U.S. DEPARTMENT OF JUSTICE Employee Locator Information 04gTRUL- 11046: ytb Si, bb oonstaf by d mina Lyn tam (niers:To (Lomt coN new any Larrnmcn m Cs am mama, Czyrma del 1:0 parp8p40:02:01.1 Ramie do yos prsord cam In oetatortowth protRas d Tv Picu.YM d 1974. a0. Colon d Geo M MANDATORY, mars, b rot On GASSMAN tsta elv cloty QM mooring or overran The YMCAS:Ma AOLUMARY re10 of re CU Ainciceml to Ye ownS•Pacn Ad Sent Cat' Pr," d tiOrminb t°egnilni by t* niuMnre‘terS amend ante nom Era= mufti tem Cub yearn d To On Meet 3 you /merry pastcre rga-Sre conker d Cs am Musa teal pas oceans aft. EMPLOYEE IDENTIFICATION PRVACY ACT STAMM: SOCIAL SUMMIT NL2361-1 AUT1=ITY• En:4410 Cot/ ITMS =41 tOrenter 22, 1041 2 PL10414r An use ma sadorso2s2y Know:TOM um:1m am*, Kura tx ratetteg kalercometo to tat: pared um pun: area Lao at Co ESN aurae mitt ,0024::40 of fixate ewe-Moyom nth:0 lane in 1 EFFECTS OF NOP 00011‘4124 Maoot cid* 11:41 b MANDATORY. Fetszo 0 Sid= Co SM4 en =Sal retl oats 0 yamLy resol art COM crocomod Fire 1, =coo Co SSA yte) nate 412Yertiel ravAH24 72. n batto CMS TO BE COMPLETED BY PERSONNEL OFFICE 4. NAME (Last Past. abaft 0. =al 5. SOCIAL SECURITY SUBMISSION DATE Li CONTROL NUMBER a TYPE OF ACTDN 0 1 Crypol 0 2 Ck-ace Nice 1— .7 -O\let . t 0.2.6-1% CURREY! RESIDENCE ADDRESS FOR TAX PURPOSES PRVACY ACT STATEMENT: RESDEN0E ACIULESSI AUTHOR110*: Vat Soolcm SSA 8817 UM Si20 a Soc0x0 1ca810, 2. INPPOSE AND L. Se Toemol Co wan rop-tormea of Far* Sala alt SRNs a. I CONOntro a/ cram Regarm Maw 4 WOMAN . Faro mama Co armr1Reave Aril MCM141011,4 tmtdeon dtbo dad aCtrasat past04 preen as proscacenvrox 7. STREET ADDRESS (No., Niers, St. Dr., PL, ce.) 8. t3EQGMD UNE STREET ADDRESS CS nacessary) "-% Jorei eW t a) reini xTRy 9. CITY 10. COUNTY OR FOREIGN 11. sratEj 12 .. . IM- ZEP CURRENT RESIDENCE ADDRESS AND TELEPHONE NUMBER POMO' ACT STATEWHiT: RESDEACE N=RESS ARIDTEXPCNE MASER-1. AUTHORTIY: a USC Sxoon SOY 2 RRPO