“the power of attorney?)
wife
6.
Re: Item # 4- Contact For, Emuercency Should
ADDITIONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMS
Follow The Below ander
P. Wife (Trem3)
B. Bother (Item 4)
C. IN-LAWS
MR. Norman H. Wy ATT
RTE 2 Box 342 B
MANASSAS, VA. 22110
Tel: (7”
“14-00000
I
CONFIDENTIAL
(When Fitted tn)
1. ICONTINUtO)
IN #HON NAME(S) ans fur accounts LISTED
My name only ________________________
Have you COMPLsIED a Last BILL AND TestAMEErO CXX ”‘" •o. ir "vest, mesne 13 DOCuMENT LOCATSOI
With me in my personal papers •
wAvivou”
“e.AtiQeei? ario Data or giefp or fug PiDLC sou wiser • The survivor’s annuity will begin upon your death and end when
to atrtiva tht suaviver ArNuite she tor hie) dies
miasef or MPa. 4 0 apsf. med.fle, fast)
• The survivor’s annuity will be 55%, of the redfucot annuity you
•”
“WOVE OFFICE POLICY NO.
U.S. Government Ecpldyee Washington, D.C.
Mutual of Omaha Zospitalization Omaha, Nleb. GIF 1514
7. HAVE COMPLETED THE FOLLOWING:
8. REMARKS:
witu[..) ves Cxm POWER Of ATTORNEY CD vEs 00 #0
Power of Attorney to: %
Edwin T. Phillies, ir
4804 Washbur”
“NO. (II "Yoo” give nome(
C88 "Yoe" s) and addrose)
name’’s) addrose) -
Jr accigung Clicker The Nattoned Bank n Washington who presses the power of attorney?)
0 ADDITIONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMS
$0000 AT TOAYe SIGNATURE
June.28 1967 Olianenth L Busti”
“):vRs A
Catherine Hylander 11965 Goinsboro Rd.
wave you EXECUTEDA POWER or ATTORNEY -. YES:
Rockvil e, Md.
P.no.-(lt*Yes"swho possess the power.ot attorney’)
06. ADDITIONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMS
SIGNED AT DATE
Tisge Tarme Fry
CONFIDENTIAL”
“14400000
PITS0L
s Y*
mottez d*te*gdkawyo zgigt./es
- ::: on employed in full: Ricardo Anibal HCUALFS Navarrette
ra %o be notified in case of emergency:
1a:e Magda Morales ..
Relatlonshriwit:_
0rcso . . 535 Soutj "cs 7th St., -t. 2
Mhiadicorida .
celeghes 371 5141 .
o”
“14-00000
CONFIDENTIAL
raN Filled In)
*- _ * VOLUNI AR Y ENTRIES _- __
Erobe fence in the handling of employ.- encr.vi dies ac. alicon inc. the O’seare e! certern prracaa! deta often de’ay: ar d comp’:
caret the settlement of estate and financial matters. The information req”
“14-00000
t
CONFIDENTIAL
(when Fitted fe)
5. 1 VOLUNTARY ENTRIES
Experience In the handling of employee omergencies has shown that the absence of cortoin por son al data often de -
lays and complicates the settimont of esteto and financial matter a. The information requeste”
“14-00000
CONFIDENTIAL
H’^ Fetlo. /ri
VOLUNTARY ENTRIES
Experience in the handling of employee overgencies has shown tent the absence of certain personal data often de -
lays and complicates the settlement of estate and financial matters. The information requested in this s”
“EADONSHi? Date or vvtn / Mo. du, ye.» examination which will be arranged try the Director uf Prrvomene!
at noi eevot to you.
• If the tenvn named as having an incurable interest should die
Sce VedMADDllD eMPLO1485 untita TItC-BePAtiCte D1OA90010 SURVIVOR hefint wins no change”
“14-00000
dgt
CONFIDENTIAL
(When Filled in)
5. VOLUNTARY ENTRIES
Experience in the handling of employee emergencies has shown that the absence of certain personal data often delays and compli-
cates the settlement of estate and financial matters. The information requested ”
“ADOPESSEET
X YE S •9
Ing PERSONS NAVCO 1* TEM ? amovE ahe ALSO BE NOTIFIED IN Ca5F of EMERGENCY. IF SUCH NOTIFICATION IS NOT DESIRABLE
BECAUSE OF HEALTH 09 OTHER PEAS065, PLLSE so STATE IN ITEM 6 Ore THE REVERSE 5160 OF THIS 10ww.
VOLUNTARY ENTRIES
InDiCAft ANY BANKING I”
“-wave vou ExECutso * POWER of ArromuKy?: Yes m No. (If “Yea", who possess the power of.attornoy?).
4LLJ-
26019734 ADDITIONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMS
nNoterMg brother-in-law, Wohn Waishihas been named executor in both
■ | the will of my wife and my will. ”
“Wifeonly________________________________
4. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY
NAME (Mr., Meo.. Mioo; RE EATIONSHIP "
Lynch, Herbert A.
(Lest-Pirst-MiJdio)
Hrs Jone Mtso K-feuch Wafsbrother
HOME TELEPHONE NUMBER
Box 46-9, Victoria, TEXAS
HOME ADDRE ss (De. Lae ”
“14-00000
1
L
CONFIDENTIAL
jaw) Fitted In)
s__________ VOLUNTARY ENTRIES
Experience in the handling of employee emergencies has shewn that the absence of certain per-unit dutg often 19/7/8 and compli-
very useful to you
rates the settlement of estate and financial mofte”
“other than’ the above,
or until much time as I beconie Insured an a retired employee. In which event this Designation of Beneficiary shall terminate. "
INFORMATION CONCERNING THE BENEFICIARY OR BENEFICIARIES:
Type or print Nest nhine, saiditle initial, and last name " " Tsso”
“1 4-00000
Cdco/gzt CONFIDENTIAL
(When Filled In)
s. VOLUNTARY ENTRIES
Experience in the handling of employee emergencies has shown that the absence of certain personal data often delays and compli
cates the settlement of estate and financial matters. The information reque”
“CONF IDENTIAL
(UNen Fiitee te)
5. VOLUNTARY ENTRIES
IExperience in the handling ef employs epergencib, has sho’m test the absence of-certeln. por sonal data often de -
I lays and complicates the cettlavent of estate and financial matters. The in formation requested in this s”
“afient is over the age of eighteen years and in act a party to the
business - *.*..:
within above entitled action; that affiant’s residence address in:-
that on the. —day 6- t19. sfiant served
the within...
on the__ _ —in said action, by placing s true thereof in an envelo”
Untitled REPORT·p. 348·source: semanticDerived signal56%CABLE REQUEST FOR POA
“14-00000
CONFIDENTIAL
(%* Filled :-
5. VOLUNTARY ENTRIES
Experience in the handling of employee emergencies has shown that the absence of certain per son al data often de -
lays and complicates the settlement of estate an d financial matters. The information requested in t”
“14-00000
CONFIDENTIAL
,te r.de: • a
9. VOLUNTARY ENT RIES_ _ _._
• Experience in the handling of employee emergencies has shown that the absence of certain personal data olien delays and compli-1
cates the settlement of estate and financial mate s. The information requested”
“14-00000
CONFIDENTIAL
when Filtee In)
VOLUNTARY ENTRIES ' __
Experience in the handling of employee energen : has shown that the absence of certain sex tongl data often delays and compli-
totes the settlement nl estate and financial matters. The information requested in thi”
“14-00000
CONFIDENTIAL
5 CONTINUED)
NEwton S. OMD and Nall S. Miler
IN #05E NAU1151 ans, fin accounts LISTON
HAVE vou CoMPurttD * LIST • ** ir "ern”. mrer is DOCUMENT LOCATED?
SAFE DEPOSIT BOX, CENTRADojLo. NAlioNAL Bank, Mount Union, PA.
HAVE *ou r*eCUTED A POUER 0- AT”
“14-00000
CONFIDENTIAL
(%l,~ filler .-
5. VOLUNTARY E.76 25
Experience in the handling of poployce emergencies has sbem to : the etsence of cortein per son al data often de -
lays and complicates the settlement of estate and financial setters. De inforention requested in th”
“FatHIN (or nole guardian) a06agss (Number) (Street) (City) (Nhdto) ELlPHONE
NAME or woTstN {or female duardien) *000535 (Number) (Sieoot) (Cl »?) (Sente) TtlEPwONE
:. PER304 TO % NOTIFIED IS CASE OF EMERGENCY
NAME PAtionsai?
ADOREGS (Number) (Street) (Caty) (State) TELEPHO”
“__ ___________ -
Pit in nos I. t elect not 17 enroll xrry sins 3 The reuson for my election is (Plouce un "X ‘ in proper bos)
PART I/ vou under the Megi Benufio Act. tal / am rovcied by o plon under the ro-alth Benefits Act through the enroll,
won NOT 10 men of my husband, wi”
“CONFIDENTIAL
(Ten Filled tel
,86. VOLUNTARY ENTRIES
Experience in the handling of employee emergencies has/shoun that the absence of, cortata per.con al deta often de -
lays and complicates the settlement of estete.md financial matters. Tre information requested in this sect”
“power of uttomey?)
Believe the lawyer has this also
«. ADDITIONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMS
P R E M TXASTeRser
SIGNED AT
J
LAY
Bara
arc 1970
CONFIDENTIAL
7Marlalle B Barta Kill”
“14-00000
CONFIDENTIAL
(whan Fitetini
9. VOLUNTARY ENTRIES
Experience in the handling of employed emergencies has shown that the ob sence el certain personal data eftea delays and compli-
cotes the settlement of estate and financial matters. The information requested in this”
“CONFIDENTIAL
(Sten Filt.n fhl
5. VOLUNTARY ENTRIES
"eperienco in the handling of employee emergencies shown that the absence of certain son el dets o ft en de •
laya and complicates the settlement of estate RN d financial matters. The information requested ; this section
we”
“am continuously employed in the above department or agency.
Inronano CEN CKENING THK BrNEICIRY on BKNSFclB:
Type er print Bret name, mikile initial and inet name Type or print address of each beneficlary fihare to be wild to
of each benedelary Relationship each he nefiovary
”
“of execation—month, day, year) (Signature of employee)
ne Ave Rochelle Nd
WITNESSES TO SIGNATURE:
(Number and street) (City, zone number and State)
(Signature of witness) (Number and street) (City, zone number, and State)
PRINT OR TYPE NAME AND ADDRESS OF EMPLOYEE THIS S”
“IGADE DEPENDENTS. JMWAVE PLANS TO HAVE
• AMT IK I-1 PROVIDE MRS. MOL INA WITH THE NAME OF THE OR IG INAL
• TRUSTEE AND THE AMOUNT PA ID TO HIM W IT H REGRETS T HAT HE CANNOT
. ASSIST HER IN THIS MATTER. WE ALSO PALN TO HAVE AMT IK-I
EXPLA IN THE METHOD OF COMPUT ING THE $13,1”
“14-Q0000
CONFIDENTIAL
ruhen Filled In)
s. VOLUNTARY ENTRIES
I" wrience in the handling of employee emergencies has shown that the absence of certain personal data often delays and compli-
& as the settlement of estate and financial matters. The information requested in this”
“14-00000
CONFIDENTIAL
(When Filled In)
___________________________________________________ VOLUNTARY ENTRIES______________________________ ___________________
Experience in the handling of employee emergencies has shown that the absence of certain personal data often delays”
“14-00000
CONFIDENTIAL
(When Filled In)
"._ VOLUNTARY ENTRIES
Experience in the handling of espivyee emergencies has shown that the absence of certain personal data often delays and comply
cotes the settlement of estate and hnencipi matters. The information requested in this”
“I l: vcaomincd tfio roauta, including cccomponying schoduloo and ctotomonto, and to tho boot of may tnswlcdgo and colici al .
it 46 tres, c rreci, EhG 09K3plot:), Declaration of proparer (othor thon toxpoyer) in boscs co all information of which he has ony Dnovlcdgo. k
SCUj You”
“designated
beneficiaries is living at the time of my death. /
/ hereby specifically reserve the right to cancel or change this Designation of Beneficiary at any time without knowledge
Gladey1218 OroLnoco.St. AlVienna,
or consent of the beneficiary.
(Date of execution— mont”
“his doelcration Is basca on oll Information of vhicli ho has any tinsizlodgo.
EDWARD L. LAMBERT P
0
SA D D •TAX.CONSULIANT
Your signature—? Cling jointly, B07W must sign Dato E
n 598919 VienrrOfAthnLVn.fongrr :
clou O ENCINO, CALLE.91316
Spouso’s olgnatero Dato T227213) 88”
“below from inside cover of Lro.bore of the plon you select)
PART: NAME 3 RUN OPTION (HIGH OR LOW) INKMENT COO NUMBER
WISH10‘1N-
POLL IM A
. HEALTH BENEFITS
PAL. - *
Association Benefit
: Lt soa :e s list all eligible for member v.H
low
1•!
1
tescephon: List your wile o”
“IC‘DE%*‘50 469 PPDVIDE DA , EISI OF OCCURRENCE ON SEPARATE SHEET IN AC-
CCGDANCE RTTM SPECIAL INSTRUCTIONS ABovE.
NO
J
EAVRSOusiburat
SECTION XXV PERSON TO BE NOT IF ED IN CASE OF EMERGENCY 1
1. NAME F ast-3-ddle-Leath 2. RELATIONSHIP
Bella Amron wife
260. a-shal. court”
AMRON, IRVING.·p. 28·source: semanticDerived signal55%CABLE REQUEST FOR POA
“or bank deposits, govern
. cental or private, movable property and personal property, and in •
general everything belonging to the inheritance of the before —-
mentioned deceased porson, without restrictions; to withdraw cash:
from the bank account (or bank accounts) that th”
“at PAID to
TYPE OR PRIT FIRST NAME MIDDLE INITIAL, AND LAST NAVE hre or PRINT ADDRESS rnchuding ZIP Code) or EACH MNERCAN RELATIONSHIP EACH ME NLFICIARY
of LACH BENLE ICIARY
(See Example:
5 villa Madrid, 95 Neuilly, France
Pamela A. Richardson Dau One half
Jr A 11 10
0005”
“14-00000
CONFIDENTIAL
III hen Pelte-f Bev)
9. VOLUNTARY ENTRIES___
Exper ience in the handling of employee emergencies has shown thoi the absence of certain per sonal data often delays and compli-
cotes the settlement of estate and financial matter s. The information reques”
“14-00000
1
CONFIDENTIAL
when Pelted In)
3. VOLUNTARY ENTRIES
Experience in the handling of employee emergencies has shown that the absence of certain personal data ovlen delays and compli
cates the settlement of estate and financial matters. The information requested in t”
“living at the time of my death, are - 3135 * "14 d_. 2205 . - .i
1 hereby-sper-soziz reserve the right to cancel or change this Designation of. Beneficuara of any tiine without knowledge’
-
■
(Date of sin month, day rear))”
WITNESSES TO SIGNATURE (Silises a ineligible is A”
“belon receive
4 any amount of LIFE IVst RANCE and ACCIDENTAL DEA TH INSURANCE due and payable-atimy death: Funderstand
that this Designate of Smeficiary will-remain in full force ami effect, with respect to any amount payable, unteas or Anti
canceled by me u writing, or until ”
“consent of the beneficiary.
Mar 27,-1963
(Iata of szecutlon--month, d-y, year
Robert Khaw {Signature of Inaured)
Mari 2.100 1114 Ellen Ave.Noe Falls Chad, Ken
W ITNESSES TO SIGNATUR € (A ivitness ia ine Gimble to receive payment as n benefcinrg):
mcbiksbnlseniends
(ignat”
“name, midlie Jocitinl and Innt neciai-sa Relationship Share to ba paid to
of rack tononiclary ‘, . • a Type or print address of each Lenedelnry each bonefolary.‘
John M. Parrish, if living.— 810 West 180th Stroot, New York, H. Y. Father All
Otherwise to: Susan A.' Tarrish 810”