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(s)
Mrs.
STATEMENT OF PUBLICATIONS AND ARTICLES OF WHICH EMPLOYEE IS AUTHOR: (30)
H
TITLES (30a)
PUBLISHER (30b)
DATE (30c)
(30)
5
(30a)
STATEMENT OF RELATIVES: (List wife, husband, mother, father, brothers, sisters, sons, daughters, including all blood
relatives or by marriage living-outside the U.S.) (31)
(30b)
RELATION (31a)
NAME IN FULL (31b)
ADDRESS (31c)
OCCUPATION (31d)
COUNTRY
WHERE BORN (31e)
(30c)
E
Husband
William Robert Day
F.H.McGraw Co.,
(31)
(sep)
U.S.Naval Operat. Base
clerk
United States
Bernuda
(31a)
+
5
Mo ther
Adele T. Brush
425 Old. Boonton Rd.
rasd
(31b)
Boonton, N. J.
housewife
United
State
(31c)
Father
George W. Brush
425 Old 1-Boonton Rd.
Boonton, N. J.
districk clerk United States
B.
G. W., Jr. & Paul
Same
Aeronautic Mech.
(31d)
Brothers
Student
United States
STATEMENT OF MEMBERSHIP IN ORGANIZATIONS: (List all organizations of which you are or have been a member since
(31e)
u
930-Organizations include.military, athletic, vocational, musical, trade, professional, social, fraternal, political:) (32)
(A
NAME (32a)
ADDRESS OF
(32)
CHARACTER (32b)
(ser)
PRINCIPAL OFFICE (32c)
YEAR OR YEARS AMEMBER (32d)
5
American Nurses Assn.
professional
Washington,
nys D.Jc.
(32a)
5
Alumni Assn.
"
Orange, N.
5,
+
(32b)
District No. 1
Newark, N. J.
5
(32c)
Oh
BECOKD: cpecy (O pureca sug
(sap)
(389)
200
WOAHES
(SVS) 3901
(32d)
Ola ansin
CLLISEL
MOLE VME
1804
vap
OM
os
COMMENCE
answir
LOMW
(33)
(34)
STATEMENT OF ACTIVITIES FROM 1914 to 1918: (33)
Il kon su que poon S n 2 104 pas AGSLA or uor 0 mpÀ Aon (34a)
STATEMENT OF VIOLATIONS OF THE LAW: (Do not include traffic violations; include all arrests) (34)
NONE
LE)
(34b)
thie
OFFENSE FOR
LHV
CITY OR TOWN IN
STATE AND COUNTY
DATE (34b)
10
DISPOSITION
WHICH ARRESTED (34a)
WHICH ACTION (34c)
IN WHICH ACTION (34d)
OF CASE (34e)
(34c)
whal
BEEW
IV
CEM
TOOK PLACE
TOOK PLACE
OM a
I
MO.I.
COjOL of part
(351)
(34d)
at
I
toge (ss#) I
COPOL (ssp) A
(xsa)
(34e)
(30)
Cpnicp (siz
brepor (sip)
(35)
Hom: sqquoaa vor se goompos
(ram)
80429
(35a)
control
(35b)
crom
STATEMENT OF FINGERPRINTING: (35)
(13)
OL
one
I: (35a) been fingerprinted. If so, when?(35b) June 22,1942 and where?(35c) Orange. N. J.
have
(35c)
(rep)
If you have not been fingerprinted, are you willing to be, with full knowledge that such fingerprints will be forwarded to the Federal
(109)
WIKE IHE LOFTOMMA
Bureau of Investigation? (35d)
2
(35d)
LOWW
(YES OR NO)
DECTVEV.LIOM

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Document data

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Type: document

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Document identity

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Document source extras

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Page context

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    "ocrText": "(s)\nMrs.\nSTATEMENT OF PUBLICATIONS AND ARTICLES OF WHICH EMPLOYEE IS AUTHOR: (30)\nH\nTITLES (30a)\nPUBLISHER (30b)\nDATE (30c)\n(30)\n5\n(30a)\nSTATEMENT OF RELATIVES: (List wife, husband, mother, father, brothers, sisters, sons, daughters, including all blood\nrelatives or by marriage living-outside the U.S.) (31)\n(30b)\nRELATION (31a)\nNAME IN FULL (31b)\nADDRESS (31c)\nOCCUPATION (31d)\nCOUNTRY\nWHERE BORN (31e)\n(30c)\nE\nHusband\nWilliam Robert Day\nF.H.McGraw Co.,\n(31)\n(sep)\nU.S.Naval Operat. Base\nclerk\nUnited States\nBernuda\n(31a)\n+\n5\nMo ther\nAdele T. Brush\n425 Old. Boonton Rd.\nrasd\n(31b)\nBoonton, N. J.\nhousewife\nUnited\nState\n(31c)\nFather\nGeorge W. Brush\n425 Old 1-Boonton Rd.\nBoonton, N. J.\ndistrick clerk United States\nB.\nG. W., Jr. & Paul\nSame\nAeronautic Mech.\n(31d)\nBrothers\nStudent\nUnited States\nSTATEMENT OF MEMBERSHIP IN ORGANIZATIONS: (List all organizations of which you are or have been a member since\n(31e)\nu\n930-Organizations include.military, athletic, vocational, musical, trade, professional, social, fraternal, political:) (32)\n(A\nNAME (32a)\nADDRESS OF\n(32)\nCHARACTER (32b)\n(ser)\nPRINCIPAL OFFICE (32c)\nYEAR OR YEARS AMEMBER (32d)\n5\nAmerican Nurses Assn.\nprofessional\nWashington,\nnys D.Jc.\n(32a)\n5\nAlumni Assn.\n\"\nOrange, N.\n5,\n+\n(32b)\nDistrict No. 1\nNewark, N. J.\n5\n(32c)\nOh\nBECOKD: cpecy (O pureca sug\n(sap)\n(389)\n200\nWOAHES\n(SVS) 3901\n(32d)\nOla ansin\nCLLISEL\nMOLE VME\n1804\nvap\nOM\nos\nCOMMENCE\nanswir\nLOMW\n(33)\n(34)\nSTATEMENT OF ACTIVITIES FROM 1914 to 1918: (33)\nIl kon su que poon S n 2 104 pas AGSLA or uor 0 mpÀ Aon (34a)\nSTATEMENT OF VIOLATIONS OF THE LAW: (Do not include traffic violations; include all arrests) (34)\nNONE\nLE)\n(34b)\nthie\nOFFENSE FOR\nLHV\nCITY OR TOWN IN\nSTATE AND COUNTY\nDATE (34b)\n10\nDISPOSITION\nWHICH ARRESTED (34a)\nWHICH ACTION (34c)\nIN WHICH ACTION (34d)\nOF CASE (34e)\n(34c)\nwhal\nBEEW\nIV\nCEM\nTOOK PLACE\nTOOK PLACE\nOM a\nI\nMO.I.\nCOjOL of part\n(351)\n(34d)\nat\nI\ntoge (ss#) I\nCOPOL (ssp) A\n(xsa)\n(34e)\n(30)\nCpnicp (siz\nbrepor (sip)\n(35)\nHom: sqquoaa vor se goompos\n(ram)\n80429\n(35a)\ncontrol\n(35b)\ncrom\nSTATEMENT OF FINGERPRINTING: (35)\n(13)\nOL\none\nI: (35a) been fingerprinted. If so, when?(35b) June 22,1942 and where?(35c) Orange. N. J.\nhave\n(35c)\n(rep)\nIf you have not been fingerprinted, are you willing to be, with full knowledge that such fingerprints will be forwarded to the Federal\n(109)\nWIKE IHE LOFTOMMA\nBureau of Investigation? (35d)\n2\n(35d)\nLOWW\n(YES OR NO)\nDECTVEV.LIOM"
}

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