65_HS1-101634279_100-DE-26505

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Record Request
FD-125 (5-27-55)
I I Birth D
Credit
D
Motor Vehicle
CJ ·Death ..____ Marriage•
INS
To:
Return to:
Fi le number
Buded
Name and aliases of subject, app1icant or employee &spouse
Addresses
Residence
Business
Former
*Date and place of marriage
/(t<A
51(1
(it pertinent)
Race
8 i rth date
Birthplace
sc::r::-ex
Male
-
I
~
w
CJ Female
Age
Height
Weight
Hair
Arrest Number
Fingerprint Classi tication
'
Eyes
======----­
FOIA(b)(6)
Cr hninal Specialty
Spec it ic intormat ion deaired
(See reverse side for results of chetk)
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