Transcript of 180-10072-10186.pdf
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JFK Assassination System Date: 10/2/201
Identification Form
Agency Information
AGENCY : HSCA
RECORD NUMBER - 180-10072-10186
RECORD SERIES NUMBERED FILES.
AGENCY FILE NUMER - 010313
Document Information
ORIGINATOR SOCIAL SECURITY ADMINISTRATION
FROM:
TO HESS, JACQUELINE.
TITLE :
DATE : 07/31/1978
PAGES : 64
SUBJECTS
OSWALD, MARINA; FINANCES, INCOME TAXES.
OSWALD, LEE; PRE-RUSSIAN PERIOD, MILITARY SERVICE,
COURT-MAR
DOCUMENT TYPE REPORT.
CLASSIFICATION Unclassified
RESTRICTIONS 3
CURRENT STATUS Redact
DATE OF LASTREVEW 07/10/1996
OPENING CRITERIA
COMMENTS Includes insurance forms, death certificate, & military documents of Oswald. Box 189.
Released under the JohnF. Rennedy
Assassination Records CollectionAct of
992 (44USC 2107 Note) Case#:Nw
38326 Date; 2025
v9.1
NW 88326 Docld: 32245128 Page 1
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DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SOCIAL SECURITY ADMINISTRATION
7o 30
US^ BALTIMORE_ MARYLAND 21235
JUL 2 8 1978 REEPo %-5-1
010313
Ms Jackie Hess
Select Comittee on Assassinations
U.S_ House of Representatives
3331 House Office Building, Annex 2
Washington, D.C _ 20515
Dear Ms Hess:
This is in response to Mr _ Blakey S 15, 1978, request for access
to all files and documents concerning or referring to Lee Harvey Oswald
and Marina Oswald. The following documents are enclosed:
1 Forn SS-5, Application for Social Security Account Number, conpleted
by Lee Harvey Oswald.
2 _ Form 8S-5, Application for Social Security Account Number , completed
by Marina Oswald.
3_ Numident showing name changes for Marina Oswald.
43 Form 04-C5, Application for Survivors Insurance Benefits , completed
by Marina Oswald
5 Certificate of Death igsued by the City of Dallas for
Lee Harvey Oswald.
6 _ Marriage certificate and translation) for Lee Harvey Oswald and
Marina Nikolaevna Prusakova _
7 _ Birth certificate and translation) for Marina Nikolaeva
8 _ Birth certificate and translation) showing child born to
Lee Harvey Oswald and Marina Nikolaevna Oswald_
9 _ 04-C704, Certification of Contents of Document(s) or Record(s) ,
re birth of child to Lee H Oswald and Marina Nikolaevna Prusakova _
NWN 88326 Docld: 32245128 Page 2
Tealtk, @oucAtION
May
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2
10 Form 04-C654, Certification By Uniformed Services
9
for Lee Harvey Oswald_
11_ Letter dated 7/25/63 from the Departnent of the to
Lee Harvey Oswald
12 _ Form DD-214, Armed Forces of the United States Report of Transfer
or Discharge
9
for Lee Harvey Oswald -
13_ Undesirable Discharge fron the Armed Forces of the United States ,
issued to Lee Harvey Oswald _
14 _ Forns 0A-C668 Claimant's Report to Social Security Administration,
completed by Marina Oswald on 3/27/64 &nd 5/1/65_
15 _ Form 0A-C669, Claimant S Report About Work to the Social Security
Administration, conpleted by Marina Oswald on 10/8/64 _
16 _ Form SSA-1425, Reporting Card, completed by Marina Porter on 5/4/66 _
17_ Forns 04-C777 , Annual Report of Earnings _ completed by Marina Oswala
for 1961 &nd 1965_
18 _ Form OAC-1OO1, Statement of Employer completed by Jaggars-Chiles-Stovall,
Inc
19 _ Form OAC-LOOl , Statement of Employer , completed by Texas School Book
Depository.
20 Form OAC-1O01, Statement of; Employer, completed by William B. Reily,
Company , Inc_
21 OAC-5002
9
Report of Contact, re contact with Jaggars-Chiles-Stovall, Inc
22 OAC-5002 , Report of Contact, re earnings under Jaggars-Chiles-Stovall, Inc .
23 _ Copies of three pages of the Warren Commission Report re employment of
Lee Harvey Oswald prior to service in the Marine Corps _
24_ Form O4-C790 , Request for E/R Action.
25 _ Memorandum da ted 6/3/65, re remarriage of Marina Oswala-
26 _ Forms SSA-L735 sent to Marina Porter and completed by Mrs _ Porter.
NW 88326 Docld:32245128 3
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27 _ Forns 04-C107 , Determination of Resumption of Award _
28 _ Forms 04-C5281, De termination of Ternination of Entitlement or
Suspension of Payments Based on Supporting Evidence on File _
29 _ Forms 04-C610, Payee, Address Change . or Hold Check Request _
30 _ Form 04-C526, Benefit Summary _
31 Form OA-C1o1
9
Determination of Award _
32_ Form 0A-C589 , receipt for check.
33 _ Form 04-C596, 1965 Conversion of Benefit Rates .
34 Form AC-512 , Appointment of Representative
9
completed by
Marina N_ Oswald and James HS Martin
35 _ Form OAC-5002_ Report of Contact, with James H_ Martin
36 _ Form OAC-5002 = Report of Contact, re Lee Harvey Oswald ' s death.
The above-mentioned documents are being sent to you in their entirety _
We have withheld only the records of wage and self-employment income
maintained under the direction of 42 U.S.C _ 4o5(e) (2) . This record is
created on the basis of tax return information received from the Internal
Revenue Service Under 26' U.S.C _ 6103, this information is given to the
Social Security Administration for the administration of the Social
Security Act and redisclosure is prohibited_ You may request this
information directly from the Internal Revenue Service
I understand that the Dallas Region has already sent you the local
folder on Lee Harvey Oswald_ We are also checking with the National
Archives to determine if it may have further social security records
on Lee Harvey Oswala or Marina Oswald_ To date we have found no
records under the aliases you provided- We will contact you if further
documents are located .
Sincerely yours
PstuwJ
Associate Commissioner
for Program Operations
Enclosures
NW 88326 Docld:32245128 Page 4
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Form 88-6 APPLICATION FOR SOCLAL SECURETY ACCOUNT NUMBER 433-54-3937
BURY DEPARTMENT
ERNAL RevENCB SEBVICB REQUIRED UNDER THE FEDERAL INSURANCE CONTRIBUTIONS ACT Do Not Writz In TKE ABOVE SPACE (Revlsed 7-48) READ [NSTRUCTIONS ON BACK BEFORE FILLINC IN FORM
FILL IN EACH ITEK: PrInt IN BLACX Or DARK BLUZ INK OR Usz TYPEWRITER FOR ALL ITEMS EXCEP: TURE IF Txe InForMATION CALLED For IN AKY ITEM Is Not KNOwn_Write "UNKNOwN
FRINT MAME YoU GNVE YoUR PRESENT FIRST NAME MIDDLE MANE FIDDLE MAME OR INITIAC DrAW ^ UNE DST MNE
EMPLOYER; Or] If UNEMPLOYED, THE Oswnld
Name You WILL USE WKEN EMPLOyed 42 RvE
MAILING ADDRESS _(NO. AND ST_ P. O. BOX, OR RFD) (CITY) (ZONE) (STATE) PRINtt FULL NamE GIvEN YOu At Birth
3
2 bhBNGES NO LB EZRRuE Oskeli
AGE On LAST BIRTHDAY DaTe Of Birtk (MOnth) (Day) (YEAR) PLACZ CF BIRTH (CITY) (COUNTY) (State)
Oct [8 [L32_ IEUL OnIens LA; 1
FatHER'S FULL NAME, REGARDLESS 0f WHZTHER VMING OR CEAD MOIHE"SFUL NAME BEFORE EVER MARRIED, REGARDLESS &; WKETHER UVING Or DEAD
Rbkt ZEE Dswa C2sLtRE CLELERY
1
(MARK (X) which) COLOR (MARK (x) wkich) (IF OEHER SPECIFY) HAVE YOU EVER BEFORE APPLIED (MaRK (X) which) 8
KALE FEKALE 10 0r WXITe NEGRO OThBR FOR OR HAD A SOCIAL Security 0r NO
SX: RAG RAILROAD RETIREMENT NuMBERI @
BUSINESS NAME & EHPLOYBR. W UNEKPLOYED , YRTE 'UNEMPLOYED" IF ANSWER IS "YES" PRINT ThE SthR 4042
State IN Which YOU FIRSt
APPLIED AND WHEN
42 EMPLOYER'S ADDRESS (No. AND STRET) (cTY) (ZONE) (STATE) ALSO PRINT YOUR ACCOUNT
DABaaer
Nukber IF You KNOW Mt
TODAY"S DATE WrII YoU NAME As USUALLY WRITTEN (DO NQT PRINT
13
RETURN COMPLETED APPLICATION TO NEAREST SOCIAL SECURITY ADMINISTRATION FIELD BFFICE
16 5528-7
NW 88326 Docld:32245128 Page 5
HAv
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JLC` 2
73+e0la Lidolic_docwIG DkJCJU LlCiL
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7?EDLWevnn
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017 Nrzw~36& RUsIoa 20
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57Jiz313654025
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73 629_83Tkon 60 Equaez2e I&v
XJWJCCjQ (5 7252 =64
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59 LiUt 822)
NWV 88326 Docld:32245128 Page 6
4
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OFFICIAL RECORD FOR SOCIAL SECURITY NUMBER 467 82 4034 PRINTED ON 071978
FORM 1:APPLICYCLE 08 64 ENTRY 0 REF# 65163940518
NAME LINE MARINA NICHOLAEVNA OSWALD 243
SIGNATURE CODE S
BIRTH DATE 0717941 SEX 2 RACE 1
MOTHER CLAUDIA V PROOSAKOVA FATHER NICHOLAI UNKNOWN
BIRTHPLACE ARCHANGEL UR#
REQ BY BR 032 SEC UNIT CLERK 00827 DATE 195 PAGE 1 OF 3
OFFICIAL RECORD FOR SOCIAL SECURITY NUMBER 467 8 2 4034 PRINTED ON 071978
DO: IRS FORM 2 APPLICYCLE 121175 ENTRY 2 REF#, 75165960637
NAME LINE MARINA NIKOLAEVNA PORTER 636
ZND NA ME MARINA NIKOLAEVNA OSWALD 243
SIGNATURE CODE S
BIRTH DATE 0717941 SEX 2 RACE 0
MOTHER KLAVDIA PROOSAKOVA FATHER ALEXANDR MEDVEDEV
BIRTHPLACE ARCHANGEL UR#
REQ BY BR 032 SEC UNIT CLERK 00827 DATE 195 PAGE 2 OF 3
OFFICIAL RECORD FOR SOCIAL SECURITY NUMBER 467 8 2 4034 PRINTED ON 071978
00 Coo FORM 8 APPLICYCLE 011976 ENTRY 2 REF#. 76010006538
NAME LINE_ M N PORTER 636
ZND NAME MARINA NIC OSWALD 243
SIGNATURE code D
BIRTH DATE 0717941 SEX 2 RACE 0
'8837E QoEiY: 388451282PSECz UNIT CLERK 00827 DATE 195 PAGE 3 Of - 3 NJ
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DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
@AS, TEMS ]
Form approved
SOCIAL SECURITY ADMINISTRATON Budget Bureau No. 72-R094.I_
Bureau of Old-Age and Survivors Insurance
APPLICATION FOR SUR VIVORS INS URANGF BENEFJS= (Do not write in` this spacc)
All items on this form requiring an answer must be nswered or marked "Unknown_
NOTICE. _ Whoever (a) makes or causes to be made any false statemeid % #epresentation
material fact for use in determining the right t0 or the amownt of benert; %; ixdeterminin} an
individual's disability, under Title II of the Social Security ct, Om Who ihaving_teceivsd a pay-
ment for the use and benefit of another person, knowingly and willfully uses such" payment for
other than the person for whom it is received; is.subjecl, under the Social Security Act, to a fine of
9
not more than $1,000 or 1 year'$ imprisonment, or both_
DhLLesai
2Ld: 423-54-3931
(Name_of deceased wage earner seif-employed person) (Social security account number)
Zyaxuna
hereby apply for all insurance benefits payable to
(Full namc of applicant)
me under Title II of the Social Security Act; as amended, and to the children listed in item 14 below.
1_ When was the deceased born? Month_ Year 3
2 _ In what State or foreign country did th: Jeceased have his fixed, permanent home when he died?
3_ (a) Did the deceased ever serve in Ailitary or naval service of the United States?
CS No
If <Yes, answer ( b )
(6) Was the deceased in active service after Seplember 7, 1939, and belore January 1, 1957?
Yes No
If (Yes,' Onswet (c) and (d).
0 (c) Give dates of service during the specified in (b) above
1
(d) Has anyone (including the deceased) received, Or does anyone expect to receive, from any
Federal agency other than the Social Security Administration, a benefit based on the em
2 ployment, military service, disa or death of the deceased?
No 1
If < Yes; name such person( s )
List all such agencies
8
4 Did the deceased work in the railroad industry at any time on or after January 1, 1937?
Yes
8 5_ Give the names and addresses 0f the deceased s employers during the 12 months before his death; if the
deceased worked in agricultural employment, give this information for the year of death and the year
1
before. (If self-employed, write "Self-employed ")
WoRK BEGAN WoRK ENDED
NAME AND ADDRESS OF EMPLOYER
Moath Year Month Year
~ @LLe z Kza 322Bsedes Kblea ` 2
2ZELLLL Ls b y 79ggn
44
LLL
4
3
6_ If the deceased was self-employed last year Or the year before, give:
Yeat Kind ef Trade o Business Amount of Net Earnings
Less than S400 8400 or more
Less than S400 S400 Or more
7 _ About how much did the deceased earn from employe ment and self-employment during
the year in which he died?
~e2 2 0
8 Give the follwing_information about each_marriage of the_deceased, including_his marriage to You:
DATE AND PLACE OF MARRIACE(s) How MARRIAGE MARRIACE ENDED
To Wuom MARRIED
Month, Year State EDED Datc Place
41.32 6 ek psleAite? "Uwua4 I ZZ "p]a] Zuu6 2x
Piaazkan
9 What was your maiden name?
Ylxasina__lekokaeuza _ ksyi
10. When and where were You born?
"aZd 4 X44._
7zMukk_E__
day Gnd year) (State or foreign country)
This may also be_considered an application for survivors bencfits under Section 5 of thc Railroad Retirement Act and for Veterans Administration
payments under Titlc 38 USC , Vcierans Bencfits; Chapter 13 .(which is, as such, an application for aher types ol death benefits under Titk 38).
NW
88326008081482245128_Page 8
(bsied Dollas
DO
JAN=
Day
period
bility,
Yo
W4se :
L
L=F
6x
City Day,
P122~
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M Indicate by whether your marriage to the deceased was performed by:
Clergyman or authorized official or Other
(Expiain)
12. Were you married belore your marriage to the deceased?
Yes
If sYes; give lhe following information about each of your previous
DATE AND PLACE OF MARRIAGE(s) How MARRIAGE MARRIAGE ENDED To Whom MARRIED ENDED Month Year Statc Date Plac
13. (a) Were you and the deceased together at the same address when the deceased died?_
No
(6) If either you or the deceased was away from home. (whether or not temporarily) when the deceased
died, give the following: which of you was away; date last home; reason absence began; reason you
were: apart at time of death; if hospitalized, name of hospital and nature of confinement
Zk-xaelsLaz E_ LezJlllesle3 RiLi
~a-t
~11
QL 2 _+e1k_-4E Repale
nattliubby;
Juee_ix-Ls UelryunbcL _
Zduzl,
14. Was the deceased survied by any unmarried children (including ste, cren, adpted, and
illegitimate children): (a) who were under 18 years of age when he died; Or (b) who were 18
years of age or older, with a disability that began before age 18?
No If your_answer is ""'No leave out the next questions and continue _with question 2L.
If your answer lo question 14 is <Yes; the following informaticn about each such child:
1
(If uncertaio as to name, date of birth, Or whereabouts of any of these children, explaio under Remarks on last page:
Sbow_relarionship_to_You and the deceased by placing in the proper column:
'DATE OF BIRTH RELATIONSHIP To DECEASED RELATIONSHIP To You
8
FuLL NAME OF CHILD
Month Year Legitimate Adopted Stepchild Ilcgitimate Natural or Stepchild
3
Adopted
1L*exak& 24ek2
TYh1EMSRZL
L9 70 6.3
1
5z 2
~LL_ (If you are nor this application on behalf of any child listed above, give under Remarks on last page tbe name
of each such child and the reason ($) for not If a child of the deceased is born afer this applicarion is fled, nocify
your office of the Social Securiry Administration promptly, as such child may receive benefts )
I
15 . Has any child listed in item 14 ever been adopted by anyone other than the deceased?
Yes No
'} If give the name %f child , by whom adopted , and when_
16. (a) Were all the children listed in item 14 with the deceased at time of death?
Yes
If < No, and the deceased was the FATHER o ADOPTING FATHER who died before September 1960 , answer ( b).
'(6) Which of the children listed in item 14 were living with their STEPFATHER when the deceased died?
17. Are all the children listed in item 14 now with
Yes No If < No, give the following information about each child not with now _
PERson WITH WHOM CHILD Now LIVES FULL NAME OF CHILD Nor LIVING WITR You
Namc and Address Relationship t0 Child
18 Has a child listed in item 14 lived with you in month since your husband's death?
Yes No If " No, list the months in which no such child lived with ou
NW 88326_Decld:32245128 Page 9
public
marriages .
Day, City
living
Lys
14
Ycs
give
Day
6x
fling
fling:
STes;
living
No
living you?
living You
every
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19. Do you understand that all payments made to you on behalf of a child must be spent or saved
for his use and beneft; and do you agree to So apply the benefits?
es No 20 _ Do you agree to notify the Social Security Administration promptly when you
no longer have
responsibility for the welfare and care of any child for whom you are this application?
Yes No
21. Have you or any children listed in item 14 married since the death of the deceased?
Yes No
If (Yes; give name %f person who married and date %f marriage.
22 . Have you Or any children listed in item 14 ever had a social security account number?
Yes No If {Tes; J) lhe following information for each person a numbet
NANE OF PERsOi As SHOwN ON SOCIAL SECURITY CARD SoCIAL SECURITY AcCOUNT NUMBER
23_ Have you or any children listed in item 14 ever filed an application for social security benefts
before?
Yes No 1f ( Yes, give the name and account number %f the person on whose earnings record such previous claim was based .
(Namc of wagc-carner or self-employed person) (Social security account number)
1
Answer questions 24 and 25 only if you are within 3 months of age 62 or older.
2 24. Were you in the active military or naval service of the United States after September 7, 1939,
and before January 1, 1957?
Yes No
25_ Did you work in the railroad industry at any . time on or after January 1, 1937?_
Yes No {
Deductions are made from the benefits (othec than disability benefts) of any person under age 72 who earns more thao
5100 a month in employment o renders substantial services in self-employmenc and has earnings in excess of 81,200 for the
8 taxable year. This applies to all employment and self-employment, whether or not covered by the Social Security Act
26 (a) Are you or any of the children for whom you are now earning more than $100 a 1
month in employment or rendering substantial services in self-employment?_
Yes No
J) If < Yes, give lhe name %f each such person _
(6) Do you expect your total earnings Or the total earnings of any child for whom you are
to exceed 81,200 this year (count all earnings beginning with the first month of this
year)?
If <Yes, give the name 0f each such person and the amount %f his expected earnings. If con - Yes No
tinue with question 27.
PERSON ExPECTED EARNINGS
(c) Did every person listed in (b) earn more than S100 a month in employment or render sub-
stantial service in self-employment in all months of this year (counting the present month)?
Yes No
If { No, give the name 0f each person and the months %f lhis year in which the person did not
eatn more than 8100
a month in employment gnd did not render substanlial services in self-employment. If any such person was self
employed , show lhe number of hours he devoted t self-employment opposite each month listed-if none , show
(( None_
PERSON MONTHS
L2 The yearly period referred fo in this and subsequent items is the sme [2-month period used in figuring income [axes_ I you or any ol the children use fiscal year (one that does not end on December enter here the name o such person and the month the fiscal year ends
NW-88326-Boeld:32245128_ Page;10
filing
give having
filing
filing
sNo ,
31),
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Answer item 27 only if the deceased died before this Year
27 . Did you or any child for whom ycu are earn more than $1,200 last year?_
Ye No
If <Yes, give the name of each such person, show his lotal and lisl the months %f last in which the person
did not earn 8100 0 month in employment and did not render subslantial services in sclf-employment. If any such person
was self-employed , show the number of he devoted to self-employment opposite each month listed_if Rone , show
J } ~None_ Do not list any month before the month the deceased died: )
PERSON EARNINGS MONTHS
Ao annual report of earnings must be filed wich the Social Security Administretion within 3 monchs and 15 after
the end of any year in which you, while under age 72 at least one full month of thar year, or any child for wthom you ac
earned more than $1,200_ Also, your benefit is not for aoy month you do not have in your care child of
the deceased entitled to a child' s beneft unless are receiving-benefts because you are a widow age 62 0t ovet
FAILURE TO REPORT THESE EVENTS MAY RESULT IN THE LOSS OF ADDITIONAL
MONTHLY BENEFITS.
28. Do you agree to file the annual report of earnings when required?
Yos No
29_ Do you agree to notify the Social Security Administration promptly if you do no have an en-
titled} ~liiid cf the deceased in your care?
Ycs No
A widow'$ entitlement to benefts ends: with tbe month before tbe montb in which: (a) she remarries, with certain excep-
tions (howevef, all marriages must be reported) ; or (6) she is under age 62 and no child of the deceased is entitled to
child'$ insurance benefits_
A child's entitlement to benefts ends with tbe before tbe month io which the child: (a) attains age 18 (unless the
child has a physical or mental impairment which began before age 18, is expected to be long-lasting, and prevents any sub-
1
stantial gainful activity) ; (6) dies; () marries, with certain exceptions wbere the child is disabled however, all marriages
must be reported) ; or (d) is legally adopted (unless the adopcion is by the child's stepparent, grandparent; aunt, or uncle 8
after the death of the parent on wbose record the child's claim is based )
If the child is age 18 or over and is receiving benefts as a disabled child, his entitlement to benefits also ends with the
8
second month after the month in which his disability ceases
30_ Do you agree to notify the Social Security Administration promptly if any of these events occur
and to return promptly any check for benefits received by you if you or any of the children are
1
not entitled to it? Yes 4
REMARKS: (This space may be used for explaining any answers to the questions. If you need more space,
2
attach a separate sheet:)
Lax-Z_azk_ Zupaatetd Hi_BLm-_
7
Aaliae-~x 3
1
LLLALZi LD Knowing that anyone ma a false scatemen or representation of 8 marerial fact for use in derermining dve right to
or the amount of Federal old-age, survivors, or disabiliry insurance benefits or in determining an individual'$ disability, com-
mits crime punishable under Federal Ia w, 1 certify that che above statements are true.
If this oRiostioh has beeo signed by mark (X), two Rit- Signature of applicant (Write in ink):
nesses sho the epplicant must sign below giving their
full addresses.
Here Zayine NQuluae
(Name) (First name) (Middlc initial) (Last name)
(Street and number)
Dz_Bak
L42.1
(Sure and numbcr)
(City) Zone number) (Saaie)
Kax 2_L75o-0
(City) (Zonc number) (State)
2 Telephone number at which I can be reached: "(Name)
4126% P_Z-Le?
(If none, write None. (Streei and numbar) Date:
(Ciry) number) (State)
(Month) (Day) (Year)
U.5. GovernmEnT Printimg Office 196 ! Of _ 58815
NW 88326 Docld:32245128 Page 11
filing
earnings , Year
hours
days
fling, payable
you
montb
kiog
Sign
Kiifil
Zonc
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STATE Of TEXAS
CERTIFICATE OF DEATH STATE FILE NO_
PLACE Of DEATA 2. USUAL RESIDENCE (Whore dccoosed livod Il institution: residonco bolore bdmission)
COUNTY Dallas STATE Texas 6. COUNTY Dallas
6. CITY OR TOWN (If outside city limits, give precinct co4) LENGTH OF STAY; CITY OR TOWN (If outside city limits, give procinct no-)
m 6. Dallas 13 Mo Dallas
d. NAME OF (Il not in hospitol, give street addross) d. STREET ADDRESS (Il murol, givo bcstion)
IGfiuTiorR Parkland Hospital 1026 N_ Beckley
0. I5 PLACE OF DEATH INSIDE CITY LIMITS? IS RESIDENCE INSIDE CiTY Limits? {IS RESIDENCE ON FARM? 1
YESD NOO YES5 NOO YESO Nob
J, NAME Of (o) Fintt (6) Middlo Ic) Lost OATE Of DEATH
DECEA SED 1 (Type Or print) Lee Harvey Oswald November 24 1963
5. SEX COLOR OR RACE 8_ DATE OF Birth AGE (ln Years FF UNDER 1 YAR #RTHR
6 Male White Married& Novor MarriedD October 19,1939 zZthdoy) Months Doyt Houn Micutet
Widowed0 Divorced 1
IO_ USUAL OCCUPATION (Give kind of worl dono] I0b. KIND OF DUSINESS OR INDSieet BIRTHPLACE (State Of foreign couatry) 12. CITIZEN OF WHAT COUNTRY?
most of working lifa_ avon i( retired) fagoiew: [Printing Book
9
Metal New Orleans,La USA
13 FATHER'S NAME MOTHER'S MAIDEN NAME [ Robert Edward Lee Oswald Margeruite Claverie
15. WAS DECEASEETR IUS ZRMED FORCESZ 16. SOCIAL SECURITY NO_ ORMANT 6 (Yos_ Ye 0f 'Sntnovn} Fo-T953 9-1989 433-54-3937
Zsz (2
18. CAUSE Of DEATH [Entor only ono causo por lino for (): (bl; ord (c}: ] INTEIYAL Jftwier Okslt Akd Deaih
3
PART DEATH WAS CAUMHEDVATE
64
FEk
R~bnda~y to GHby
Cocdi fion: %%t8to 4
Juadwr 4ldteAt
9
4 $ bmutb
obove couso (); DUE TO (BL
stating tho under-
Iying causo bst. 4 DUE TOuc)
PART Ii, OTHER SIGNIFICANT CONDITIONS CONTRIBUJTING TO DEATH BUT NOT RELATED TO THE TERMINAL DISEASE CONDITION GIVEN IN PART Ia) 19_ WAS AVopsy PER:
FORMED?
YESE NOD
1
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20. TIME OF Hour_ Month Yosr
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hereby certify thot | ettanded tho dorosed mom
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22a. SIGNATURE (Dogreo or titlo) 226_ ADDRESS 22c . DATE SIGNED
Ass
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2J6. BURIAL, CREMATION, REMOVAL (Spocify) 23b. DATE 23c _ NAME OF CEMETERY OR CREMATORY
JBWEXZI REMOVA L November 25 1963 Rose Hill BuriaDPark
8
23d. LOCATION (City. town, 0r county) (Stato) 24. FUNERAL DIRECTOR'S SIGNATURE Zezy
tetzz 4 13775
9 Fort Worth Texas Miller Funeral Home Ft Worth Texas
250_ REGISTRAR'S FILE NO 256_ DATE REC'D BY LOCAL REGISTRAR 2Sc REGISTRAR
axw
BY
ZVTY 7
6712 DEC 6 1963 ACTING REGISTRAR
DALLA S , TEXAS Jen. 2, 196 4:
I HEREBY CERTIFY THA T TR $ IS A TRUE COPY OF DEA FE
'CCRTIFICATE 07 ONE Lee Harvey Osvald
As IS RECCRDED IF TH $ OFFICE In.TE CITY OF DALLA S ,
COCNTY OF CF TEXAS, DAl{_i ZES
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NW 88326 Docld:32245128 12
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Page 13
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A REQUEST For ASSIStANCE
(Complete only il document is sent t0
TRANSLATION anotber ollice [or translation:
DATE: NAME OF [NSURED INDIVIDU AL Vw3/6x
2 LANGUAGE 0f DOCUMENT: SoCiAL SecuRity AccounT NUMBER
433-88-3937
3 'PERson(S) FoR whom PRoof SU BmiTTED: TRAnSLATing officE (Il married woman maiden name)
Social Security Administration
FAcT(s) To 3 6 PROVED;
ALLEGED DATE EVEnT IN ITEM A-4
OCCURRED:
B TRANSL ATIoN
(To be [illed out by ollicial_Lranslator)
Type 0f DOCUMENT: 2 . DA TE EVENT RECORDED,'F DA TE DOCUMENT
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6_ Does this document appear genuine ad uhatered, and to have beex
made_at_the_time_purported? YES No
7_ Is Foreign Service post verification stamp
shown on document YES No
8_ Describe and explain any irregulaities in docunent:
9_ The docunent, which is in the_ ~anguage , contains the following pertinent infornation:
OsulO_ Jee bes_IeL1s/3s
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REcuES ING OfFice: SiGNATURE Of AuthorizEd
TRANSLA TOR
Social Security Administration
4191454YAha
Title
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DA TE
NW 88326-Dociy7722445128-Page-13
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Page 16
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A, REQUEST FoR ASSISTANCE
(Complele only if document is sent t0
TRANSLATION another ollice (or translation.)
DA TE: NAME OF INSURED INDIVIDU AL Yzzles
2 . LANGUIAGE 0F DocUMENT:
SociAl secuRiTY ACCOUNT NUMBER
433-5Y 3937
Evesunn
3 PERsON(S) FOR Whom PRoof SU BMITTEd:
TRANSLATinG OfFice (If manied uoman give maiden name)
Sociol Security Administration
FAct(s) To 36 PROVED:
ALLEGED DATE EVENT IN ITEM A-4
OCCURRED:
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2 . DA TE EVENT RE ORDED,'F DATE DOCUMENT TyPE Botb; Gxuca&c
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TitlE 0F 0F FiceR ExEcutit bOCUMENT: 5 . NAME SSUING AGENCY:
6_ Does this document appear to be genuine and unaltered, and to have
YES No made at the_time purported?
7 _ Is Foreign Service post verification stamp
shown on document YES No
8_ Describe and explain any irregularities in document:
9 The document, which is in the_ language , contains the following pertinent information:
~Nam:
Prucamcla- Qndhli Ykolaurcl
Luzls
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RECU Ting OFFICE: SiGNATURE 0f AUThORIZED
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Social Security Administration
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DA TE 1/23/ey
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Page 18
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A_ REQUEST FoR ASSISTANCE
(Complete only il document is sent to
TRANSLATION anotber ollice (or translation: )
NAME; INSURED individu AL DATE: '/13/6-
SOCial SEcuRity ACCoUNT NUMBER 2. LANGUAGE 0F DOCUMENT:
433-4-3937 Russiaw
TRANSLATinG 0F FicE 3 PERsON(S) FOR whom PRoOF SU BmittED:
(I{ manied woman give maiden name)
Social Security Administration
FActis) To 36 PRO VED:
ACCEGED BATE EVENT IN ITEM A-4
OCCURRED:
B_ TRA: &ATIon
(To be_lilled_0ut by ollicial Lranslator)
PE 0F T ; 2 . DA TE EVENT RECQRDED,'F DA TE DOcUMEN BEe lykuatl
SHOWN: 2leslbe "ssueez/zs6z
TitlE 0 F of FIcE R EXeutinG DOCUMEN 5 - NAME OF iSSUING AGENCY:
Buxew
mana
Aicl.0y Borzaco ~i4tchu
BL
6_ Does this document appear to Be genuine and unaltered, anette 34741,2
made at the time purported?
HEEK;
KdenyEs No
7_ Is Foreign Service post verification stamp
shown on document YES No
8. Describe and explain any irregulaities in document:
9_ The document, which is in the_ language , contains the following pertinent information:
Aam SWALD [Thk '5 NAHE 1swl
lt Nowe_
FATbeR-'S
Lee
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ttctlept TATTCUATTY Rogsan
RussuawSsp
Rec No. 2,08 (202
RECUESTing Of fice: SiGNATURE 0f AUThORizED
TRANSLA ToR
Social Security Administration
481 Katsbtr
Titu
DA TE
1/23/-
NW 883267 J324.5223517282 18 GPO 1962 0 648770
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Page 19
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NW 88326 Docld:32245128 Page 19
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Page 21
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DepARTMENT Of
HEALTH, EDUCATION AND WELFARE
CERTIFICATION OF CONTENTS OF DOCUMENT(S) OR RECORD(S)
SOCIAL SEcurity AdministRATion
BUREAU Of Olo-AGe AND Survivors INSURANCE (This lorm must be executed by an authorized employee of the Social Security Administration)
Name ol Cvage Jelf-employed person Social sccurity account number er-[Ezl
Lia 3 > 574 - 3937
Every item in a block must {Be filled out with exact excerpts the paper certified or the item must be marked tnot shown_
If the date on which an was made in 3 family record is not shown indicate under "Remarks any allegation as t0 when the
document or record was
elblished"
esta CROSS OUT ALL UNUSED SPACES.
A. AGE (OR RELATIONSHIP) OF:
L_ NAME OF PERSON As ShOwn ON EvIDENCE BORN AGE BIRTHDAY AT WHICH AGE SHown DATE RECORDED
Voho/3 LAST NEAREST LkLOuzbL
NEXT Not GIvEN MO
NAYE OF THER AGE NAME OF MPTHER AGE
Not SHOWN Not SHowN Y_OLu- "IsAlulabauna ~L
PERSOX: HAVING CUsToDw; RELATIONSHIP To APPLICANT, AND ADDRESS: NATCRE OF EvIDENCE
APPLICANT lu
AXD ADDRESS OF AsSUIxG AGENCY ( If cerlifing from a Bible, give dale %f publicalion_ DocUMEN] No_
CUsTODIAN BVs Y3z
2 OF PERSON AS Show ON EvIDENCE BORN AGE BIR THDAY AT WHICH AcE Show DATE RECORDED
LAST NEAREST
NExT Not GivEN
NAME OF FATHER AcE NAME OF MOTHER AGE Not SHOwN Not SHOWN
PERSON HAVING CUsToDy_ RELATIONSHIP TO APPLICANT, AND ADDRESS; NATURE OF EvIDENCE
APPLICANT
NAME AND ADDRESS OF ISSUING AGENcY ( If certifying from Bible , giv dale of publicalion DOcUMENT No. CUsTODIAN
3 . NAME OF PERSON As SHOWN ON EvIDENCE BORN AcE BIRTHDAY AT WHICH AGE ShOwn DATE RECORDED
LAsT NEAREST
NEXT Not GIvEN
NAME OF FATHER AGE NAME OF MOTHER AGE Nor SHOwN Not SHOWN
PERsON: HAVING CusToDy RELATIONSHIP To APPLCANT, AND ADDRESS: NATURE OF EvIDENCE APPLICANT
NAME AND ADDRESS OF ISSUING AGENcr ( If certifing from Bible , give date % publication DoCUMENT No. CUSTODIAN
NAME OF PERSON 4S SHOwN ON EvIDENCE BORN AGE BIR THDAY AT WHICH AGE Shown DATE RECORDED
LAST NEAREST
NEXT Not GIvEN
NAME OF FATHER AGE OF MOTHER AGE
Not SHOWN Not SHOWN
PERSON HAVING CUSTOD), RELATIONSHIP TO APPLICANT, AND ADDRESS: NATURE OF EvIDENCE
APPLICANT
NAME AND ADDRESS OF IsSUING AGENCY If certifing from Bible , give date %f publication_ DOcUMENT No_ CLSTODIAN
B_ MARRIAGE OF:
NAME OF HuSBAND As SHOWN ON EvDENCE NO OF PREVIQLS MAR - BORN AGE BIR THDAY AT WHICH AGE SHOWT RIAGES (1, 2, ETC.)
LAST NEAREST
Not SHOWN NExT Not GIVEN
NAME OF WIFE AS SHOWT ON EvIDENCE NO OF PREVIOUS MAR - BORN AGE BIRTHDAY AT WHICH AGE SHOWA
RIAGES (1, 2, ETC.)
LAST NEAREST
Nor SHOWN NEXT Not GIVEN
NATURE OF EvIDENCE PLACE OF MARRIAGE
MARRIAGE CERTIFICATE
PERSON' HAVING CusTopy; RELATIONSHIP TO APPLICAAT, AND ADDRESS: DATE OF MARRIAGE APPLICANT
NAME AND ADDRESS OF ISSUING AGENCY ( If cerlifing from Bible , giie dale %f publication DOCUMENT No. CUSTODIAN
OA-C704
NW 88326 (658341d.32245128_Page.21 (OVER)
from
Uudsya Ml'Ln4
U
REL Rs4
Nam;
NAME
NAME
Form
==================================================
Page 22
==================================================
DEPARTMENT OF HEA: DUCATION, AND WELFARE
SOCIAL SECURITY ADMINISTRA
CERTIEICATION BY. UNIFORMED SERVICES
Bureau of Old-Age and Survivos 6E5Ee82
The information requested below is for use in connection with FROM: Social Security Administration
a claim for social security benefits based at least in part o active Divieion of Claims Policy
service in the armed forces after September 7, 1939_ Entitlement Branch, Room
Baltimore, w_ 21235
#oxxex
Thomas C_
Ferrott IL Date
1pk/64
Director
PART |-To BE COMPLETED BY SOCIAL SECURITY ADMINISTRATION
LAST NAME FIRST NAME MIDDLE NAME DATE OF BIRTH DATE OF DEATH SOCiAL SECURITY NUMBER
Oswald, Lee Harvey 10/19/39 11/24/63 433-54_29
BRANCH OF SERVICE DATE(s) OF ENTRY INTO SERVICE DATE(s) OF SEPARATION PLACEVE OF SEPARATION
Marine_Corp8
RATE OR RAnK 10/24/56 9/11/59
No "71653230
Part II Part III below to be_completed by the service department
REMARKS:
PART II-SERVICE DEPT. CERTIFICATION ABOUT ACTIVE SERVICE AFTER SEPTEMBER 7 1939.
DATE(5) ENTRY INtO 2 . DATE ( 5) OF SEPARATION 3. CHARACTER OF SEPARATiON(5) (If Bad Condu M{CATE SF GIVEN
ACTIVE SERVICE FRom ACTIVE SERVICE As RESULT OF General court MARTIAL)
240c t56 1lSep59 Honorable
"IF CKARACTER OF SEPARATION WAS Not Honorable, Under
Honorable Conditions , Dishonorable , NOR Bad Conduct As RESULT
Iperiod of service was less than 90 days, WAS INDIVIDUAL DiS- OF 4 General COURT MARTIAL, CHECK REASON FOR SEPARATION BELOW:
CHARGED OR RELEASED From ACTIVE SERVICE AS RESULT OF [NJURY
a. DESERTION OR DISABILITY INCURRED OR AGGRAVATED IN SERVICEIN LINEOF DUTYI
b. RESIGNATION ForR THE Good Of THE SERVICE (Officers Only).
YES No
CONSCIENtIOUs OBJECTOR Who REFUSED To WEAR THE UNIFORM
OR OTHERWISE To COMPLY With LAWFUL ORDERS OF COMPETENT
IF PERIOD OF SERVICE HAD AN ENTRY DATE AFTER 2/31/46 AND MILITARY AUthoRiTY _
BEFORE I2/16/50,BY WhIchOfTHEFOLLOwING WAS ENTRY EFFECTED?
d. Conviction BY CIVIL COURT For TREASON, SABOTAGE, Espio- DNAGE, MURDER, RAPE, ARSON, BURGLARY_ RobBERY KIDNAPPING, INDUCTED CALLED FROM ENLISTED ASSAULT With INTENT To KiLL, ASSAULT With DANGEROUs INACTIVE SERVICE WEAPON, OR OF AN ATTEMPT To Commit ANY OF TKEse CRIMES.
RE-ENLISTED COMMISSIONED NONE F THE ABOVE.
PART iI-SERVICE DEPT. CERTIFICATION ABOUT RETIRED OR RETAINER PAY (See instructions on reverse side)
IF THE VETERAN WAS NEVER RETIRED or TRANSFERRED TO THE FLEET RESERVE, check this box:
and return the form without answering items 1, 2 and 3 below_
1. (a) Was this veteran an, enlisted member of the Army, Air Force, Navy, Marine Corps, or
Coast Guard and retired after September 15, 1940, and before October 1, 1949, because
of disability ? Yes No
(b) Was this veteran ever retired or transferred to the Fleet Naval_(or Marine Corps) Re-
serve after September 15, 1940, for any reason other than disability which is the proxi-
mate result 0f the performance of active duty ? Yes No
If answer to 1 (a) or 1 (b) is "Yes, answer (c) and (d) .
(c) Was active service after September 15, 1940, and before July 25, 1947, used to establish
eligibility to receive retirement or retainer pay ? Yes No
(d) Was active service after July 24, 1947,,and before January 1, 1957, used to establish
eligibility to receive retirement or retainer pay ? Yes No
2. (a) Has the retirement (or retainer pay of this individual ever been fixed under a formula
which includes a multiple of active service ? Yes No
If answer is "Yes; answer (b) and (c)_
(b) Was this multiple increased because of active service occurring after September 15, 1940,
and before July 25, 1947 ? Yes No
(c) Was this multiple increase because of active service occurring after July 24, 1947, and
before January 1, 1957 ? Yes No
3_ Did the veteran active duty o active duty for training after December 31, 1956 ? Yes No
REMARKS BY CERTIFYING AGENCY;
Served in an inactive status in the Marine Corps Reserve from 12Sep59
to 13Sep60 when discharged as Undesirable. CSNTINUED ON REVERSE SIDE
ORGANIZATION Records Service Sec tTon SIGNATURE
U: .S . Marine Coprs
U 0Teew
DATE
27Jan64
RANK OR TITLE
Head 0I Section
Form OA C654
(261)
MW 88326 Docld:32245128 22
645
OF
Sign
have
Hq;
Page
==================================================
Page 23
==================================================
-WOJ 3q U4 046 IL #od pl Jt; L7
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8 Ja4a Sq
318Y} HI "#[!f AIBAIFUI 8,UBI9434 34} uf
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auqujazap 02
SN0IpnHLSNT
G-Jzji" LC 0Ol 'YJ
Lelecom.
with Marine Corps 1/24/64
and attached OA-C654 completed 1/27/64 _
Attached OA-C654 reflect8 DWE ' s honorable
active service 10/24/56 9/11/59 which
confirms telecom. with Marine Corps
(W_ C. Keene, Record Service Section,
Hags Marine Corps, Washington, D.C. ) on
1/24/64 . Tbe DWE 8 discharge 8s Undesirable
was from his inactive status in the Marine
Corps Reserve from 9/12/59 to 9/13/60, which
discharge dia not affect the character of
separation from earlier service _
MS wege credits for 10/56 12/56 are not
precluded by type of discharge from later
period of service. See CM 1823.
Lorene B. Benning
Cleims Policy Examiner
Nac
Ln _ ~nee
mnlky
Aewice
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Page 24
==================================================
DEPARTMENT OF THE NAVY
NAVY DISCHARGE ReviewI BoaRD
wabhinoton 39, Dc: In acpLY ArtA To
EXOS:QB( 33)
JAPagJo
JUL 25 1963
Mr. Leo E, Oguald
P, 0.
Box30061
Nev Orloans, Iao
Dear Mp~ Oswaldt
Tho rovicw Of your dIschorgo has bcon
comploted in
accordanco NIth tho
rogulationo govorning tho
proceduros
Bcard,
Corofui condidoration va8 glvcn to tha
of thig
bchalf 09 wcll 00
that contaLned
ovIdonco prcscnted In your
Tho Sccrotary Of tbe Nevy bab
In your offlofal rccords.
reviewcd tho prococdinz8 of tbe Board,
It
18 tbo deciofon that
no change, correction or
mdification 10 warranted In jour d1echargoo
SIncerely you8,
D. W: BOKCMAN
Captain; DSN
Preoidont
Navy DLecharge
Reviev Boara
Enclo}
97c8izal_@tsoha Gatod ;1 %aat%962, 1J Nov 1961.
Two (2) lettore
Inforuatlon on ReonlLotment
NW 88326 Docld:32245128 Page 24
2
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NWV 88326 Docld: 32245128 Page 25
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Page 26
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NW 88326 Docld:32245128 Page 26
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==================================================
Page 27
==================================================
4 €6-4
UNDESIRABLE
DISCHARGE
FROM THE
ARMED FORCES
OF THE
UNITED STATES UF AMERICA
THS IS TO CERTTFY THAT
PRIVATE FIRST CLASS LER HARVEY_OIINLD 1653230
WAS DISCHARGED FROM THE
UNITED STATES MARINE CORPS
ON THE 132h DAY OF SERAEHEBER1950
AS UNDESIRABLE
2e2%ahn
H, G. LETSCHER ERST LIEUTENAN USC
DmR
J6Mud ]
NW 88326 Docld:32245128 Page 27
==================================================
Page 28
==================================================
ity for discharge _
0t on lhe day of
19__, lo serue 'ycars,
8 8ctwoc
eld on dischargc
(Drst & m:'4
ww
'1
occupalional 8pcciqlly
(sc0,, forcign, ballles, cngagcmcnts, cxpedilione)
numbcr
ation
discharge
V Wai &1& &bove is corrzc: Gccording lo {he Bcrvice ccords.
HAS GLENV IEH ILL.86 Sceg6
non-delfvery of Digoharee
(addrese unkown)
211 By dIreotion
3rr0g wMc} 16#5h
NW 88326 Dig1083245128 28 Page
==================================================
Page 29
==================================================
Form OA-CI91
(8-58) UNIT DESTINATION
ADJ COR
CC CR
CL DR
INCOMING CORRESPONDENCE ASSIGNN
(MAIL AND DISTRIBUTION SUBUNIt)
DEPARTMENT OF
HEALTH, EDUCATION, AND WELFARE Form Approved
SOCial security DMINISTRATION Budget Bureau Referred to Iureau Of Old-Age NNe SuIvivors]IrsuranCE No. 72-R597.1
Received by CLAIMANT'S REPORT TO
SOCIAL SECURITY ADMINISTRATION
Searcher PrINT NAME Of PERSON About Whom ReportIs MAde
Final disposition Matul OsuLL_
SOCIAL sicuRITY CLAIM NUMBer
433-54-3232 E,
Fil_in Only the Item(s) reported
REMARKS: CHANGE OF ADDRESS: (Fill jnncw_oddress at bottom )
Check if change is for : Zmore thon 6 months D'6 months or To avoid in receipt of check: you should olso Gle @ regular
of oddress notice_with Your local pcst office.
Enter date of marrioge
2_ MARRIAGE
Shoxew name
3_ Enter date of deaths DEATH_
DIVORCE OR ANNULMENT OF Enter date decree finol MARRIAGE spouse beneficiary from
insured individual)_
5. CHILD OR OTHER CLAIMANT UEFT Enter date child Ieff Your YOur CARE core
6_ CHILd LEGALLY ADOPTED Boter date of odoption
BY
Stepparent Grandparent Aunt Urcle Other
7 WORK Outside THE DRWTED STATES:
wos employed or self-employed outside Month and Year
te United States beginning with the month of
SIGNATURE of person making mhis report
Manina
@wua2c
Date signed
Paeh 2 7 4
P.o_ Bor or Street
629 Blt
2ea
Zone No_ State RALnL
2s080
Form OA-C668 (10-62)
Gpo 1962 Of_661532
NW 88326 Doeld: 32245128 Page 29
CLz
being
Iess
delay change
(of
Lpa
==================================================
Page 30
==================================================
Form OA-C591
(2-84) UNIT DES'
PES
CC
CAS
INCOMING_CORrrcdOnntAT
DEPARTME 01 Fomm Approvod_
HEALTM EDUCATION, AND WELFARE Budget Buroau
SOCiAl security__AdMinistiatiON No. 72-R597.2
FLAIMANT'$ REPORT To
SOCIAL SECURiTY ADMINISTRATION
FrJNT NAm Of Persoh Oi Personis ABout Whom Report_is MADE
MARina OswALD
SOCIAL Security Clim Numberys)
433 _
54*3937-E
Fill in Only the Item(s) being reported_
CHANGE OF ADDRESS_ (Fill in new oddress ot bottom )
Check if change is for: more than.6 months 6 months or less
To avoid in receipt of checks You should olso fle regular change
of oddress notice with your local Post office.
Enter date of marriage
2 MARRIAGE
Show New Nome
3 DEATH OF (Show Name) Enter date of death
DIVORCE OR ANNULMENT OF MARRIAGE Enter date decree finol
(of spouse beneficiary from insured indi-
vidual)
Enter date child leh Your
5 Child OR OtkeR CLAIMANT Left Your
car CARE
Show Given Nlmes) of Personls) Who Loft:
GOiNG OUTSIDE THE U.S_ Date of departure from
Nome ol country to which going U.S.A
Given Nomels) of Personls) Going
Enter date of odoption
Child LEGALLY ADoptED
Show Given Namels} of Child(ren)
BY Stepparent Grandparent Aunt Uncle Other
SIONATURE of person making this repon
'Mles_ Zeaiba Oturle
P.O. Box Or Stroet
12 45 DoxxA Drive
State Zip Code Richarnson Texas 750s0
Knter Tume B1 &uny, any. in which you Ilivo Dote Signed
DALLAS County 5-/-LS
Gpo 196J Of _696-004 FORM OA-C 668 (6-63)
NW 88326 Docld: 32245128 Page 30
delay
==================================================
Page 31
==================================================
For OA-C669 Form Approved.
(11-60) Budget Bureau No. 72-R598
CLAIMANT 'S REPORT ABOUT WORK To
SOCIAL SECURITY ADMINISTRATION
Print NAME OF PERsON AboUt WhoM REPORT I5 MADE Marina OSNALD
SOCiA SECURiTY CLAiM NUMBER 433-4332237-4
FIll in Only the be roported,
REPORT HERE IF You Work
and expect to eam more than $1,200 during this taxable
year
am work for wages of more than $100 (or rendering substan- Month 6 Year tlal servlces In self-employment)
beginning with the month of
Fill in both boxes
estinate that my total eamings for Amount
thls tarable year wlll be- 37ooo n
Your estimate will be used t0 schedule benefit payments
{0 YOU the year. At the end of the year On onnuol
report of actual eamings is required, at which time
justments, 0's necessary, Will be made_
REPORT HERE IF You Stop working
for wages of more than 5100 a month (or rendering substan-
tial services in self-employment )
The last month I worked for wages
of more tha $100 (or rendered Month 6 Year substantlal servlces In self-
employment) was
Report HERE To REVISE AN ESTiMAte
of earnings you previously gave for this toxable year.
Amount estImate that my total earlngs
for thls taxable year WIll be
'If $1,200 or less show '81,200 or less
Your benefit payments will be rescheduled in line with
the changes in your work activity reported above_
SIGNA TURE of person maklng thls report Date signed
222s_Pazina_Eeelkost_8_ZSL$.
P.o. Box or street
629 Belt Lws Kono
Clty Zone No. State
RieHARDION ZExas 750 &0
GPo 1960 0-572919
NW 88326 Docld:32245128 Page 31
item ing
Ing
during
ad:
==================================================
Page 32
==================================================
"l [ UUUII"N+ 10' (2-84)
PES COR
CC RECON
CAS REC
INCOMING CORRESPONDENCE ASSIGNMENT RECORI
(MAIL_AND DISTRIRITIoN_Crrnss
form Approved
Budget Bureau REPORTING CARD No. 72-8597 3
ABOUT WHOM REPORT (S MADE PRINT NAME Of" PERSON Or PERSONS
Mnxins N PosTec
Referred to SecuriTY ZAM IWHR I This SPACE nit
ENTER SOCIAL
433 3737
being reported Received by Chedh 0r l ONY Ihe Informalion 'ate
OF ADDRESS (Prini new oddre;s 57 botoor)
WCHANGE than 6 mos. 6 mos . or less Searcher Cherk if change is for: More
WiLL EARN OVER S1,500 THIS YEAR:
Final disposition 2 :KING AND
than 3ing for wages of more MONTH AND YEAR
22
month (or rendering substan- 1
tial ;ervices in self-employment) be
ginning with the of osition
Fill in both boxes 9 AMOUNT 2
REMARKS: estimate Ihat my total earnings for
this taxable year will be
1
3.
STOPPING WORK:
1
The last
worked for wages of
AND YEAR 6 'fhan 5125 (or rendered sub; MONTH
more Gervices in self-employment) 4
stantial
wos
4
Us. GOERNMENT PRINTHI SIGNIFICANT CHANGE IN ESTIMTATOU
~
total earnings for
AMOUNT 28
estimate that my
this taxable Year will be
ENTER DATE OF DEATH
5. DEATH
DATE GOINC
COING OUTSiDe THE U.5
Name of country to which going DDATE EXPECT TO RETURN
of MARRIAGE
MARRIAGE (City, County & Statel
Place of marriage
DATE DECREE FINAL
8
DIVORCE OR ANNULMENT
OF TNTER" DATE CHID LEGALLY ADOPTED DY ADOPTION
Brothor or Stepparent
Sister Aunt or Uncle
Other
Grandparent ENTER DATE HE TEFT YOur
10 CHILD OR
OTHER CLAIMMANT
CARE
LEFT YOUR CARE
Of PERSON MKING TH1S REPORT
SIGNATURE Malne n
TUs
AND STREET, P.O_ Box, Or "ROUTE
NUMBER
6448 Dusn sJa~_ lane
Zip CODE STATE
CITY
78/2
DRLLas Texa {
NUMBER , IF ANY TELEPHONE
DATE SIGNED
$-4-6l Em& 277_
IF ANY IN WhICH YOU LIVE
ENTER NAME OF COUNTY ,
pnila
FORM
SSA-1425 (12-65) Kc
NW 88326 Doeld: 32245128 Page 32
SY
L
month
1
1 month
1
DATE
Poker
==================================================
Page 33
==================================================
064 Jih 37]
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NW 88326 Docld:32245128 Page 33
1
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Page 34
==================================================
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~ NW 88326 Docld: 32245128 Page 34
}
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==================================================
Page 35
==================================================
Form OAC-5002
(1-64)
OFEICE: REPORT OF CONTACT TR
(USE [NK OR TYPEWRITER)
DATE: LLO-eL
WIE OR S/E PERSON AfN
Tuem4
02L1L F23_54-3 737
NAME AND ADDRESS @F PERSON(S) CONTACTED: LAze_ 0 Ue) bAs _
7aruodZah
k1-1-Ss 0 |
ConTAC MADE: PLACE OF CONTACT
IN PERSON TELEPHONE
5e26
22272
(u Clue ZS &Z
0
24 2/
4z4/ud s
d72 1 2L
i
&luLauz/
T/ 7 F
2362_
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7_794
196 Z_
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1/967
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247
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Kzeeus_
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KAzZL4
Eea_3y_3722
4A Y33-54
5
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5 41'
A_
Mel 7
r
6c8 Ts
($
0
fo*
&
CONTACT MADE BY
lliYz
(SIGNATURE) (TITLe)
(FOR CONTINUATION OF THIS REPORT, TURN PAGE. KEEP MARGINAL SPACE AT RIGHT FOR BINDINGS
U,S_ GOVERNMENT PRINTING OFFICE 1958 0 -486513
NW 88326Qocld; 32245128_Page 35
~lloy
Vx
722
222
0 Sws(J
04P4
~jc t
5am
dd 10
Ur 20 o 3/37
rz ps Wrun) J $ rkzs 51
2 7
doneuni $ 3l.
unde r
==================================================
Page 36
==================================================
0 B998 aih 3v3
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2
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pH
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=
HH;
5
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NW 88326 Docld:32245128 Page 36
;
4
1
==================================================
Page 37
==================================================
Xova 6998 dih Ova
2 8 ~
2 2 =
k
3 =
1
8 2
1
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2
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X 0o
|
=
#
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= 2
1 11 E 8
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= 0 3 2
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NW 88326 Docld:32245128 37
1
2
2
1
2
Page
==================================================
Page 38
==================================================
DEPARTMENT OF BEALTE, EDOCATION, AND WELPARE Form approvcd: SOCIAL SECURITT AdYInI9TRA tiON
Bureau 0 Old-Age 8nd Survivors Insurenoo Budeet Burcau No. 72_R247. 12
In replying, Address: SOcIAL SECURITY ADXINISTRATION
3716_Rawline St R.0 Box_6556_
Daiiab Texeg:75219
T8rep?6.2885 RI_9-e991ate
i/ie/s
Ve have {eceived an application for social security benefits based upon the wages to {he indi_
vidual named below Fe oeed a statement of wages to process this claim_ cooperation in promptly
fiking out and-etuming: this-starement willbe_appreciated -An_envelope fequiring no postage is enclosed
for your use. (The filing of an application does not necessarily mean that a currently employed wage eamer
Alans_Io_guit working)) ~uxj
Tae qaks- e(iies- Stvccl,Ewc .
517 J.Tedwd K R
DeLLAs TEK~ > 74 71ill
Zfzksx -
Vanager.
Enclogure.
STATEMENT OF EMPLOYER
~TThis i8 t certify that wageg in the amounts ghown have been PAID during the calendar year(s) to _
1_
LEE HarvE
sWaL 32-54 ~ 2.127_
(Neme o wege earder) (Bocial security eccount number)
1
Include the value of all remuneration before withholding of tax whether paid in cash o kind (but for
services performed in a private home as &-domestic, Or in work not in the course of the employer'$ trade
2 or business, show oly the cash amount paid) If oo wa ges were in the periods checked below write
"None"' if the amounts are unkoown, write 'Uokoown If you believe any of the amounts showo are
not wages Or any of the employment is Dot covered under the Social Security outline reasons
1
under Remarks on the back of this for_
2 WaGEB PAID WaGes PAID WAOE8 WAGES PAID PEBIOD
YeAb 10. 62 Year J9- ba Yeab 19_ Year 19_ {
8 Januery 1-March 31, inclusive 8 none_ 8_945.69
8 S
April 1-June 30, inclusive_ S___one $_121.67_ 83 83
1
July 1-September 30, inclusive S__fone_ s__none_ 8 8
October 1-December 31, inclusive 8_
727,81
8. none_ 8 S_
In item 3 below use specific tems such as file clerk, traveling o city salesman, maid, plumber,
attorney, etc_ In item 7 use specific tems such as radio manufacturing, wholesale retail grocery
store physician' S office, private home, etc_
3.EMPLOYEE'5 OCCUpATION NaTuRE OF BUSINESS
Canera_Dept Tyogapby
BUSINESS NAME Of EMPLOYER (Typa or print) ~ TRRITTEN SIgNATuRE Of EMployeR Or Authorized Employee Uf Firm
Jaggers-Chiles-Stovell, Inc. 2alze
5. StReeT Address Of Employer TiTLE Of PERSON Signing ABOVE
522 Browder Secretary-_Treasurer
6. City StATE 10_ EMpLoYeR 5 FEDERAL 11 Date This STATEMENT FilLed Out
idenTification No_
Delles, Texes 75 0359250 1-10-64
QAC-001
NW 88326 Docld:32245128 "page 38
paid
Your
ST
Diatricl
paid
Act, your
PAID
drgs ,
St e
Form
==================================================
Page 39
==================================================
DEPARTMENT OF HEALTE, EDUCATION, AND WELFARE Form approvcd
BOCIAL SECURITT AdMINistrAtion Budgrt Burcau Vo 72-R247.12 Bureau 0l Old-Age 8d Survivors Insuranoo
3716 Igyeplying, Address: SocIAL SECURITY ADMINISTRATION
St_ P_ 0 6556
RI .9-2885
RI
Tclephone Dete
Ve have received an a Pplication for social securicy benefits based upon the wages t6, indi
vidual named below _ We need a statement of wages to process this claim_ Your cooperation in promptly
-filling-out.and refuming this statenent_vill be appreciated: 4n envelope requiringno postage:is enclosed
for your use. (The of an application does nothecessarily mezn that a currently employed wage earner
plans to_ working.)
TEX+S Scfad L B 00 [c
DEPOS / T 0 @y
ECm 'T HavsTav
cLhonac=
L-AALLA $ TEXAS
"Diszriti" anager .
Enclogure.
STATEMENT OF EMPLOYER
Thi8; to:certify that geges in the amounts ghown heve been PAID during the calender yeer(8) to _
1
2EE HAEiEY OswAL) 22-54.2137
(Name o wage earner) (Socia} security account number)
L
Include the value of all remuneration before withholding of tax whether in cash or kind (but for
selvices performed in a private home as,2 domestic, Or in work not in the course of the employer's trade
3 Or business, show only the cash amount paid) If oo wa ges were paid in the periods checked below write
'None"' if the amounts are unkoown, write Uokoown _ If you believe any of the amounts showo are
not wages or any of the employment is not covered under the Social Security Act, outline Your reasons 1
under Remarks on the back of this
2 WaGE8 PAID WAGE9 PAID WaGE9 PAID WAOes Paid
PERIOD YEAB 1P_60? YEAR 19_ YEAR 19_ YEAR 19_- 9
8 Jenuery 1-March 31, inclusive_
sNeNE
S_ 5 8
April 1-June 30, inclusive_ S.
NAJe
8_
1
July 1-September 30 , inclusive_
sNANE
S_ 8_
October 1-December 31, inclulsive_= 8.
ZeLbzi
S_ S
In item 3 below use specific tems such as file clerk, traveling o city salesman, maid, plumber,
attorney, etc In item 7 use specific ters such as radio manufacturing, wholesale drgs, retail grocery
store, physician' s office, private home, etc.
3.EMPLOYEE*S OccuraTion 7_ NaTURE Of BUSINESS
BUSinESS NAME Of EmployeR
244
(Typo PKNT) 8 , WRiTTEN
LezZ _Eezc
SiGNATURE Of EmpLoYeR Or AUTHORized EMPLOYEE Uf Firm
DX ~zaZezy 2Alze2p
5 StReeT AdoReSS Of EmPLOYER Title Of PeRSON Signing ABOVE
Zez
@1 euZauS
S
Lic?
MeiZ
Sity StaTE 10_ EMPLOYER'S FEDeral 1_ DaTE This StaTEMENT Filled Out
idENTificaTION M
(1zxos
@7S-DS?LeeL-Io_6X
NW 88326 Dodid?2672 39
Rawlins
Box Dallas,_ Texas 75219
9-2991_
paid Athe
filing
quit.
ig
paid
for _
Jotael
(Rage
==================================================
Page 40
==================================================
DepabthbXt 07 BBALTE, Bdocation, AND WBLTARe Form approvcd:
Bozal SrcEHITT AdXWutLatior Budeet Burcau No. 72-R247.12
uresu &/ O1-AfC aba Burvivon IDuraso
In replying, Address: SocIAL SEcURITY ADXINISTRATION
1Q1
~Iet8lng,
Aveaue7011]
9
Telephone
527-2551
Datc
ke/ey
have received an a
'Pplication for social security benefits based upon the wages {8 theindi=
vidual named below _
Ve Deed a statement of wages to process this claim. Your cooperation in promptly
filling out and retuming this statement will be appreciated. An envelope requiring no postage is enclosed
for usc . (The filing of an application does not necessarily mean that a currently employed wage eamer
YOuI
Plans [O working.)
EJssLe_B Rzbza,Mz=
6 I=
Jaxta Lls foon"
LUeu
Ilzf
d
(Mrs . ) Martha A. McSteen
Dislricl 'Anager
Enclogure.
STATEMENT OF EMPLOYER
ThilT8 to certify that mages in the amounts ghoy have been PAID during the calendar year(e) to _
Le_
332,2142137
(Name 0 wage earner) (Social securkty account number) 1
Include the value of all remuneration before withholding of tar .whether in cish or kind (but for
services petgormed in & private home as a
domestic, O in work not io the course of the employer's trade
or business_ show only the cash amount paid): If oo wa ges were in the periods checked below write
4
"None" if the amounts a[C unkoown, WIite 'Uokoown _ If you believe any o the amounts shown are
not wages
or any of the employneat is not covered under the Social Security A== outline your feasons 1
under Remarks on the back of this form_
WAGES PXID WAGES PaiD WAGES PAID WaGES PAID 2 . PEBIOD
YAi I9_
6.3
Y24ljo_ Year J9__- = YEaR 19_ 8
8 Januery 1-March 31, inclugive_
April 1-June 30, inclusive
s42225.
8_ 1
July 1-September 30, inclusive 83
L9[2SI
8
S October 1~December 31 inclusive__
In item 3 below use specific tems such as file clerk, traveling O city salesman, maid, plumbe:,
attorney, etc _ In item 7 use specific tems such as
radio manufacturing, wholesale dmgs, retail grocery
StOre, physician' S office, hene, etc
7 NATUEE Of BUSINESS 3. EMPLOYEE S GL
&
nlX Lxes 7_
8 WrittEN TuRe Of [MpLoyer Or Authorized EMpLoyee Uf Firm BUSINeSS NAME Of EMpLoyeR (TyPo O8f Erint)
W~L
'LiLLBn dxts
GLLs
Title Of PIRSON Sigming AbOvE 5. StreeT AddreSsOf EMploter
YLAL
i0_ [Mploter $ Federal DaTe This Statement FilLed Out
city identifkcation Mo_
NW 88326 Docld 9245128 [Pag6 40_
0.1,L
Z 7o3o Vis/4
paid
Te
quit
4o
paid
paid
ct,
private
%54_
ResLy
2e 6 4d
==================================================
Page 41
==================================================
1 [ |
Wage Earner
Z H bwwd -_
A/N
43z-54_3432
Understanding that this statement is for the use of the Social Security
Adinistration in the administration of the Social Security Act, Title II, I
hereby certify that the following information is correct:
(1) Were the wages shown on the attached statement of employer
reported to the Director of Internal Revenue ?
Yes No
If wages were reported, please give date (s) reported and under
what employer S naine the report(s) was made
5 a& Ae
Rxsu _
(3) If the wages were not reported, please give reason for failure
to report:
10
ky EAlhuta
Date Signature
Attachment to Form OAC-1OOl
NOLA-7/63
NW 88326 Docld:32245128 Page41
(2)
Se a
Qmt_Uhx
==================================================
Page 42
==================================================
F0x~0A C89
9 DEPARTMENT OF
EDUCATION, AND WELFARE Always give 433-54-3937-1
HEALTH, Claim No. SOCIAL SECURITY ADMINISTRATION
when writing about your claim
10-14-64
nowledged ot the following: SCHEDULE NO. AMOUNT DESCRIPTION OF REMITTANCE
OcT 1 5 74
37 . 50 I~~ 7 'sonal check dated 10-6-64
Forwarded by: Previous balance
Mrs. Marina Oswald
ACkMOWLEDGEd
Current remittance
629 Belt Line Road @CT 1 5 i67
Richardson , Texas
75080
Current balance Yp
Next date fr payment
NW 88326 Docid: 32245128 Page 42
==================================================
Page 43
==================================================
porm OAC-5002
(1-4)
OFFCE REPORT OF CONTACT
(USE INK OR TYPEWRITER)
Dal Tas, Texeg
DATE: LLLs_Ies
WIE OR SIE PERSON AIN
<€ 12eL 433-54-3432
NAME AND ADORESS OF PERSON(S) CONAKCTED:
CONTACT MADE: PLACE OF CONTACT:
IN PERSON TELEPHONE
71 _
7a
ZZ 7z ZL Z3Za
2 22L122227197
21,21 2,_. 12144
A 222I
24-44714
Qz2222A 222Z2Z44
fhx2 Y 824
Kaaz 4222 22l
Ziezy 22x2 9 E2Ze 24e_2Z
2L 2221402 /9 ZI 71z_
4
@8z'
2r4/23Z
27E_AXL 22
ZJ 2ez224Z
222 LzziZ 213722
72c7e
2 Z 720 841Zn ZeAze LZ
5e: 21
722
ZA z 12AY
3A22 22sZ
24z-5A
2912222
ZL__84ez_
22222 212e 777/
72k2 =
24 42z 74_2 22e977712 ,
2 7 4224824Z831
ZEc 247,
{
ULe cez)
Gz2 /2
82
7 /3+
772 ~Ll) ~t f2 (s7en
DU2L
COMTACT MADE BY
Cletbs
TSTGNATURE) TTITLE)
(FOR CONTINUATION OF This REPORT TURN PAGE KEEP MARGINAL SPACE AT RIGHT FOR BINDING)
U 5. GOVERNMENT PRNTING OFFICE 671392
NW 88326 Docld: 32245128 Page 43
{24-9oz
4 4
2
24N 7Az
Ta/e
249
7+
Rope
c
==================================================
Page 44
==================================================
Military &cuational IICML[i@
Mrcrn
Rany Modu mu0m
Bn 4o
AxElectroniccoper CiaSpd It_DFL-nadsl28r_2Tay57
Elun5z 67b1
Ovilian Cccupntion
IDLcaTiom
0 Mu ( m Gmputet)
CIYIUAR
5 # OCfLceBop
Turs [IRredt Ih %mddl 04d E4KD un T} To XkD D1 11
GrihmM%ka B U 1952 1-23402 Tormed varLolb Zlerical
dutios
Mrh smaa Acad 14 I /195 DIJ Rwoaatd Per
dellverIng meg- puch 08 detrIbut:ng matl,
cquicl-vamtrmy Fegee & enstering telephone. Folpod fIlo
Tldr Buretd Fecords & operated dtto, lettar opening
#eutart
Sealing pachtbe.
n Aco 5ny (Sarrisn Uertputten Xni imrdnooe CYuILD n
AludScol_JAI 641952
001 Iuc} IIRratdt
AperGrsa Kcoalor_.AD 641951
oMd Muioald
Tcsting And SpeciaL QuaLificaTiONS
TORIKG# Lukcusl
64r4d On
Lous VADS IMTO Iou #D 40 24nta Vardnd
Ruailan DA Aca F 1574 55 (pl 1(2) 3P) 2(2) 251b59
Onla1o (Ntm4 wdln: rkl alpncs, @) QassifKATION, Aptitude; ANd TRADE TESTS
JutrtKtKatio
MTu Dn Ginde_Ia {U Tera)
GGT 33 II-los Irans Doa_aldpage
[RY 33 I-l25
[ac 3 II-lQ8
LAR II-M
FPA_ 31 [II-9k
L tLt RG 8i32 Doct56 II-92
UcohwIEOlD Du11 HMCXIM FUn00
Arcatt_Hatntananca_and Repalr lutrcatt_Yialntananca_And_Rapar_
Dulrils Hisonuiyod Gmlduid3
17_Comnleted_ESJovol OEDP
234rS9 88t pageed DSAFI HS GED Fr. 1-6, 2-57, 3-55, 4-58 , 5-52
sma (Lu} 7bo [YMirw)
GALD Lad Harver_ 165323
En LI} Dlc# #1 4471 4 4t Otna Tmion Mtk im (0- Oad upeK 1m (M+0 Op,i5-Omim
T3#ob@to (RPRED 03F 53#Mi 1
FOLsoM ExEIBIT No.1--Continued (p 7)
NW 88326 Docld:32245128 Page 44
Vo
(Nm
==================================================
Page 45
==================================================
The Aarine has no firm offer of employment he hag indicated that his former eiploycr Will entertain offering
e,ploy-ent with a suitablo selury to provide the necess_ry
sup;ort of his mother
3 In 0val ation of ell facts 'a vailable, it is the opinion
of the Board that Private First Class OSNALD meetw the
requirement 9 of p-r::ruph 10273 " Ci for release from
ac;ive
4 The Board recomrends that Private First Lee ii.
CSWALD be released from active with the "arine
for reasons of dependency-
R:aae_
B. J Xoza
Lieutenant Colonel, U , S: Marine
FoLBOM EEIBIT No 1- Continued (p. 80)
10:CCK:Ivdp
26 1959
TIIRD ENDOR SEMENT on Pfc OSWALD's ltr of 17 1959
From; Commanding General 3d Marine Aircraft
To: Senior Member , 3d Marine Aircraft Hardshipl
Dependency Discharge Board.
Sub j: Dependency Discharge; reguest for; case of Private
First Class Lee H. OSiALD 1653230/6741 USMC
Ref; (6) Para 10273 MarCorMan
(c): CG 3d MAIv 1tr to LtCol' KOZAK: 1O:RH:dln of 30
Jul 1959-
1. Delivered.
2 In accordance with the provisions of subparagraph 9c of
reference; (6), will convene the 3d Marine Aircraft
Hardship/Dependency Discharge Board a5 designated by ref-
erence (c), as soon as prac ticable Tor
the purpose of con- sidering the sub ject case.
3 The recommendations of the Board will be returned to this Headquarters by endorsement ` hereon as expeditiously as possible.
SFE :
Fi A CLCMAN , JR,
By direction
FoLsoM ExHIBIT No. 1-~Continued (p 81)
726
NWV 88326 Docld:32245128 Page 45
i.8%-
Clas?
daty Cor;S
Corps
Aug
Aug
Wing
Wving
You Iving
==================================================
Page 46
==================================================
50:EJa :awh
K88
1259
FOJr Tf ENDOitSEENT on Pfc O3 ALD's ltr of 17 aug 1959
rron: Senior Aember 3d Jarine Aircraft Ning Hardship or
Dependency Discharge Boara
Comnanding General 3d .sarine Aircraft Wing
Subj: Discharge bz, reason of depende adeacY ; request for case of
Private First Class Lee H. 1653230/6741 US:C
1S Guided by tne provisions 0f reference (2) and in compli-
ance xith Third Endorsenenlt hereto, the Hardship or Dependency
Discharge Board net at 1530,_ 27 August 1959 to consider the
case of Private First Class Lee H OSIALD 165323076741 US.C _
The Marine had subm itted an official request for a dependency
discherge in accordance with reference (a) The following
members were present:
Lieutenant Colonel Bolish J_ Kozak 07108 USIiC (AWWHG-3)
Rjor George E_ MC CLANE 016430/7335 USC " (iAG-36)
~ajor Eugene T . C AD 035129/7304 USzC (niHC-3)
2 _ Upon examination of the , basic reqiest supporting encl-
osures Service necord
Private First Class i. OS ALD
was interviewed by the Board _ 'Che following facts were
then considered:
a , Private First Class Lee H_ OS ALD not married _ on
his initial three (3) year enlistment in the Marine Corps
is obligeted to serve on active until 7 December 1959.
b 'The Marine submitted hig request for 3 dependency
discharge in order that he may provide physical and
financial assistance to his invalid mother residing in
Fort (orth, Texas.
C The home situation of; Private First Class OSililw' nas
been' aggravated subsequent to his enlistment date throuc:
incapecitation of his mother a5 2. result of an industrial
accident The mother is no lonEer gainfully employed die
to her physical conditian and has: no source of income Te
presence of her son Private First Class OSWALD , is 'required
for physical and financial assistance
d . One son married and residing in Fort Worth is
unable to
provide either finencial 'or physical assistance
to the "iarines mother due to his marital respongibilities
the inability of the two fsinilieg to maintain a COr;mon 38t
Another son , married, with the U _ S Air Force on
ictive in Japan _ cannot furnish financial support .
FoLSOM ExEIBIT No." 1-Continued (p: 79)
NWV 88326 Docld:32245128 Page 46
2 8
To:
Lee and
duty
duty
==================================================
Page 47
==================================================
3 1 EE 1 1 1
9 1
1
1
2
1
1
: 6
5
3
1 1 I
3
1
2
2
%
7 1 1
1
J3 1
5
1
1i
3 8
1
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1
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i2 1x
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1
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;
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9
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A86: 1
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NOIJ3V 4/3 8oJ Lsano3a
NW 88326 Docld: 32245128 Page 47
;
==================================================
Page 48
==================================================
OPTIONAL FORM No. 10 5010-107
MAY 182 EdiTiON
GSA GEN REG , No_ 27
UNITED STATES GOVERNMENT
Memorandum
CONFIDENTIAL G
ADMINISTRATIVE
TO Kansa8 City Payment Center DATE: June 3, 1965
FROM Jesb C. Carter, Assistant Manager
Dallas Texab
SUBJECT: Lee Harvey Oswald AfN 433 54 3937
Our newbpaper has reported the re-marriage of the wage earner'5
widow. Since the language barrier 18 btill a problem with ber
it i8 possible she will overlook making a proper report_
Reportedly the marriage took place on Tueeday June 1, 1965.
Qwn aZed
(516'5 rot, 52 G
Rcs/
Lo 2-
1
Asik ,
U Bonds Regularly on tbe Payroll Savings Plan
NW 88326 Docld:32245128 Page 48
64
Buy Savings
==================================================
Page 49
==================================================
~1f Ie
NR
DEPARTMENT OF HEALTH, EDUCATION;, AND WELFARE
SOCIAL SECURITY ADMINISTRATION
J}* {*7
4.022a_s
NN LLor
kuofFICe Rawlirs Street WAGE EARNER:
Rhen wtlting about your clalm
F.o. Fox 6556 olwaye glve Clalm No:
Delles Texes 75219 4 32_
54-3937 @
Ju
GWJ
7 33
Zza_LU~
}ihmJ 2 75@ 8 0
This will acknovledge inquiry regerding the check( s) for the
month( s) of U& 14 6 9 Ge 1e@/ A
The Treasury Department desires that each person promptly receive the
amount due him but wishes to avoid unnecessary expense in record search-
which results in many instances in finding the check wes correctly
d_ On a notice, such as you have furnished uS , the Treasury Depertment
must necessarily search its payment records from the date of issuance of
the check until the date that a substitute check will be issued _ Because
of the lerge volume of payments , the searching operetion entails & heavy
expense for each item - Accordingly, it is requested that you fill
the questionnaire on the reverse of this notice and RETURN IT IN THE
ENCLOSED ENVELOPE UNLESS THIS QUESTIONNATRE IS RETURNED NO FURTHER
ACTION WILL BE TAKEN _
If you receive the check before heering from the Treesury Department
you should notify the social security district office shown above- Yen
may use theenelesed post cara to nottfy "S, After sending in this noti-
fication, you may cash the check.
Upon receipt of this questionnaire, action if necessary , will be taken
by the Treesury Department to plece 8_ stop payment on the check and to
refer the case to the United States Secret Service for investigetion and
clearance s0 8 duplicete check can be sent to you The Treasury Depart-
ment will in touch with you if it needs further information
Sincerely yours,
District Manager
Enclosures :
Diles,
Envelope
Post-Gard- 0A-C1247
DONOT WRITE BELOW THIS LIN
#bc 131338
Check Number Date Amount
{ili}
Foni $34-L7as (10;66)
SfFORMERLY.OA:CL735)
NWV 88326 Docld:32245128 Page 49
"NU}
3716
your
Qu8
ing
pai-
out
get
==================================================
Page 50
==================================================
Fom Approved
Budget Bureau No. 72-R417.7
PROMPt REPLY WILL EXPEDITE ActiO
QUESTIONNAIRE
1 Have you received the check described on the other side of this sheet? _ Yes
80 If your answer is "Yes' destroy this fm; fill out and mail the enclosed post card:
2. If your answer is ''No, have you asked your local post office about the check?
(I your answer is "'No," this should be done.) MYes No
3. I you recently changed your mailing address, have you tried to find out whether
the check is held there for you at old address or was returned to the post
office? (If your answer is this should be done.) Yes No
4 Have you any information which you think might assist the Treasury Department
in locating the check? (If your answer is "Yes," please give such information
der ' Remarks.") Yes No
'it possible that you Ieceived the check and cashed it, thinking it was issued
for another purpose? (If your answer is please uder ' 'Remarks. ') Yes No
6. If this check was illegally cashed, you will be entitled to payment of the amount of the check; however,
another check in place of it will not be issued until the case has been fully investigated by the United State:
Secret Service. As it may be necessary to contact you for further information, please fumish on the line below
the address at which you may be reached during the daytime, if such place is different from your residence:
321e 8.
(Number and Street) (Clty, Stete end ZIP Code)
7 _ If she check was madled to a different address than shown below, please fumish that address:
(Number and Street) "iCity State and ZiP Code)
8 After reviewing all circumstances, I/we wish to make formal claim to the Treasury Department for stoppage of
payment of this check and the issuance of a substitute check: Yes
9 REMARKS (State any otber facts wbich may aid in locating lbe cbeck):
SIGNATURE 0f PAYEE OR CLAIMANT If this quebtionnaire ha8 been gigned by mark (X), two witnesse8
who know the Pereon muet below, giving thefr full addreesee.
NAME
1ps . Kmel pk_
ADDRESS (Street number, State end ZIP Code) SiGNATuRE 0 F Co-PAYEE (Both husbad md wife must 8&n [f &
peyee8 0f 0 combined check)
2. NAME RESI DENCE NUMBER AND STREET
Jz"LL_ UJ
ADDRESS (Street number; City, State &d ZIP Code) city STA TE AND Zip CODE
Lszh~Las_ 22_
DA TE (Mo., Day, Md Yeer) TELEPHONE NUMBER
2sg L2 1J
- 0 720
U.5. GOVERKHENT Printimg Office 1966 0_2J8--900
NW 88326-Docld:32245128Rage-50
beiog your
'No,
"Yes, explain
0e4s
Jezse
sign
City,
73 3
==================================================
Page 51
==================================================
'763/
44
YR
1t
DEPARTMENT OFHEAETF EDUgA Uu FARE
SOCIAL SECURITY ADMINISTRATION
3716 .Revlins atreet
OfficE P,0, Box 6556 WAGE EARNER: 2}
Dzenesl
Dellas Texes 75219 When writing about your cloim
olwoys give Claim No.
476 7-82-403y
{
77o.
pxTu
8
733 Ecasal
Lhada~ Jx 7s080
83
This will acknowledge your inquiry regarding the check( s) for the mont
of Zune
The Treasury Department desires that each person promptly receive the
amount due him but wishes to avoid unnecessary expense in record search-
which results in many instances in finding the check was correctly
paid. On a notice, such as you have furnished uS , the Treasury Department
must necessarily search its payment records from the date of issuance of
the check until the date that a substitute check will be issued. Because
5
of the large volume of payments , the searching operation entails a heavy
expense for each item. Accordingly, it is requested that you fill out
F
the questionnaire on the reverse of this notice and RETURN IT IN THE
ENCLOSED ENVELOPE _ UNLESS THIS QUESTIONNAIRE IS RETURNED NO FURTHER
@
3 ACTION WILL BE TAKEN .
If you receive the check before hearing from the Treasury Department
you should notify the social se curity district office shown above Yex
62
~ay_use_the enclosed postcard tonotity4S . After sending in this noti-
fication, you may cash the check_
receipt of this questionnaire
)
action if necessary , will be taken
by the Treasury Department to place a paynent on the check and to
refer the case to the United States Secret Service for investigation and
clearance SO a duplicate check can be sent to you_ The Treasury Depart-
ment will in touch with you if it needs further information-
Sincerely yours,
Ulentnc Yh?a ben
District Manager
Enclosures:
Envelope
Post_Card 04-81247
D NOT WRITE BELOW THIS LINE
Check Number Date Amount
Form SSA-L735 ( 10-66) "7od0
(FORMERLY OA-CL735)
NW 88326 Docld:32245128 51
LtA. EDUC_
=
1969
ing
Upon
stop
get
Yhk9
Page
==================================================
Page 52
==================================================
Form Approved Budget Bureau No. 72-R417.7
PrOMPT REPLY WILL EXPEDITE ACTION
QUESTIONNAIRE
Yes No
check described on the other side of this sheet?
1 Have you received the
this form; fill' out and mail the enclosed pos; card:
If your answer is "Yes" destroy
Yes No
have
your local posf officf about the check?
2. If your answer is "No,
answer is 'No,' this should be done:) _
(If your mailing address; have You tried to find out whether
3
If you recently chang-d your old address or was retumed to the
the check is being held there fof you,at Your Yes No
answer is 'No,' this should be done.)
post office? (If your
infomation which you think might assist the Treasuty Dpararient
4 Have you any answer is "'Yes, please give such information
No in locating the check? (If your Yes
under ' 'Remarks.")
received the check and cashed it, thinking it "askissued
No
5 Is it possible that you under 'Remarks. ) Yes
for another purpoce:
(If your answer is "Yes, please
of the amount of the check; however,
6 this check
{"legally cashed, you will be entitled t payment investigated by the United States
in
of it will not be issued until the case has been fully
on the line below another check place for further information, Please furnish
Secret Service.
As it may be necessary to contact you
is different from residence.
which
may be reached during the daytime, if such place "1
the address at you
3
733 JsHsh2z_ clz
Lishsdssz
State
[8s
an6Z1F Code)
6
(City, ;
(Number and Street)
than shown below,
furnish thal address <
7_
If the check was mailed to a different address 3
"(City , State and ZIP Code)
2
0
(Number and Street) 5
formal claim to the Treasury Department for stoppage of
[eviewing all circumstances, I/we wish to make
8. After
of this check and the issuance of a substicute check.
payment
otber [acts wbicb ma) aid in locating lbe cbeck):
9 REMARKS State any
M5iGATURE PAYEE OR CLAIMANT
questionnaire has been signed by mark (X) rwo witnesses
If this
si below, giving their full addresses.
who know the person must gn
NAME
1Ys K vn2th pkz
[5iGNATURE 6F Co-PAYEE Both husband and wife must sign if co"
ADDRESS (Street number,
State and ZIP Code) lpayees of 0 combined check)
733 Julsdeke
RESZDENCE NUMBER AND STREET
2 . NAME
1chaedsmz_ (~xs $ 7 so8 0
city STATE AND Zip CODE
ADDRESs (Street number, City, State and ZIP Code)
TECEPKONE NUMBER DATZ (Mo., Day, and Year)
CCsi i 8
AD-L-0Z20
PRINTING OFFICE 1967 0 265-973
4 U. S. GOVERNMENT
NW 88326 Docld:32245128 Page 52
asked you
explain
wa;
your
44
1
1
please
6 v2
oF
City,
c6
1s6 }
==================================================
Page 53
==================================================
Department of Form OAprovez (5-682 DETERMINATION OF Heolth, Education, ond Welfare Approved by Comptroller Generol, U.S. Social Security Administrati on January 28, 1955 RESUMPTION OF AWARD
district OFFiCE ACCOUNT NUMBER
31 6 R Awcins s7
DESSAS_LTEX
433-58-3922
TKE Following DETERMINATioN I5 BASED On Supporting EvidencE ON FiLE AND €ERTIFICATION of PAYMENT Is RECOMMENDED As FoLLows:
NAME AND FOR MINOR CKILDREN OF
Mae ?
N, Pok Tery
12 4 5 3 0 N Na 3r:
For
R icH Aeeson 7X 750x0 GUARDIAN OF
1 . TEMPORARY DEDUCT IONS EMPLOYED_
2. PERMANENT DEDUCTIONS EMPLOYED
2
25 EA_
TOTAL CHA RGEABLE TOTAL
EQRNINGs $_
S13b_Ybe:tikss =
S
3680 EXGESSGs $ _ BONFYYs)
$
40.30_
MOTHER HAS A Child in
3 EMPLOYED OUTSidE THE U: $ 4. HER CARE BEGINNING
It HAs BEEN DeTERMinED ThAT TME ABOVE AGE 65 To CoRRECT MAME OR SCCIAL 5. PERS On Is Now THE Pro PER PA YEE. 6. RECOMP 7. SEcURiTY ACCOUNT NO. 8. NEW ADDRESS
9_
AGEAYZED
10.
ToeCONEINEFITS
M1.OTHER
TERAL_Ckas EemRITAZ' 202 (T) EXC
ONE CHECK ConditiONAL FOLDER
ONLY AWARD ADJUSTMENT SupP L/s ADJUSTMENT REFERENCE
BENEFICIARY NOTicE:
987(510.2L 3Ls834s6 Rys(4o38s-2/65
MONTHLY BENEF ACCRUED BENEFIT DEDUCT IONS
PMT BEN. NET IDEN_ IDEN_ PERIOD EFFECTIVE R w
CODE CODE BEGIN_ MONTHLY AMOUNT AMOUNT F AMOUNT
DA TE RA TE Frm To Trom DUE D C
3340 545416260
H0.3014 S66bL
6 oz3b5 sks[a046
3160
REMARKS
PIA
FBS-Cs
A - 6 J 41KCe SC -3
PREPARED&x EXAMINER DATE APPROVED BY-REVIEWER DATE Eld 1 [x3 6
LARRLLE-30-/3 bzsl66
NW 883262 Dodl32245/78/Page 53
Form
Jas
46o
6"
To
Ys
ks
76,00
Iljja
==================================================
Page 54
==================================================
Department of
Form OA-C1O7 (2-64) DETERMINA TION OF Heolth, Ed: cation, and Welfore
Approved by Comptroller Generol, U.S. Social Security Administration
January 1955 RESUMPTION 0F AWARD
DIstRiC T OfFICE CLAIM NUMBER 3716 Rawlins St_
Dallas, Tex. 75219 433-54-3937
TAE Following DETERMINATION I5 BASED ON supporting EVIdENCE ON FICE AND CERTIFICATion PAYMENT 15 RECOMMENDED As FolLows:
NAME AND ADDRESS FOR MinOR CHILDREN OF
FOR
Marina N, Oswald
629 Belt Line Rd _
G UARDIAN 0F Richa rdson, Tex. 75080
TEMPORARY DEDUCTIONS
E
EMPLOYED
9/64 ON (Partial)
2 PERMANENT DEDuctiONS EMpLOYED
TOTAL CHA RGEABLE TOTAL TOTAL EXCESS EXCESS MONTF EARniNGS 5 EARNiNGS 5 EARNINGS S BENEF
MOTKER HAS A CHILD IN EMPLOYED OUTSIDE THE U.s _ 4 HER CARE BEGINNING
IT HAS BEENDETERMINED THAT THE ABOVE AGE 65 To CORRECT NAME OR SOCIAL 5 _ PERSON I5 Now THE PROPER PA YEE_ 6 RECOMP SEcuRiTY Account NO 8_ NEW ADDRESS
ATTA INED To COMBINE 202 (T) EXC
9_ AGE 72 Ut0_ A & B BENEFITS 11.OTHER
ONE CHEC k CONDITIONAL FOLDER ONLY A - AwARD ADJUSTMENT SUPP L/s ADJUSTMENT REFERENCE
BENEFICIARY NoTIce:
"S"
MONTHLY BENEFIT ACCRUED BENEFTT DEDUCTIONS Pmt BEN NET
IDEN.IIDEN BEGIN MONTALY PERIOD EFFECTIVE R W AMOUNT
CODE CODE DA TE RA TE AMOUNT AMOUNT F DUE FROM To FROM To D C
E 37. 60 9/64 9/64 37 . 60
E 37. 50 AA 37.50
E 10/64 31.40 9/64 9/644 31.40 2 31.30
REMARKS
PIA 71.00 AA-Excess refun received on
MAX 106.60 Schedule #7h, dtd. 10/15/64
E 31.40
C2 37.60 C1-37.60
3 - C C
OCL
PREPARED BY-EXAMINER DA TE APPROVED BY-RFMEWER DATE
Io-6-6Y
auxz Vehlsy
NW 88326- Docld;32245128 Page 54
Form
28,
0F
3 5KC
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Page 55
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Department of
Form OA-C1O7 (5-64) DETERMINA Tion 0F Health, Education, and Welfare
Form Approved by Comptroller General, U.S. RESUMPTION 0F AWARD Sociol Security Administrotion
Jonuary 28, 1955
DistRicT OfFIcE AccounT NUMBER
433-54_3937 /
The Following DETERMINATion is JBASED On supporting EvidencE ON FILE AND certificaTion 0F PAYMENT Is RECOMMENDED As FolLows:
NAME ANd ADDRESS For minor CHiLDREN Of
MMA RinA 0swA62
FOR
GUARDIAN OF
TEMPORARY DEDuctions EMPLOYED
O Qe2+ah
2 PERMANENT DEductions EMPLOYED
9ay 2sz -(adiah )
ToTAL RGEABLE TOTAL
ERRAINGs
$ _
99902 EXFESGs $_
85yiee
ZArreNGs
$
24,82 MONEFFs)
$
37_62
MotkER KAS A CHILD IN
3 EMPLOYED OUtsidE THE U. 5_ 4 HER CARE BEginniNG
IT HAS BEEN DETERMINED THATTHEABOVE AGE 65 To CORRECT NAME OR SOCIAL
5 PERSON IS Now THE PROPER PA YEE 6 _ RECOMP SecuRitY ACCOUNT No_ 8 NEW ADDRESS
ATTAINED To COMBINE 202 (T) EXC
9 AGE 72 10_ A& B BEnEFiTS 11 OtkeR
ONE ChEcK CONDITIONAL FOLDER
OnLy A _ AwARD ADJUSTMENT SupP LIs ADJUSTMENT REFERENCE
BENEFICIARY Notice:
MonthLy BENEFTT ACCRuEd BENEFIT DEDUCTIoNS NET Pmt BEN. R w
IDEN IIDEN BEGIN MONThLy PERiOD EfFECTIVE AMOUNT F
AMOUNT
Amount DUE CODE CODE DA TE RATE
From To FROM To D C
REMARKS
PiA 71,0 2
Pr[PaacD Iainer DATE APprov '0Y-REYIEWER DATE TALL
202 2/2 7 Ls
Zx~h Cogs 221/5
NW 88326 Docld: 32245128 Page 55
Ves
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Axux Dao
FORM O4-C528b (4-84) KC
DISTRICT OFFICE CLAIM NO PIC
DETERMINATION OF
TERMINATION Of ENTITLEMENT
433-54-3937-E B
w.EJ OR SUSPENSION OF PAYMENTS
BA SED ON SUPPORTING EVIDENCE ON FILE
ADJMT CODING DATE
611/65
CR, BLOCK NO_
Marlna A. Osvela 980 2 08 JUh '65 KC
INITIALS DATE OF Birth
PAYEE FILE
CLc Monthly RATE SKoULd HAvE BEEN (Should BE} STOPPED
DIARY FILE A
45 31.40 6/65
SPa LAST SCHED. NO . TREASURY REQUESTEDTo Discontinue PAYMEnT crosS-REF
94 6/65
ACCOUNt NO.
0. Investigation pending determ: of cont: disability 4. Failure to have a child entitled 7_ Refused VR Services
1. Worked outside the United States to benefits in your Care 8. Payee not determined
2. Worked and expects net earnings to exceed 5. OAIB worked outside the 9.
S1200 United States
3. OAIB worked and expects net earnings to exceed
81200
" J
dhlos
(Clerk) (Date) (Reriewer) (Date)
0_ Benefits payable by some other agency 6 Death Marriage of child
1 Death of benetficiary
2 Dependent teminated due to death of insured individual 7C. Adoption
3 Eigsoxxdlorie Remarriage Adoption of child
4C. Attained age 18 and not disabled
4. Child attained age 18 and not disabled 8H. DIB no longer disabled
5. Beneficiary entitled to other benefits 8. Mother terinated:
6C. Child no longer disabled Child no longer disabled
9_ X DIB atlained age 65
R Claim withdrawn
NWN 88326 Doeld:32245128 Page 56
niLo-
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FORL O4-C528 (4-64) KC
DistriCT OFFICE CLAIM No_ Pic
DETERMINATION Of 433-54-3937 2
TERMINATION OF ENTITLEMENT
w E_ OR SUSPENSION OF PAYMENTS
BASED ON SUPPORTING EVIDENCE ON FILE
ADJMT CODING DATE
49
10/16/64
Cr. BLOCk No.
'64 KC
Marina H. Oswald
[NITIALS DATE OF BirTH
PAYEE FILE
Elc monthly RaTe ShouLd HavE deeN (SHOUd BE ) STDPPED
Kea
DIARY FILE
4s 3,60
Spa LaST SCHED. Ho. TreASUry RequestedTo Discontinue Payment CROSS-REF
91 Jo/6h AccOunT No_
0. Investigation pending determ. ol cont: disability 4 Failure to have a child entitled 7. Retused VR Services
1 Worked outside the United States to benefils in Your care 8. Payee not determined
2. Worked and expects net earnings to exceed 5, OAIB worked outside the 9_
S1200 United States
3. OAIB worked and expects net earnings to exceed
81200
rercierk)
7p
(Reriewer
#
(Date)
0. Benefils payable by some other agency 6_ Death Marriage of child
1. Death of beneliciary
2. Dependent terminated due to dealh of insured individual 7C. Adoption
3. Divorce Marriage Remarriage Adoption of child
4C. Attained age 18 and not disabled
4_ Child attained age 18 and not disabled 8H. DIB no longer disabled
5 . Beneficiary entitled to other benetits 8 Mother terminated:
6C. Child no longer disabled Child no longer disabled
9 X DIB attained age 65
R Claim withdrawn
NWV 88326 Docid: 32245128 Page 57
130 4 020C7
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PREVIOUS DistRiCT OFFICE DEPARTMENT 0f NEW DisTRiCT OFFICE
HEALTH, EDUCATION; AND WELFARE
SOCIAL SECURITY ADMINISTRATION
PAYEE, ADDRESS CHANGE, OR HOLD CKECK REQUEST
DATE WAGE EARNER Pic CLAIM No.
5/1o/65 B
FLOA LLOA MBA SPA
03140 MarIna W Oswela 433 5h/3937 %
Tr FILE CODE CLc 5 & C CODE 12k5 Donne Dr
94 45 Ls3904 RIchardson Tex 75080
ADDRESS CHANGE
HOLD ck DATED_
PAYEE CHANGE
REPLACE CK DATED 6/3/65
DRAWN PAYABLE To
Mariena N Ogwala
FORM OA-C610 (2-64) FILE COPY
mvj
NW 88326 Docld:32245128 Page 58
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PREViOUs district OffIce DEPARTMENT Of NEW District OFFJCE
HEALTH_ EDUCATION; AND WELFARE
Social SEcURity ADMINISTRATION
3716 RaWL HS_St'
PAYEE, ADDRESS CHANGE, OR HOLD CHECK REQUEST PAtASfX75210
DATE WAGE EARNER pic CLAIM
05/05/65 0 6
FLOA LLOA MBA SPA
2 3
03140 Meellua 433 54 3937 E
TR FIlE Code CLC 3 & C CODE MARAANA N OSWALD
9h lys Ws390 1245 DONNA DR
ADDRESS CHANGE
RichaRdSoN TEX 7508 0
HOLD CK DATED
PAYEE CHANGE
REPLACE CK DATED
DRAWN PAYABLE To-
ARIBN& N Oweyl_REDIRECTED
FoRM OA-C6108 (6.64 ) FILE COPY
NW 88326 Docld:32245128 Page 59
No.
Qf4ks
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US District OFFICE DEPARTMENT Of NEW District OFFice
HEALTH, EDUCATION; AND WELFARE
SOCIAL SECURITY ADMINISTRATION
PAYEE, ADDRESS CHANGE, OR HOLD CHECK REQUEST
WAGE EARNER PIC CLAIM No.
4-3-64 B
LLOA MBA
03760 Marina N Ogvald 63} 5L 3937 $
CODE CLc S & C CODE 629 Belt Line
45390 Richardgon Tex 75080
JRESS CHANGE
~D CK DATED
'EE CHANGE
'LACE Ck DATED
4WN PAYABLE To
A-C610 (6.63) FILE COPY
NWN 88326 Docld:32245128 Page 60
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Page 61
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Form OA-C526 (1-61)
Form approved by
BENEFTT SU MMA RY
Department of Health, Education, and Welfare
Social Security Administration Comptroller General, U. $,, October 25, 1950 Bureau Of Old-Age and Survivors Insurance
CLAsS OF ACTION ACCOUNT NUMBER
'833-54 3937
MONTHLY BENEFIT ACCRUED BENEFIT DEDUCTIONS PMT_ BEN NET IDEN: IDEN PERIOD EFFECTIVE R W AMOUNT CODE CODE BEGIN MONTALY AMOUNT AMOUNT DUE DATE RATE FROM To FROM To
6 8
E 32c0L"sz_ 'Iss
1l2.80
E
613,00 4S . 313,60
325.86
ei 7sack"/s3_
225L0 22560
REMARKS
@i 7
I'7 P 7 4KC FEB
CLERK DATE REVIEWER DATE
7.eaieel
4/:hx)T1IeL?
2 - %-6 t
4 U_ 5 GOVERNMENT PRINTING OFFICE: 1962-666!2 1
NW 88326 Docld:32245128 Page 61
A/6k
hs 'Ibxk
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Focs-0A-C-/0/ DeterminaZcov~ % Awarx
Form approved 57 C72 61985 GeneIQUT"' L 3 January 1958
DATE OF DEAT DAn CUMM FilED
W | NI 0 DATE" Of BiRTH
TNSURED TNBMIDUA 10/19/39 11/24/63
Iee H Oswald RACE I
BASE Yr: 0r CLOSTNG DATE Lump SUM AMOUNT
CURRENT QTRS. 3 First Base Yr. Or Starting Dato LAST
2 REQUIRE aTs_ HAS At LEAST 213.0
6 6
1951 1963 CRMOnS
PRIMARY AMOUNT
OTSABILITY peRiOD EXCLUDED EUAPSED YRS_OR DiVISOR
5. TotaL EARMINGS OROPPED 71.00 61 825
24 3306.85
ANy OTHER ADJUSTED RELATIVE"S ACCT.
DATE OF DATE CLAIM ORiGiNAL
BENEFIT NUMBER (IF ANY)
NAME BIRTH FILED BENEFIT BENEFITS
SYMBOL
Gl
7/17/41 Y9/64
53.30 37.60
E
C2 June L
2/15/62 0 53.30 37,60
C1 Audrey M 10/20/63] 53.30 32.60
MaXMMUM]PAYABLE REMAINS UNPAID
REIMBURSABLE F_ H, EXPEMSES ARE PAID AS FollOwS 112.80
8
5.0. CODE
TI. REMARXS 3716 Rawlins St 814
Dallas Tex 75219
187 P 7 4KC FEB
HF
DATE OF LumP SUM
ENTITEMENT Montkly DEATH
12_ CertificaTiON Of PAYMENT To MONTHLY BEMEFIT PAYMENT BENEFITS
as Alaimant Or a5 representative_of_the_claimant
Symbol Name and address of payee
14/63 37.60 213.00
B Marina N Oswald
63 Bx 1Lo7
Grand Prairie Tex 75050
Marina N Oswald for minor children of L H Oswald 11/63 75.20
ame
certlty that pursuant to lawfully delegated authority have verified the
lawfully delegated authority, certif that, On application by above statements with tha supporting evidence on file in this 08icce thaatali
Pursuant to
claimant(s) named above as payee(s) and the supporting
have computed al1 amounts and that same are corecision sshowtitiand |
of tha Or on behalf of the statements are my determinatlon indicated benefitis) are in accordance with the provisions ot
evidence forwarded herewith, haebeoeei2in gto
be paid as indicated_ Social Security as aptonded.
of fact and decisions a5 to-the
Ll
Approved (Claims Authorizer) By_ (Claims Representative) 2 [64
4/16/64 Date_
Date
NW 88326-Dociq:37245128 Page 62 Rapo 1982-836070
Acz?
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44
ACCOUNT NUMBER 1958 1965 FAMILY REMARKS TRANSCRiF
PIA PIA MAXIMUM
433 54 3937 71. 0 76 , 0 0 114 ,0 0 0 9/65R
BENEFICIARY'S NAME pic BIC LAF RETROACTIVE NEW
AMOUNT PAID MONTKLY RATE
OSwALD AUDREY M C1 C1 24 , 6 0 57 . 0 0
0 1 37 , 6 0 0 1 37 , 6 0f 01| 37 , 6 0 0 1 37 , 6 0 0 1 37 , 6 0 0 1 53,30
PD 2,70 PD 2,7e Pd 2 , 7 0 Pd 2 ,70 Pd 2.70 PD 3 , 70
4 0 , 30 40 , 30] 40 , 3 0 40 , 3 0| 40 , 3 ' 57 . 0 0
0 1 53,30 01 53, 30]
PD 3 . 7 0 PD 3,70
57 , 0 0 57 , 0 0
OSwALD JUNE C1 C2 24 , 6 0 57 , 0 0
0 1 37 , 6 0] 0 1 37 , 6 0 0 1| 37 , 6 0 0 1 37 , 6 0 0 1 37 . 6 0 0 1 53.30
PD 2 .7 0 PD 2,70 Pd 2,7 0 PD 2.70 PD 2 , 7 O PD 3 . 7 0
40 , 30 4 0 . 3 0 4 0 , 30 40 , 30] 4 0 , 3 0 57 . 0 0
01 53,30 0 1 53, 3 0
PD 3 , 7 0 PD 3 . 70
57 , 0 0 57 , 0 0
TOTAL PA YMENT AMounT 49 .20 114 ,0 0
'dSwALD MARINA N E E 10 _ 33 , 4 0
21 31,40 21 31 ' 4 0 21 31,40 21 31, 40 21 31 - 0 31 .40
PD 2,0E PD 2 , 0 0 Pd 2 , 0 PD 2 , 0 0 Pd 2,0 NP 2 .00
33 , 4 0 33 , 4 01 33 , 4 0 33, 4 0 33 , 4 0 33 , 4 0
OLD MBA w B OLD MBA R B OLD MBA R w B OLD MBA R B OLD MBA R W B OLD MBA INCREASE INCREASE INCREASE INCREASE INCREASE INCREASE
NEW MBA D NE MBA D D NEW MBA D NEW MBA NEW MBA 0 NEW MBA
Forv OA-C596 '5-65} 1965 CONVERSION OF BENEFIT RATES
NW 88326 Docld:32245128_Page 63
T3
'4
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DEPARTMENT OF
HEALTH EDUCA TION, AND WEL FARE
SOCiAL SECURITY ADMINISTRATION
APPOINTHENT OF REPRESENTATIVE
[
Same 2)
"(am
ab
to act as my repre
e of repre Bentative)
sentative with respect to my claim under the Social Security Act; based on the eamings record of
Lee_Harvey_ Oswald 433-54-3937
(Name of wage earer or sekf-employed Individuel) (Soc ial securlty account number)
The above-named representative is authorized to obtain from the Administration infora
tion conce= my claim; and it is understood that any notice quest sent to him shall have
the same force and effect as if sent to me
1lle_hiliua @salc_
(Signatwe)
Ex_Ox_Box_14Oz_
(Addree8) Ze_
2L-Lees
Grand Prairiez Texas
(Dete)
ACCEPTANCE OF APPOINTMENT
accept the above appointment: [ am a Person in standing in my community and I
am
able to assist and advise the above party in this case:
am
AdzE
(Unlon repre Bentetive, Feiauvo; etc.
Zumus Z21asYn
'(Signature)
EFasLezAz
(Addeo0 Q zo Z26v
Dallas;ZZaz
(SEE REVERSE SIDE FoR REGULATIONS AS To FEES OF REPRESENTA TIVES FOR SERVICES TO
PARTY AND INFORMATION ON COnFLICT OF INTEREST)
Ac-512
(3-60)
NW 88326 Docld:32245128 Page 64
appoint_
ming
good
Ford
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0b 61.9
Form OAC-5002
(1-54)
OFFICE: REPORT OF CONTACT
(USE INK OR TYPEWRITER)
Pee
DATE:
1 =10 _
6Y
w/e OR S/E PERSON AM
Kr
aaneGun 483-54-2137
NAME AND ADDRESS OF PERSON(S)
4mAXL
Ylzn) 8w
7unLg-V 7bi 74 .
ZxdC
CONTACT MADE: PLACE OF CONTACT
IN PERSON TELEPHONE
TzES
Licud ZeLnuE _4
1963_ Uqu_(alz
8Le
Al
iLULe
LuuuL
euO Sk__ZZL
C C 2L1 2Lyn
L1
zL_
A7n mb
2ff/222
42 ZEZ_4
Aan_au4
Z : LC
ZC 2z/963_te
Lsby
CONTACT MADE BY
Dxz
(SIGNATURE) (TITLE)
(FOR CONTINUATION OF ThIS REPORT_ TURN PAGE_ KEEP MARGINAL SPACE AT Right FOR BINDING)
U.S. GOVERNMENT PRINTNNG OFFICE 1958 0 -486513
NW 88326 Docld:32245128 Page-65-5
4U ~
==================================================
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Form OAC-5002
(1-54)
OFFICE: REPORT OF CONTACT
(USE INK OR TYPEWRITER)
DATE:
W/E OR S/E PERSON AM
NAME AND ADDRESS OF PERSON(S) CONTACTED:
raneml
CONTACT MADE: PLACE OF CONTACT:
IN PERSON TELEPHONE
7avS24ee
2CLa
Eh E ZF
uEck
AEU ee_ZE_IC
Vlatk,
2_4
rV
2 C eia_ 4 x
0J ZZTr
w/
ZZz2"
ALL
Lu?
nx
CONTACT MADE BY
&z,7142 .
(SIGNATURE) (TITLE)
(FOR CONTINUATION OF This REPORT. TURN PAGE_ KEEP MARGINAL SPACE AT RIGHT FOR BINDING)
U. 5 GOVERNMENT PRMNTING OFFICE 1958 0.-486513
NW 88326 Docld;32245128_Page 66
TUs6x_
23Y81 Ulv