oftices To #mich You MvE AppliegFor Et
sinCE 1940
None.
To texRoYAE-FocB8xtA ?2 ahy 0f The 38y5e Mave CONDUCTED investigation DF You. indicate Tme NaME Of The
agency Tpe Date Of investigatiok:
Note SPECiAL 1f yow 0n{78' i$ rES" t0 the foiloving Quastiont 10. 11 o 12_ povido tka Inlormotion roquested (ot ood
imstructions quesion On 0 erporato, {Igned ,Roc} ond attoch tho sheot to Ihis Iorz ia 0 golod evolopr.
I03 KavE You Y8FR,ov8-r+893;EpeE_{O7743 {Rouse: Exer#E57 Pe" EP; /8385 {5? JNRES5?PF2888R victed 7er8257 Amy Violatioy OptmelatotreaThan ^ Traffic ion im Tme united States Oa E}
{8c8R8,7347E,89 ,oUR3e City_ State_ country_ date. aTuRE Of OfFERSE KnD Disposition Of Case I* Witm Tme specixl instruetioh Xdove: X 4o
Yr #XE,g8x EYi8, Been Arreste 32894R7 3853+32 O_ Or OTyebyise Pumished Uwder Wilitary Lar Oa rec-
Descrige YCi and Provide uate(s) Os Occurrence Oy separate SheET IM Ac Cordance Nith Spzcial #structioms ^bove
N0
M5 Eu83936E4 #NemY8rAeE8 €.'Flperers_ In Y848488 Bfe888 ~en8ONE 8 8827 {elma Be R3485E8e8
Ex-
Tes
Plamation 15
"38E?
So_ Riae
3888485 Sy 7R858303978ix 888888R778
Om separate Smeet im Ac Cordance Qith SpeciAL iRs7 Ructions Above: X
Ko
sectiom XXv PERSON Be Notified Im CAsE OF EMERGENCy
I.NaME (Tiu-Hidjic-List) Relatiomship
Mre.fRacbel Estber Wlchtrlcb] 6 6 Wlfe
J. Koke ADEZESs 7.6 , 71r831 c#t Ion8_ 5t0t0. Counln) mome_Pwomg No:
Toluca Hlgtway, Klm 19 1/2 Cuajimalpa Mexlco D.F 20-77-47 0k
84ra;RoRREETNG; Sinast Zo5o. 5077, Cs3IT) indicate NaME Of Firt Or 6. Business Pmoke Mo. ExT . IF ABle Xmerlcan Chamber of Commerce W Mexlco (6
io;
Lucera Mexlco, D.F
29 (5-96-53] 0k.
1 case Cr O7gea CLase Tova Volr 736o477L, UE Notified.76 Sucm Notipicatiom
1s Not ccsiA, F8EE38E8
^6Le Xiee Cr He4Ltm
9878 SEASoNS pl{aseSq Mr or Mr8 Elen Clarldge 619-]6th St: N.wg (0
Albuquerque, New Mexlco (Glster l law)
6(es
Xlxo
G4
To
71.
#78,
{to 6 _ Lae
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Page 18
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14-000QQ
1}
Section Yiv CERTif iza7iom
YCN Kre InfORMed THAT The corRectmFss Qf shiy StatemeNT KaDE IN This AppiicaTion
Yill BE In{E TiSATED.
hovo mad 0nd urdrstond Itv iastructions. ICanily Ihat ru boragoing onsr77! %8 #5? &d cerrect 1o Ihe tidoa
inockoz' ed belicl. 20586 Ihat Ony misftatecymt 0 05t8b a8 to materiol f181 ~6ll conu1t1t graunds lo
dismusezl & glectien % opplicotion: alto undkosond Itm tolse solenem aod kerem moy b0 Penishobb b1
1a= (U Code; Tifla 16, [7 8986S0395"
DaTe Ov Wgmatures YRe
8 377216
3
7ZZ72L
67
sMwed ^t (cmt I4 J190o) InaturE Of MtrE
I} : )xz _
ZLL
SOTE: Uu % tollom1n8 sPac {or exlre deteus. Reletence eb €amtinued Item by sAilon Andsen buzber t0 which & rbtet
J9 } 30 n8me 1t Ibe cad ol the addcd matcril H,oddt:xasl spoce is requued usdaklfa A*ee} (be b8m6 s[ze 61 Wut
PeBe &rd !ien rch uuct 2438.
Sectlon XI (9) Shares In Ron Castillo S.h. Mexico, D.F.
Sbares in Telefonos de Mexico, S.A.
Section XXI (3) Only nelghbozs remaining in area.
7~ ll Suo #t ' k"
(|e4
0y
Gtz {axaz+
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Page 19
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14-QQ0QQ
PERSoNal HISTORY STATEMENT
~ (Appendkx I)
Lsted beizrv are names O[ crgankzallons Identliled by lbe Attorey General under hls responsbuty pursuant to
Execuyre O: #r 1045O, dated % Aprtt 1953, t Lst tbe names %t cach Iorelgn or domestlc organbzatlon, assoclatlon.
movement, 617J0 Or comblnatssm OL persons walch be deslgralet us Totaltarian Fasclst, Communlst Or subrerslve,
0 as ha! 28 sdopted or hevlog thow 8 pllcy O[ advocatk % 6r approring the commlsslon 0L acts OL force Or rlo
knce t etbers thckr rigbes under the Constltutlon Ot Lhe Unlted Btates 0 @ eeklng to aller the IOr 0I
soverment @ tc Unlled Btates by unconstitutlonal mezm
Each epplzant Or employee and spouse (II any) must renkev the followlng Hst 0L organlzatlons {or certldeatan
purposes eod %g On the last F286.
Abobams Llpors Erioda Bra bchool I6r Mutr 8toller Bottoj Kaacbuattu Abretsm Lncax &chool Chctgo: rlbol Brrdre-mberuson-&chmld} Deedt Comntteeo aautd comnre @ Ptov Bptt Nar Deleran Amerkaad Feoawa Lettus 4 tb Cotted_Bote 4
Deout Poopx, Ituotbond Aexchra (C0 Comauutst pauu- An
c Msocldte)
Anerican hqutan {0 Reconstrxoa 0 Yuboaberka Ioc
Ampertcad Dn0j= 4 tho Peder:o 0 Outet Marltto Calons Cuttarelt LmcrBtnly Detcato Conmlgeee
Amerkan ChnA Retlonalbst 7urv Cetorla Labot &bool, B5e_ * Dlnudeo Butet, @ap Irnctea
Anxerkc-n Comr-crto I0r Zuroptan Wertart Eallat (010 Bcsalst Culldtalo
cumnoBuerted Peoplet Bckty Worten Ferat
e74F ~- Lukcu M Liera Fode 0t Croethn Deredl Uo ~; ~J 1 [Nzo Bon to 0 Ccntr Coa c Anerian Crosthan Tore X~ ADIc0 Cot_ter [~f Bpankeb Rreetm ru Counc" 0* Crou Mc den Ameertad Comr[tt aT tbo Eotterra I 0I Jetd [n Ebobldlen, Ibe
Amerosn COEI e? I0t Yubqtlat Raler Inc ctN Jopacgee asscsum (Bektoru Cruo Ntpponyln ENl)
Cerin Jopedero Asocutca 4 Bouubers Crlklortls ADerican Corr-ec t0 Buntty Labor Caadltons l0 Laope
Aetkcan Counct % Democrotlc Otexce, {ormerl] tnovp 0 t0 Cet Ureatnttou o{ t Oerman-Amerko3 Nitonu Nuaace
Gtter Amerk Dx Councl; Oreck A7017 Conmlttex)_{or Xc (Enujercbe-Amerutanbecbs Dnbyfestoue)
ttopul Colsy Cetvtater Ynlernu TO et]
Lercn Coud-I 0 Bovlet Relate 1 Crts Ftxeto Appenj_ 136
47e7cad Croatax Congtes Ctosla Cultural Cener
Lnvrcap Jortdt Llbor Coudcd Clorsns Cormlttee {Cr Barz] Erlctd
Aertcn Lencur Aatst War and nrtna Clttrous Coramltud Q{ tba Cpz West sd0 (Nev Yort CIJ)
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14-QQQQQ
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14-000QQ
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14-QQQQQ
CERTYTCATOH
I certlly tbat I have fead the names & ttc abore Hste orzankzelcL
To the best 0t mJ Loriedge and belle I &m DOl, Dor bare [ biro 2 Zenber 0L, Ci bated recetred Ilter-
ature Iran , dered pezdons 0L or b bebzH OL, Or a*rEed meetz? Ot any O.T;artzca Msted 46076, Or aDT
organizaliop outsde tbe Cnlted Btates espsJ€ Comcanust, ?asclct, eltartan 0 Xc (xlses: except AJ Doled
belor.
To tbe best of EJ borledge &nd bebel; cone 0 5i} cote reletirer zre; nor bare €e: teen membert OL, cOD-
trlbuted 1. recelved Literature .Irom, dgped pettlong 0t 0r tn behall 01, & a-tended meea=$ Of any such organlze-
tons; except a5 noted bebor.
MSTRDCTZON8
For the purpase 0] $hls certlfcatlon If an pplicant or emplovee $ cpleltng thbs {vy, the term Fclose rela-
tice" will inctude spotsse, chlldren, parenls, brothets. Yrets, uncles. C-C cuts. ~Close rearzes" 01 tie bpouse, Ior
tnLs putpOs?_ wI &ckude children, parents. brothcts, rsteTs, kncles, C5: auats.
II there are erceptions t0 lhls certlfccton, set forth belotc undat :rmatks 0hl pert ent tnformatlon concern-
tno the nclure and €zr7t 01 YOUT actizite} OT those 0l IowI ciose Ies=zes & such 0rjezations, lncludtnp thc
name 0] the orgoniections, dates 01 mersershtp; mecting} attendes, 34les 0] positions hed. amounts and dates
01 contributions, tatle 0] Petilions signedl Jailing ulthin [he meantn: &1 tle abore cettiueation cnd citcuiustanccr
tnereo], Uites and author} 0f llerature recerted, and dctes 0n rhbch IExced_
In exceptions concerztng relatives, tclde 0nlv much mformalia presentlv Knotsr to pOU 0r aballable trot
otn tecotds.
It necesscsy; %e additional sheets and sgR each skeet Mrlte WTu If tnerte are Ro @rreptions
REMARKS: DEicOmpleted_bZ_Szpuse RZMARKS: Zotecomgetad_57 AELcart@ Emplozee
Ze21
Datc Dte JZ-4_3 1-2
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