CURRENT RESIDENCE AND DEPENDENCY REPORT - CARANCI, JOHN C.

• Document Type: FOIA
• Keywords: CARANCI JOHN C
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0001496347
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: June 22, 2015
• Document Release Date: December 31, 2008
• Case Number: F-2007-00327
• Publication Date: March 15, 1957

UNF
;NTIAL
.
F e ?~11ed In)
INSTRUCTIONS: COMPLETE IN DUPLICATE. THE DATA RECORDED ON THIS FORM IS ESSENI AL IN DETERMINING TRAVEL EXPENSES
ALLOWABLE IN CONNECTION WITH LEAVE AT GOVERNMENT EXPENSE. OVERSEAS DUTY,~RETURN TO RESIDENCE-UPON SEPARATION. AND
FOR PROVIDING CURRENT RESIDENCE AND DEPENDENCY INFORMATION REQUIRED IN THE EVENT OF AN EMPLOYEE EMERGENCY. THE
ORIGINAL OF THIS FORM WILL BE FILED IN THE EMPLOYEE'S OFFICIAL PERSONNEL FOLDER. --
[bII61
NOME OF EMPLOYEE (Last) (First) (Middle)
- (b131
Kl
'
a 4, 4
RESIDENCE DATA
PLACE OF RESIDENCE WHEN APPOINTED
LAST PLACE OF RESIDENCE IN CONTINENTAL U.S. (If appointed abroad)
1 4
1
PLACE INCONTINEM.ZAL
U.S. DESIGNATED S PERMANENT RESIDENCE
/
2. MARITAL STATUS
CHECK (X) ONE: SINGLE MARRIED SEPARATED DIVORCED WIDOWED ANNULLED
MARRIIED, INDICATE PLACE OF/MARRRIAGE /
DATE OF MARRIAGE
IF DIVORCED. PLACE OF DIVORCE DECREE -! '~ ?
E- DEC
IF WIDOWED. INDICATE PLACE SPOUSE DIED
DATE SPOUSE DIED
IF PREVIOUSLY MARRIED, INDICATE NAME(S) OF SPOUSE. REASON(S) FOR TERMINATION, AND DATE(S)
3. MEMBERS OF FAMILY
Street
Zone
City
ADDRESS (No.
State) TELEPHONE NUMBER
,
,
,
,
NAME$ OF CHILDREN
p
THE A NCY FOR EMERGENCY WPURPO E?S? L"
WHAT MEMBER(S) OF YOUR FAMILY HAS BEEN TOLD OF YOUR AFFILIATION WITH
4? PERSON TO BE NOTIFIED IN CASE OF EMERGENCY
Mr Mrs. Miss) Last-First-Middle RELATIONSHIP
.AtAMP
T PAON-C NUMBER
BU i EXTENSION
1--~ YES NO
IS THIS INDIVIDUAL AUTHORIZED TO MAKE DECISIONS ON YOUR BEHALF?
YES NO
DOES THIS INDIVIDUAL KNOW THAT HE HAS BEEN DESIGNATED AS YOUR EMERGENCY ADDRESSEE?
YES C, NO
THE PERSONS NAMED IN ITEM 4 ABOVE MAY ALSO BE NOTIFIED IN CASE OF EMERGENCY. IF SUCH NOTIFICATION IS NOT DESIRABLE
BECAUSE OF HEALTH OR OTHER REASONS, PLEASE SO STATE IN ITEM 7 ON THE REVERSE SIDE OF THIS FORM.
5. VOLUNTARY ENTRIES'.
INDICATE ANY BANKING INSTITUTIONS WITH WHICH YOU HAVE ACCOUNTS
t
s
4-1
5
1
1 v, CONTINUED ON REVERSE SIDE .^ u ' ~~
CURRENT RESIDENCE AND DEPENDENCY REPORT
FORM N-O. OESOLETE PREVIOUS
I AUG 56 61 EDITIONS.
CON4ENTIAL
APPROVED FOR RELEASE^DATE:
12-Nov-2008
 5. (CONTINUED)
IN WHOSE NAME (S) ARE THE
ACCOUNTS
LISTED?
HAVE YOU COMPLETED
A LAS
T WILL AND
TESTAMENT? YES No. -IF
,"YES', WHERE IS DOCUMENT LOCATED?
HAVE YOU EXECUTED A POWER OF ATTOR
NEY? Y
6. ADDITIONAL DATA
AND/OR CONTINUA
TION OF PRECEDING ITEMS
SIGNED AT
DATE
S I G N A U R E
(When. F'~edr,In)