“):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”
“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”
“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”
“14-00000 CONFIDENTIAL (When Filled In) ‘96.__________ ,1 _________ VOLUNTARY ENTRIES_________ - 1«I Experience in the nonilling of employee emergencies hgs shown that the absence of certain personal data often delays and compli-I cates the settlement oiestate and financial ”
“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 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 ”
“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”
“effect, unless or until canceled by me in writing, so long as I am continuously employed in the above department or agency. INFORMATION CONCERNING THE BENEFICIARY OR BENEFICIARIES: Type or print first name, middle initial, and last name Type or print address of each beneficia”
“14-00000 - CONFIDENTIAL ruhen Palled Irt) 5. VOLUNTARY ENTRIES Experience in the handling of employee emergencies has shown that the absence of certain persont zana often delays and compli- cotes the settlement of estate and financial matters. The information requested in”
“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”
“CONFIDENTIAL (When Filled In) 9. VOLUNTARY ENTRIES -___ Experience in the handling of employee enargencies has shown that the absence • certain porsonal date often delays and compli- cotes the settlement of estate and financial matters. The information requested ^ this sectio”
“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”
“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”
“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”
“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”
“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”
“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”
“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 ,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”
“A POWER CP ATTORNEY’ C ven (7 NO. revov”, who pobseea the pvwer of attorney”) ’ Myanfather chned not emergeny because y be rati o herned in con ADDIT IONAL DATA AND/OR CONTINUATION OF PRECEDING ITEMS health and 9 Age SIGNED AT Amiel 0 Daniel TOlore X sionafus CO”
“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”
“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”
“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”
“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”
“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”
“14-00000 CONFIDENTIAL (When Filted fey & wiLOfe Jointly 52 (CONTINUED) ■ ‘.’ 1 IN most NAME(S)‘ARE tit accounts LISTED* SelFt Have YOU COMPLETED A LAST WILL AND TESTAMENT »1 - 00, If "vt9",. wiet is occomENT Cocarkor • r HAVE vou EXECUTED A POWER OF ATTORNEY? 0•0.115”
“in which event this Designation of Beneficiary sal terminate." INFORMATION CONCERNING THE BENEFICIARY OR BENEFICIARIES: Tape or print first name. mildwinitinl and last nateel Type or print address of cach benedlelary oShare to be paid to lef each beteLciaryse . ten” A each be”
“14-00000 WARNING—Do not fill out this form until you DESIGNATION OF BENEFICIARY STANDARD Foam NO. 2809 JUNE 1966 U S Civil Service Commission have read all instructions. CIVIL SERVICE RETIREMENT SYSTEM tom Sucolshent 031-1 2808-104 A. INFORMATION CONCERNING THE DESIGNATOR »”
“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”
“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”
“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”
“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 •”
“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 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 cempli- cotes the settlement of estate and financial matters. The information requested in th”
“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”
“__ ___________ - 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”
“Comptroller General of the United States, and without knowledge or consent of the beneficiary. 1 December 1967 (Date of execution—month, thy. year) WITNESSES TO SIGNATURE: Danker (Signature of employee) Margaret Tonce Elizabeth AnnReil y 2400 So. Glebe Rd Arlington, Va ”
“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”
“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”
“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”
“14-00000 CONFIDENTIAL (When Fille-f In) 8. VOLUNTARY ENTRIES Experience in the handling of employes emergencies hos shown that the absence of certain personal data often delays and comply cates the settlement of estate and financial matters. The information requested in thi”
“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 ”
“14-00000 Standard Form N^ 1152 Cxw Farm prescribed by • • Comptroller General, U.S. DESIGNATION OF BENEFICIARY IMPORTANT October 23, 1930 Read instructions (Gen. Reg. No. 1u4, Supp.No. 1) UNPAID COMPENSATION OF 1 on back of duplicate DECEASED CIVILIAN EMPLOYEE I before f”
“me well known and known to me to be the person described in and who executed the foregoing] instrument for the purposed therein expressed. Witness my handland official seal this 19th day of May, A.D. 1976. 1 in ki , Viline Wilke Notary Public, State of Florida , at La”
“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”
“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”
“Richarie Better (Date of execution—month, day, year) (Signature of insured) WITNESSES TO SIGNATURE (ct witness is ineligible to receive p’vnecnt is a beneficiary):- 13219 AlembieU 1 Number and street) Rochelle Nd and ZIP Codes (Signature of witness) its. State, and ZIP Co”
“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”
“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”
“or until such time ds I become insure d as a retired employee, in which erent this Designation of Beneficiary shall terminate. INFORMATION CONCERNING THE BENEFICIARY OR BENEFICIARIES: • or print first name, middle initial, and last name Type or print address of cash beneficiar”