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ay
(5)
Mrs.
H
STATEMENT OF PUBLICATIONS AND ARTICLES OF WHICH EMPLOYEE IS AUTHOR: (30)
5
TITLES (30a)
PUBLISHER (30b)
DATE (30c)
(30)
(rap)
a
querte
(30a)
(380)
(580)
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)
(TRP)
(59%)
E
RELATION (31a)
NAME IN FULL (31b)
ADDRESS (31c)
OCCUPATION (31d)
COUNTRY
WHERE BORN (31e)
(30c)
(330)
-
(534)
Husband
villiam Robert Day
(31)
(519)
(sep)
(380
U.S.Haval Operat. Base
(sip)
+
clerk
United State
(318)
Bennia
(31a)
(S3)
e
No ther
Mele T. Jrush
425 01. Boonton Rd.
(31b)
(sein)
Jeonton, N. J.
housewife
United
States
(31c)
(30))
Father
George V. Brush
425 014 Boonton Rd.
Boonton, N. J.
districk cleric United States
Brothers
Same
Aeronautic Mech.
(31d)
G. Vas Jr. & Panl
(30))
1
United thtes
(se)
u
STATEMENT OF MEMBERSHIP IN ORGANIZATIONS: (List all organizations of which you are (or) have been a member since
(31e)
(sep)
30-Organizations include military, athletic, vocational, musical, trade; professional, social, fraternal, political.) (32)
s
(seB)
(32)
(301)
5
NAME (32a)
CHARACTER (32b)
(sep)
ADDRESS OF
PRINCIPAL OFFICE (32c)
YEAR OR YEARS A MEMBER (32d)
(sée)
(sem
Vashing nhs ony nyo.
(32a)
American Hurses Assn.
professional
5
(100)
Alumni Assn.
A
#
Orange. N. Je
5
DEMEL
(32b)
District No. 1
cpock pelo:
Newark, N. J.
5
(T03)
(129)
DEOKEICA
VMD IVAVE BECOKD:
CUGCK to orge
(32c)
you
(sap)
($29)
(rep)
(380)
(sau)
WOLHEN
(308)
(SEP)
(32d)
11
E
Ols
(sep)
AO whr VM Vr VMD EMOVOED on os anewia hom MMI-123 (33)
(310)
(34)
(13 C)
STATEMENT OF ACTIVITIES FROM 1914 to 1918: (33)
(sap)
Il Aon SLG su STIGU gug pesu 9 Leargeup of gpo a 2° [OL BAG ACSLA or LIOLG suq psag wor pecourg gr PESTG Aon (34a)
(7)
(133)
STATEMENT OF VIOLATIONS OF THE LAW: (Do not include traffic violations; include all arrests) (34)
(34b)
(S$0)
OFFENSE FOR
CITY OR TOWN IN
STATE AND COUNTY
WHICH ARRESTED (34a)
LHV DATE (34b)
10
DISPOSITION
WHICH ACTION (34c):
IN WHICH ACTION (34d)
OF CASE (34e)
(34c)
oh
HVAE BEEV IV
CEA
TOOK PLACE
TOOK PLACE
(stp)
I
OM a
DE
MOIL
(ssq)
(536
($51)
(34d)
(sip)
HO.LOCHVbH
(515)
COjOL (ssp)
(sso)
(34e)
(so)
(180)
(30)
OI
brapot (sip)
(35)
(iap)
(189)
LAI) (Tap)
sea
Hond
(35a)
(104)
developies
(isp)
STATEMENT OF FINGERPRINTING: (35)
(35b)
(199)
(11)
have (35a)
I been fingerprinted. If so, when?(35b) June 22,1942 and where?(35c)
Oxange, n. J.
(10c)
(35c)
If you have not been fingerprinted, are you willing to be, with full knowledge that such fingerprints will be forwarded to the Federal
(1ep)
VIVKER .LHE
(YES OR NO)
4
(35d)
Bureau of Investigation? (35d)
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Document data
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Document source extras
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