FOREIGN DUTY DATA SHEET - COLLINS, CHARLES P.

• Document Type: FOIA
• Keywords: PERSONNEL FILES
• Keywords: COLLINS CHARLES
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0001426030
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 3
• Document Creation Date: June 22, 2015
• Document Release Date: March 20, 2008
• Case Number: F-2007-01041
• Publication Date: May 12, 1954

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APPROVED FOR RELEASE
DATE: DEC 2007
 RESIDENCE AND DEPENDENCY _ REPORT"
INSTRUCTIONS: Submit in duplicate when ordered overseas or whenever designated place of residence, marital or
dependency status changes. This information is important in determining travel expenses allowable inconnec-
tion with leave at Government expense, overseas duty, return to residence upon separation, and in determining
transportation expenses. allowable in connection;?with shipment of remains of employee or member of family.
1. NAME OF EMPLOYEE (La ) (F' tl (Mid'
2. RESIDENCE DATA
PLACE OF RESIDENCE WHEN PPOINTED
LAST PLACE OF RESIDENCE IN CONTINENTAL U.S. lIF APPOINTED ABROAD)
-
PLACE I N C NTINENTAC U. s: DESIGNATED PERMANENT P LEGA EP 9E
?9 I' ,1 }+ qtr: a~ p ; p
3. MARITAL STATUS
[~ Single
Married
PLACE 0 MARRIAGE
DATE MA R G
?
PLACE OF DIVORCE DECREE
ATE OF ORCE SCREE
Divorced
PLACE SPOUSE DIED
DATE SPOUSE DIED.
Widowed
4. MEMBERS OF FAMILY
NAME OF POUSE
ADRESS (Number) (Street) (City) ( tate)
~
;
TELEPH NE
fD
E 3 tt
ar3Yr
'
NAM CHILDREN
ADDRESS (Number( ("$tree ) (City) lStateI'
SEX
G
NAME OF FATHER. (OR MALE GUARDIAN)
ADDRESS (Number( (Street) (City) . a e
TELEPHONE
NAME OF MOTH R- (OR FEMAL GUARDIAN)
.(Street( (City) (S ate(
ADDRESS (N:umbeer)
TELEPHONE
~
5 ? PERSON TOBE N . TIf I ED I.N CASE. OF EMERG
ENCY '
NAME
P
RELATIO II
#
AD RESS (Number) (Street) ityl (State)
TELEPHONE
TH ER S NAMED IN ITEM 4 ABOVE WILL ALSO BE OTIFIED IN CASE OF EMERGENCY. IF SUCH NOTIFICA-'
TION IS NOT DESIRABLE, DUE TO HEALTH OR OTHER PERTINENT REASONS, PLEASE SO STATE UNDER REMARKS.
VOLUNTARY ENTRIES
THE FOLLOWING AGENCY ENDORSED LIFE AND HOSPITALIZATION INSURANCE POLICIES ARE IN FORCE IN MY NAME: THE "POLICY
NO." SHOULD BE ENTERED IF POSSIBLE, SINCE THIS INFORMATION WILL ASSIST IN EXPEDITING ACTION BY THE INSURANCE COM,
PANY SHOULD A CLAIM BECOME PAYABLE.
FULL,.NAME OF COMPANY
ADDRESS OF HOME OFFICE
POLICY NO.
7. I HAVE COMPLETED THE FOLLOWING: WILL Yes No POWER OF ATTORNEY
Yes L Na
s.. Remarks:
A- A,
SIGNED AT
DAT.
SIGN E
FORM NO. JUN 1933 37-79 PRE ".'S EDITIONS NOT TO BE USED.