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SECTION III CONTINUED FROM PAGE 1
27. DATES AND PLACES OF RESIDENCE OUTSIDE OF UNITED STATES AND FOR THE PAST 10 YEARS OR SINCE AGE 18, WHICHEVER IS SHORTER.
N.A.
28. BRANCH OF U.S. MILITARY SERVICE
N.A.
29. OFFICE OF OTHER GOVERNMENT AGENCY (SPECIFY) IN WHICH EMPLOYED, POSITION, AND DATES OF EMPLOYMENT.
Clerk in U.S. Consulate, Ensenada, B.C., Mexico, from 1935-37.
SECTION IV RELATIVES BY BLOOD, MARRIAGE OR ADOPTION LIVING ABROAD OR WHO ARE NOT U.S. CITIZENS
1. FULL NAME (Last-First-Middle)
NONE
2. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES
3. RELATIONSHIP (Specify)
4. AGE
5. CITIZENSHIP (Country)
6. FREQUENCY OF CONTACT
7. DATE OF LAST CONTACT
1. FULL NAME (Last-First-Middle)
2. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES
3. RELATIONSHIP (Specify)
4. AGE
5. CITIZENSHIP (Country)
6. FREQUENCY OF CONTACT
7. DATE OF LAST CONTACT
1. FULL NAME (Last-First-Middle)
2. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES
3. RELATIONSHIP (Specify)
4. AGE
5. CITIZENSHIP (Country)
6. FREQUENCY OF CONTACT
7. DATE OF LAST CONTACT
1. FULL NAME (Last-First-Middle)
2. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES
3. RELATIONSHIP (Specify)
4. AGE
5. CITIZENSHIP (Country)
6. FREQUENCY OF CONTACT
7. DATE OF LAST CONTACT
8. SPECIAL REMARKS, IF ANY, CONCERNING THESE RELATIVES
SECTION V FINANCIAL STATUS
1. DO YOU HAVE ANY INTEREST DESCRIBED IN YOUR SALARY OR COMPENSATION FROM YOUR PRINCIPAL EMPLOYMENT, INCLUDING STOCKS, BONDS, CORPORATIONS OR BUSINESSES OR IN OR THROUGH YOUR SPOUSE? (If yes, give complete details on a separate sheet and attach in a sealed envelope.)
YES [ ] NO [X]
2. ARE YOU RECEIVING OR ANNUITY FROM THE UNITED STATES OR BENEFITS OR DISABILITY COMPENSATION UNDER ANY RETIREMENT ACT, OR ANY ANNUITY FROM THE UNITED STATES AS A SURVIVOR? (If yes, give complete details.)
YES [ ] NO [X]
3. IF YOU HAVE ANSWERED "YES" TO QUESTION 1 ABOVE, GIVE COMPLETE DETAILS.
4. INCOME IN ADDITION TO YOUR SALARY, STATE OTHER SOURCES OF RECURRENT INCOME NOT INDICATED IN PREVIOUS ITEMS.
None
SECTION V CONTINUED TO PAGE 3
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