HR- APPOINTMENT AFFIDAVITS -ELIZABETH SUDMEIER

• Document Type: FOIA
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 06942918
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: July 23, 2025
• Document Release Date: July 31, 2025
• Publication Date: November 12, 1951

Approved for Release: 2024/12/17 C06942918
i �
STANDARD FORM 61 (REVISED AUGUST ISM)
� PROMULGATED BY CIVIL SERVICE COMMISSION -
FEDERAL PERSONNEL MANUAL
APPOINTMENT AFFIDAVITS
IMPORTANT.�Before swearing to these appointment afiidavits, you should read and understand the
attached information for appointee
C.I.A.
(Department or agency) (Bureau or division)
El i z abe th ie r
, do solemnly swear (or affirm) that�
A. OATH OF OFFICE-,'
I will support and defend the Constitution of the United States against all enemies, foreign and -
domestic; -that I:Will 'beak true faith and allegiance to the same; that I take this obligation freely
without any mental reservation rir purpose of evasion; that I will well and faithfully discharge the
duties of the office- on which I am about to enter, SO HELP ME GOD.
B. -AFFIDAVIT AS TO SUBVERSIVE ACTIVITY AND AFFILIATION
I am not a COMmunistrir Fascist. I do not advocate nor am I a member of any organization'
that advocates tile. overthrciw of the Government. Of -the United States by force or violence or Other
unconstitutional' ineai* or Seeking by force or violence to deny other persons their rights under the
Constitution of the United 'States. -I do further. swear (or affirm) I will not so advocate, nor will
I become a member of such organization during the period that I am an employee of the Federal
Government.
C. -AFFIDAVIT AS 'TO STRIKING AGAINST THE FEDERAL GOVERNMENT
I am not-engaged' n any strike against the Government of the United States and that I will not
so. engage While an .employee Of the Government Of the United States; that I am not a member of
an organization of Government employees that asserts the right to strike against the Government
of the United States, and, that I will not, *line -a Government employee, become a member of such
an. organization.
Wasliin . D
(Place of employment)'
i
D. AFFIDAVIT AS TO PURCHASE AND SALE OF OFFICE
I have not paid, or offered or promised to pay, any money or other thing of value to any person,
firm or corporation for the use of influence to procure my appointment.
E. AFFIDAVIT AS TO DECLARATION OF APPOINTEE
The answers given in the Declaration of Appointee on the reverse of this forni are true_ and_
correct.
(Date of of entrance on duty)
Subscribed and sworn before me this 12t1
at
iszaLl
(City)
day of November
A. D. 19 5
_
U .3
NOTE.�If the oath is take before a Notary Public the date of ex-"ration of his commission should
be shown.
(Title)
16-65180-2
Approved for Release: 2024/12/17 C06942918
Approved for Release: 2024/12/17 C06942918
DECLARATION OF APPOINTEE
:
This form is to be completed before entrance on duty. Answer all questions, Any false statement in this
declaration will he groom% for cancellation of annlication or dismissal after appointment Impersonation is a
crimina:
I. PRESENT AC
L (A) DATE OF BIRTH
/A i6T/92
(B)=IRTHo (ar town nd Stet count )
i /
3. (A) IN CASE OF EMERGENCY !LEASE NOTIFY
(A) RELATIONSHIP
(C) STREET IfiD NUMBER. CITY NDST
(D) TELEPHONE NO.
: ,.-)' i:: : �
// A ..CJ t A
4. DOES THE UNITED STATES GOVERNMENT EMPLOY. IN A CIVILIAN CAPACITY. ANY RELATIVE OF YOURS (EITH BY BLOOD OR MARRIAGE) WITH WHOM YOU LIVE OR HAVE LIVED WITHIN
THE PAST 24 MONTHS? 0 YES NO
If so. for each such relative fill in the blanks below. If additional apace is necessary, complete under Item 10.
�
NAME
POST OFFICE ADDRESS
(Give atreet number, if any)
(1) POSITION (2).TEMPORART OR NOT '
(3) DEPARTMENT OR AGENCY IN WHICH
EMPLOYED
RELATm.
SHIP
MAR- I =me
( Check one)
2. --------_----
3.
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2.
3.
.
1
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2.
3.
INDICATE "YES" OR "NO" ANSWER .BY PLACING "X"
IN PROPER AOLUMN
YES
, .
NO .
10. SPACE FOR DETAILED ANSWERS TO OTHER QUESTIONS
, ntm
NO.
WRITE IN LEFT COLUMN. NUMBERS OF ITEMS TO WHICH-DETAILED ANSWERS. APR.?
3. ARE YOU A CITIZEN OF OR DO YOU OWE ALLEGIANCE TO THE UNITED STATES7_
1/
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_
� _ . .. ,
___ � �
6. ARE YOU AN OFFICAL OR EMPLOYEE OF ANY STATE. TERRITORY. COUNTY. OR
MUNICIPALITY?
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_____ _ __________________ _______ _ _____________ _.__
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If your Answer is "Yes", give detail's in Item 10.
7. DD YOU RECEIVE ANY ANNUITY FROM THE UNITED
COLUMBIA GOVERNMENT UNDER ANY RETIREMENT
OTHER COMPENSATION FOR MILITARY OR NAVAL SERVICE?
If your answer is "Yea", give in 'tenth)
that is, age, optional disability, or by
or involuntary separation after 5 years'
retirement pay, and under *hat retirement
if retired from military or naval service.
_
. . ,
STATES OR DISTRICT OF
ACT OR ANY PENSION OR
n for retirement.
reason of voluntary
service; amount of
act; and rating,
A. SINCE YOU FILED APPLICATION 'RESULTING IN THIS APPOINTMENT HAVE YOU
BEEN DISCHARGED. OR FORCED TO RESIGN, FOR MISCONDUCT OR UNSATIS-
-FACTOR/ SERVICE FROM ANY POSMON7 � ' � ' ' � " - -
If your answer ia "Tea" , give in Item 10 the name and address
of employer, date and reason in each case.
� .
.
9. HAVE YOU BEEN ARRESTER (NOT INCLUDING TRAFFIC VIOLATIONS FOR
WHICH YOU WERE FINED $25 OR LESS. OR FORFEITED COLLATERAL OF 325011
LESS) SINCE YOU FILED APPLICATION RESULTING IN THIRAPPOINTIRENT?....,
. . , ,
�-
, If your answer is "Yea", Ian all such oases under Item 10.
Give in each case: (1) The date; (2) the nature of the offense
or violation; (3) the name and location of the court; (4) the
penalty imposed, if any, or other disposition of the case.
If appointed, your fingerprints will-be taken.
INSTRUCTIONS TO APPOINTING OFFICER
The appointing officer before whose the foregoing certificate is made shall
determine to his Own satisfaction that this appointment would be in conformance
with the Civil Service Act, applicable Civil Service Rules and Regulations and
acts of Congress pertaining to appointment
This form should be checked for holding of office, pension, suitability in con-
nection with any record of recent discharge or arrest, and particularly for the
following:
(1) Identity of appointee.�It is the duty of the appointing officer to
i guard against n ation and to determine beyond reasottatde doubt that the
appointee is the same person whose appointment was authorised, The
appointee's signature and handwriting are to be compared with. the application
� and/or other Pertinent papers. If the appointee qualified ;in. a- written exams-.
nation, the signature on this form should be compared With the signature on
the declaration sheet, which was signed in the examination room. His physical
appearance may be-Checked against the medical certificate. The appointee
may also be questioned. on his personal history for agreement with his previous
statements.
(2) Age.-11 definite age limits have been established for the position,lt should
be determined that applicant is not outside the age range for appointment.
Until such determination is made, the appointment may not be consummated.
(3) Citizenship.�The appointing officer is responsible for observing the
citizenship provisions of (1) the Civil Service Rules and (2) appropriation acts.
Form 61 constitutes au affidavit for both purposes and is acceptable proof of
citizenship status in the absence of conflicting evidence. In doubtful cases the
appointment should not be consummated until clearance has been secured from
the certifying office of the Civil.Service Conenindon.' � t,
(4) Members of Farnify:.�Seciiiin 9 of the cliii Service Act provides that
whenever there are already two or more members of a family serving under
probational or permanent appointment in the competitive service, no other
member "of such- family El eligible for probational or permanent appointment in
the competitive service. The appointments of Persons entitled to veteran
preference are not subject to this requirement The members-of-family provision
does not apply to temporary appointments. Doubtful cases may be referred to
the appropriate office of the Civil Service Commission for decision.
O. 11. 00VGRNOILNT PRINTING tarries 16-16160-'
Approved for Release: 2024/12/17 C06942918