“14-00000 9 & SECRET * SECTION IX QUALIFICATIONS FOR OTHER OPERATIONS + *DICATE SPECIAL AgiLitity, falet9, OR QUALIFICAtlOns POSSESSED av WuDJrct anice CouLD conctivapLC PL of VALUE Fom O1 ta OPERatiONs. 1 - ce r 1, • *1 SECTION X COMMITMENTS • if It is PROPOSED to pa”
“14-00000 % SECRET r when Filled In) SECTION V CONTINUED FROM PAGE 2 a.mavevou zytn wren IN. OR PETIVIONr? son. BAN*mpPrcy , ]_ | Hi IXT 9. If YOUR anteER is "ves" 10 ths ABOSE QUESTION. Give PARTICULARS, INCLUDING count AND pATFIS) • 00 YOU DECEIVE AN ANNUITY FROM THE UN”
“14-00000 / (14) F. IF, TO YOUR KNOWLEDGE, ANY OF THE ABOVE HAS CONDUCTED AN INVESTIGATION OF YOU, INMCATE BELOW THE NAME OF THAT AGENCY AND THE APPROXIMATE DATE OF THE INVESTIGATION: - - . - Federal Purose of investigation -1966--------- ---------------------- —..... ....”
“1, MEMBERS OF FAMILY *9E Of.sPOyS ADDRESS (Vo.. Street, City, Zone, State) LOUISE HIDALGO TELEPHONE NUVSER NAMES or CHILORSN annRrss sex F Luz MARIA **/3 9 FRANCES REBECCA Balmes N Hidalgo VAME OF FATHER (Or note @uordson) ADDRESS TELEPHONE NUMBER cr MOTHER (Or femal”
“completing the questionnaire as. thoroughly and accurately as possible and returning it to your Administrative Officer within the time allotted. .// George E. Melon SECRET Security Information FORM BO. 37 14-158 MAT 1932 */-*0”
“questionnaire as thoroughly and accurately as possible and returning it to your Administrative Officer within the time allotted. CODED J1 -OR gil H- Wo George E. Melon SECRET Security Information may so, 1, Ft 1982 182 37-182 h-::i 'I■ welveninyade”
“14-00000 F.1F, TO YOUR KNOWLEDGE, ANY or THE ABOVE HAS CONDUCTED AN INVESTIGATION or YOU, INDICATE BELOW THE NAME OF THAT AGENCY AND THE APPROXIMATE DATE OF THE INVESTIGATION: Sec. 26.PERSON TO BE NOTIFIED IN CASE OF EMERGENCY: NAME -.RELATIONSHIPS: ADDRESS (SL and Num”
“AND WILLFUL FALSE STATEMENT ON THIS FORM CAN BE PUNISHED S7 FINE OR IMPRISONMENT OROTH (S9o U. S. Code, title 18, section I6O1)- Peter C. Ghh DATE 5 Donald W Noble 15 APRIL 1975 . MR DONALDI NOBLE 5314 DENWCOD AVE.OXON HILL,MD. 20022 TEAS SECHSOE To FE COMPLETED BY AUTH”
“14-00000 J A SECRET FaNen Pilled In) St CTION V°C ONTInUED FROM PAGE 2 4. wave YOU EVER BEEN IN. OR PETITIONED FOR. DAN«RUPICY+ J .ese I 4. S. If YOUR ANSWER IS ves" TO THE ABOVE QUESTION, GIVE PARTICULARS, INCLUDING COURT AND DATE(S) 6 00 YOU RECEIVE AN ANNUITY FROM THE”
“s. CITIZENSHIP (Country) 6. FREQUENCY of CONTACT 7. DATE OF LAST CONTACT . FULL NAME (Loot-Pirot-Middlo) J. RELATIONSHIP 3. ACC a. ADDRESS on Counray st WHICH RELATIVE RESIDES 4 5. cniatwiT (Country) 6- FREQUENCY or CONTACT / DATE Of LAST CONTACT 9 SPECIAL RINAS, IF ANY.”
“14-00000 rear * SECRET PART III 1-—- NOTE: DETACH THIS PORTION OF FORM AKD DISTRIBUTE SEPARATELY sea • 6741 1%. SOCIAL SECURITY NO. 2 00 8-5884Z IF SOCIAL SECURITY NO. IS NOT AVAILABLE. HAVE FORM 4O. $5-5. 20. CITIZENSHIP "APPLICATION FOR SOCIAL SECURITY ACCOLMTS," COM”
“1 4-00000 SECRET (When Filled In) SECTIOP ¥ COM TEN UED FROM PAGE 2 4. HAVE You EVER srIN in, OR PEliTianre roe. aN**uPrCy* H» x j *0 5. If YOUR ANSWER Is "YES” 10 THE ADOvE QUESTION, GIVE PARTICULARS, INCLUDING COURT AND DAT$(5) NA 4. 00 YOU RECEIVE AN ANNUITY FROM TH”
“(14) F. IF, TO YOUR KNOWLEDGE, ANY OF THE ABOVE HAS CONDUCTED AN INVESTIGATION OF YOU, INDICATE BELOW THE NAME OF THAT AGENCY AND THE APPROXIMATE DATE OF THE INVESTIGATION: SEc 26. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY: NAME RELATIONSHIP ADDRESS ZVY8 LITA" ■ SEC. 2”
“FULL DETAILED STATEMENT. IF ASSOCIATED WITH ANY OF THE ABOVE ORGANIZATIONS. SPECIFY NATURE AND EXTENT OF ASSOCIATION WITH EACH, INCLUDING OFFICE OR POSITION HELD, ALSO INCLUDE DATES. PLACES, AND CREDENTIALS NOW OR FORMERLY HELD. IF ASSOCIATIONS HAVE BEEN WITH INDIVIDUALS WHO AR”
“record up to date. - war 3. Your cooperation is requested in completing the questionnaire as y r- thoroughly and accurately as possible and returning it to your Administrative Officer within the time allotted.. George E. Melon SECRET Security Information FORM NO. 47 .”
“1 SECRET (When Filled In) 0 SECTION V CONTINUED FROM PAGE 2 4. HAVE YOU EVER BEEN IN, OR PETITIONED FOR, BANKRUPTCY! YES NO S. IF YOUR ANSWER IS "YES" TO THE ABOVE QUESTION. GIVE PARTICULARS, INCLUDING COURT AND DATE(S) x NA 0 S' 00 YOU RECEIVE AN ANNUITY FROM THE UNITED STA”
“14-00000 I J28.00L3 YOUR IINANCIAL POSITION PERMIT D1SCMA-GL OF ALL CLB13 %- b. IF NO: RESIDING ABROAD WAVE YOU teLs PAID CyNEUT XYI : hen I’r *NC n.t 3 ";* ser P *%: Gel 57:6 9 "EN ” dADP 5:7 MIE EN ::! Y1 A J.J. INCSAL "As? JVE3 Co0 IF ANSTE? NAMES Or CRUITORS, AMOUNTS”
“14-00000 SECRET ,5 P (When Filled In) SECTICE • CONTINUED FROM PAGE 2 a. NavE You tit# BECN i: on PEtirrongo ken, Ba**oprcff ves 1x1". • %. IF voum ANSWER IS "YES", TO Owe ABOVE coesTreny qivE PARTICULARS, INCLUDING COURT AND DATE(S) NA ■ A - . : • 1- 09 YOU RECEIVE AN ”
“34-00000 SECRET (aheo Fillet (") SECTION HI CON TIUED FTO1 PAGE1 71. DATES v MILITA9Y SERVICE 0: 0000 Prom. ??- BRANCH or SERVICE 2a COUN’M, •!»» enico MllItaRy Staling StriLtatEo A 2 4 DETAILS Or OTHER covrasvesf seoait!, 0.9. 0'‘ OPLIGN % /' SECTION IV RELATIVES B”
“NO 2. SINCE THE DATE OF YOUR LAST PHS. HAVE THERE BEEN ANY UNFAVORABLE INCIDENTS IN YOUR LIFE WHICH MIGHT REQUIRE EXPLANATION. YES (explain below) X NO 3. NAME OF YOUR PRESENT IMMEDIATE SUPERVISOR (include Room Number and Extension) Mr. Nestor Sanchez % RM 3030- X-7451 ”
“RELATIVE RESIDES 4 $ CITIZENSHIP (Country) 6. FREQUENCY OF CONTACT 7. DATE OF LAS T CONTACT 5. SPECIAL REMARKS. IF ANY. CONCERNING THESE RELATIVES SECTION V FINANCIAL STATUS ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY’ VES x~° 2,00 100 HAVE ANY FINANCIAL INTEREST IN, OR O”
“IS THE SUBJECT AN ALIEN OR A NATURALIZED CITIZEN OF THE UNITED STATES? R X b. ANY FOREIGN CONNECTIONS, INTERESTS. EMPLOYMENT OR MILITARY SERVICE? /y c. ANY FOREIGN TRAVEL OTHER THAN FOR THE UNITED STATES GOVERNMENT? X d. EMPLOYMENT BY A FIRM HAVING A CLASSIFIED US GOVERNMEN”
“INVESTIGATION OF YOU, INDICATE THE NAME OF THE AGENCY AND THE APPROXIMATE DATE OF THE INVESTIGATION. UNK NOTE SPECIAL If your answer is "YES" to the following Questions 10, 11 or 12, provide the information requested for each INSTRUCTIONS question on a separate, signed shee”
“IS THE SURDECT AN ALIEN OR A NATURALIZED CITIZEN OF THE UNITED STATES? b. ANY FOREIGN CONNESTIONS, INTERS EMPLOYMENT OR MILITA ICE? C. ANY FOREIGN TRAILL OTHER THAN FOR THE UNITED STATES JOVERNMENY, V d. EMPLOYMENT B A EUR AVIMO A CLASSIFIED US QOYERNMONY CONTRACT? 0. FORMER”
“(voluntary - CIAPDS) 20. DATE REVIEWED 21. PROFILE REVIEWED By 22. I TERS 1* 1 RESlRe!D l VERIFIED By ERPLONIE 1? 22 Sep 1971 obs ’ No FORM 0-57 1200 (PART 1) •** •mtiseus SECRET PROFILE tax”
“--------------------------------------------------- • —Fr------ P—27ue.------------------------------------------------------------- IFTYES. DESCRIBE THE CIRCUMSTANCES. ATTACH ADDITIONAL SHEETS FOR A FULL DETAILED STATEMENT. IF ASSOCIATED WITH ANY OF THE ABOVE ORGANIZATIONS. SPE”
“XSNO ARE YOU NOW OR HAVE YOU EVER BEEN AOOICTEO TO THE USE OF HABIT FORMING DRUGS SUCH AS NARCOTICS OR BARBITURATES? YES XDuo ARE YOU NOW OR HAVE YOU EVER BEEN A CHRONIC USER TO EXCESS OF ALCOHOLIC BEVERAGES? YES ONO IF THE ANSWER TO ANY OF THE ABOVE IS "YES." EXPLAIN IN ITEM ”
“TO Voun KNOWLEDGE, ANY OF fir Anovr. HAVE CONDUCTED AN INVESTIGATION OF YOU, INDICATE THE NAME OF THE ACENCY AND THE APPROXIMATE DATE OP THE INVESTIGATION. • CSS 1943 U.S. Arrer 1956-57 A 350 1946 ACSI D of A 1959 010 1947 CIA 1948 49 NOTE SPECIAL If your answer la "YES"”
“ABOVE, WHICH MAY BE DISCOVERED YER IN SUBSEQUENT INVESTIGATION. WHETHER YOU WERE DIRECTLY INVOLVED OR NOT, WHICH MIGHT REQUIRE EX PLANATION? IF SO, DESCRIBE INCIDENT(S) AND PROVIDE DATE(S) OF OCCURRENCE ON SEPARATE SHEET IN AC CORDANCE WITH SPECIAL INSTRUCTIONS ABOVE. X NO ”
“HISTORY OF MENTAL OR NERVOUS DISORDERS? YES NO ARE YOU NOW OR HAVE YOU EVER BEEN ADDICTED TO THE USE OF HABIT FORMING DRUGS SUCH AS NARCOTICS OR BARBITURATES? YES NO ARE YOU NOW OR HAVE YOU EVER BEEN A CHRONIC USER TO EXCESS OF ALCOHOLIC BEVERAGES? YES NO IF THE ANSWER TO ANY O”
“1 1-00000 Z *.e : SECRET (When Filled In) SECTIC# • CONTINUED FROM PAGE 2 4. wave vou tven oftt Im, on PETITIONED (os, BA0,#UPTCYt D4 9. IF YOUR A95 L0 it “ves” TO THE 400 V8 Qutstipe, CIVE PARTICULARS, INCLUDING COURT AND DATE4 S) 6. NA 00 You RECEIVE AN ANNUITY F”
“of birth (Cay. State, Country) (2), 3 Cimsenship (Country) • Address (Number, Street, Coty. State, Covatry) - / Type and location of service fit knowe) % j I Nemo tlov - for - b.ddie) 2 Belaherab-p 3 Date of birth 4 Place of birth (City. Srate. Country) (3) $ Citserahip (C”
“AGENCY AND THE APPROXIMATE DATE OF THE INVESTIGATION. 1 NOTE SPECIALIf your answer is * ES” to the following Questions 10, 11 or 12, provide the information requested for each INSTRUCTIONS I question on o separate, signed sheet and attach the sheet to this form in a sealed e”
“GENERAL TERMS SUCH AS "DEROGATORY" MAY RESULT 1* A SEARCH THAT DOES NOT FULLY MEET REQUIREMENTS.). Any information except basic biographic and/or occupational . data since previous Green List, No 125246, dated 5 Sep 62.[ INSERT CARBON: FILL OUT FORMS COMPLETELY. INSTRUCTIO”
“WHICH RELATIVE #:91015 4 s. CITIZENSHIP (Country) 6. FRCQUrNrV Or CONTACT /. DATE OF LAST CONTACT B. SPECIAL NEMARKS, i/ ANY, CONCERNING THESE NrLATIVES SECTION V FINANCIAL STATUS L. ANE YOU ENTIRELY Dt PENDE NT ON YOUR SALARY? XTas 7. DO YOU HAVE ANY I INANCIAL INTERI ”
“DISORDERS? YES XXNO ARE YOU NOW OR HAVE YOU EVER BEEN ADDICTED TO THE USE OF HABIT FORMING DRUGS SUCH AS I NARCOTICS OR BARBITURATES? YES NO ARE YOU NOW OR HAVE YOU EVER BEEN A CHRONIC USER TO EXCESS OF ALCOHOLIC BEVERAGES? ANSWER TO ANY OF THE ABOVE IS "YES." EXPLAIN IN ITEM ”
“FAMILY, AND ASSOCIATES . • :0 13. OTHER SIGNIFICANT DATA (POLITICS, RELIGION, ETC) ATTACH EXTRA SHEETS WHEN NEEDED INSERT CARBON: FILL OUT FORMS COMPLETELY. INSTRUCTIONS: SEND BOTH SHEETS TO FI/D. SEE CS1-10-7 FOR ss-sa 50 use pecvroun rerrsons. SECRET (9) Jtsrhnikoix”
“14-00000 8 SEC. 15. HAVE YOU EVER BEEN DISCHARGED OR ASKED TO RESIGN FROM.ANY FOSITION? HAVE YOU LEFT A POSITION. UNDER CIRCUMSTANCES WHICH YOU DESIRE TO EXPLAIN? GIVE DETAILS: MO SEC. 16 OIVE FIVE CHARACTER REFERENCES — IN THE U.S. — WHO KNOW YOU INTI MATELY - (GIVE R”
“14-00000 SCCTICH_15._NE(GH00RS-THREE_IM 15.-1TLD STATESA r005 nAMi — * LELT aDwMg: 611 ATE NAME UNKNOWN A00€55 STALE: AND numhrH city - Siari NAME ADDRESS STREET A*D NUMBER CITT STATE SECTION 16 MISCELLANEOUS pin Y00 EVER waVt cu ce rou NOW HAVE MEMETRSHIP IN, OR supre”
“vov vas Dorothy A. Flores (Spare) give same bid a-Ktress of peroor, *9 an r. who can make such teclelane to Case of emergency.) 06%, this INDIVIDUAL inov THAT ME seas BEEN DESIGNATED AS VOUN EMERGENCY ADOMGSeGR ill anewe, le No* esp/ain sA, • itemn 6.) NO ivr)J No . T”
“FIRM, OR AGENCY? YES NO HAVE YOU EVER BEEN REFUSED BOND? YES 463-74-2051 x NO IF THE ANSWER TO ANY OF THE ABOVE IS ’YES," EXPLAIN IN ITEM 20. 14. CREDIT AND CHARACTER REFERENCES (Do not include relatives, former employers, or persons living outside the United States or its T”
“ENTIRELY DEPENDENT 0% roav SALAD? Lrilres 2,00 YOU HAVE ANY FINANCIAL INTEREST se. CR OFFICIAL CONNECTION wIt+, NON-U.S. CORPORATIONS C° *:51466565 CR IN 09 NO WITH U.S. CORPORATIONS OR 809.95589 waVIno LUBS ANTAL FOREIGN INTERESTS? YES IF YOU HAVE ) ANSWERED "YES." GIVE C”
“14-00000 § MINE or mle eru trtOYrE GFRAt No —len,".Eurtoyrs T*JFOSE EXT rE 1 / / SECRET INBIN crtova 1 TIES FORM visr BE RETURNED ve rior MRIIFiN wiine VICE WAm FIKrORvED .ng.T— DO NoT Ltry : - _. .___ . (po-sAFE5p.n0it. OMUmlAM ZD.EM / BFRVICE AS OR MUTILATE ”
“0006 •060 26 ’ Residence Oc) address 6•00 26 Occupation or business • o< • €00 26 d Business or employment address • 0 0 26 e) Citizenship status •• e 6 0606 0 • o 26 Ie Alien.............< • 0 26 .II. Naturalized citizen III. Native-born citizen ••• (f) Nationality back”
“)4-00000 23. EFIFENCES -be thedo P revi twin, in the *teatot Gustes or Toreit-rtes • thie t’rite State who are NOT tel-int to peu and wholeve mints krowlatug * your suolificationa and helew -r the po-nitee kor when h res yro prasyiryg. De n. t ret wit notes of supervim.e lteto”
“or roTRY 1.4. PLACE of ENTRY 15 CiTiZENSHiP (Country) 16. GATE Acquito Tir. wurag CQulafo (Catr. State, Country) U.S. 18- CuPATION :9 PRESENT (MPLOY 9 (A:aa oenos noloyer, or if spouse tt Housewife unemployed, Ist 8 to e-ployefs) to. EMPLOYER’S ew BUSINESS ADDaess (No.. S”
“14-00000 9%. SECTION XI FINANCIAL STATUS : 49€ YOU ENTIRELY DAPCNDENT ON YOUR -ALARY’ €5 ND tits ,009 ANSAER it "no’* to n.t anovr. STATE SOURces or OTHER INCOVE ). RANKING INSTITUTIONS **T*‘*NICH you GAVE aCCOUNts sast or rotitIO 0093% (City, State, Counter) J. HAVE ”
“RELATIONSHIP 3. AGE 4. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES 4 s. CITIZENSHIP (Country) 6. FREQUENCY OF CONTACT 7- DATE OF LAST CONTACT 5- SPECIAL REMARK S., IF ANY, CONCERNING THESE RELATIVES SECTION V FINANCIAL STATUS I. ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY X”
“or those of your close reiztices in such orcanmations, including the names of the organizations, dates of membership, meetings attended, piles of positions held, amounts and dates of contributions, nature of petitions signed falling within the meaning of the above certification”
“RELATIVES ""tr •I SECTION V FINANCIAL STATUS L ARE 2,00 YOU YOU ENTIRELY HAVE ANY DEPENDENT ON FINANCIAL YQUR INTEREST SALARY? th. OR OFFICIAL 6 CONNECTION YES WITH. x N° NON- U.S. CORPORATIONS OR BUSINESSES OR IN OR WITH U.S. CORPORATIONS OR BUSINESSE”