REQUEST FOR PERSONNEL ACTION
REQUESTING OFFICE: Fill in items 1 through 18 and A through D except 6B and 7 unless otherwise instructed. If applicable, obtain resignation and fill in separation data on reverse.
NAME: Dr. James A. Moore
DATE OF BIRTH: 19 Mar. 1931
DATE OF REQUEST: 16 Feb. 54
DATE ACTION IS TO BE EFFECTIVE: 28 Feb. 54
POSITION TITLE: Chief, BA-121-14
SALARY: $8,000.00 per annum
LOCATION: Caracas, Venezuela
... (additional details follow)
SIGNATURES: Various signatures and approvals are present.
NOTES: Additional handwritten notes and stamps are visible.