65_HS1-834228961_62-HQ-83894_Section_009

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4::-22 (~av:½-7'-ss)
.•
•
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Federai Bureau of Inves~
ion
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.,
Records Braneh
---'~~-~I_O__ , 1958
CJ Name Check Unit - Room 6523
CJ Service Unit - Room 6524
CJ Forward to File Review
c:::;J Attention ..--,,-----.--r-----r=-e--.---­
[ill Return to \N Ci LK s
/s l5
Supervisor
Room
Ext.
Type of References Requested:
0Regul ar Request (Analytical Search)
(X] All Refer~nces (Subversive & Nonsubversive)
CJ Subversive References Only
C:=J Nonsubversive References Only
LJMain _____ References Only
Type of Search Requested:
CJ Restricted to Locality of _______
CJ Exact Name Only (On the Nose)
@Buildup
[=::J Variations
C:J Check for Alphabetical Loyalty Form
C, g. P\o..hl'£
Subject -----
-
- ----------
Birfhdate & P l ace _____________
Address _________________
Localities ----------------rt- ­
Searcher ~
R ,,._ ____ Date
Il---10
Initials
-~
FILE NUMBER
SERIAL