Final Personnel Record for Newhouse, Delbert C., U.S. Navy, 1957

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RECORD OF EMERGENCY DATA
l..;-·1
•
SEE INSTRUCTIONS ON REVERSE BEFORE MAKING ENT81ES
I. DESIGNATOR'S LAST NAME-FIRST NAME-MIDDLE NAME
2.. PRESENT SERVICE NO•
I
S. DATE OF BIRTH
. .
I3~;RATE
14·;~;
NEWHOUSE.
Delbert Clement
17728'3
6-~-13
7. FORMER SERVICE NO,
6. HOME ADDRESS AT TIME OF LAST ENTRY 1Ntp SERVICE (Citv, countv, and State)
393 07 21
Garibalcij.,Tillamook, Oregon
DESIGNATIONS
ADDRESS
FIRST NAME-MIDDLE NAME-LAST NAME
3581 SE Grant Court
8. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY
9. BENEFICIARY FOR GRATUITY PAY
IN EVENT THERE IS NO SURVIVING
SPOUS~ OR ELIGIBLE CHILD
10. BENEFICIARY FOR
SERVICEMEN'S INDEM­
NITY(PL!S,Bld Con•
(lrua) ( AU prior dea­
ignationa are canceled.
Deaignation for in•
demnitv dou not afect
inaurance ( NSL or
USGLI) benejiciar11
deaignation)
PRIN­
CIPAL(S)
CONTIN•
GENT(S)
II. BENEFICIARY OR BENEFICIARIES
• FOR UNPAID PAY AND ALLOWANCES
( PL 147, 84th Congrtaa)
12. PERSON TO RECEIVE ALLOTMENT
OF PAY IF MISSING OR UNABLE TO
TRANSMIT FUNDS
PRINCIPAL
CONTINGENT
SHARE
s
SHARE
s
SHARE
s
SHARE
s
SHARE
100
%
SHARE
%
PERCENT OF
PBQ%CHMO.
RELATIONSHIP
Wife
Mother
Brother
Wife
Wife
Norma Isobel NEWHOUSE
Edith May RICHTER
Darrel Edwin NEWHOUSE
Not Applicable. NSLI
Norma Isobel NEWHOUSE
Norma Isobel NEWHOUSE
~ortland, Oregon
PO Box 127
Garibaldi, Oregon
Rt. 6, Box 756
Tacoma~ Washington
3581 SE Grant Court
Portland~ Oregon
3581.SE Grant Court
Portland~ Oregon
13. PERSON TO RECEIVE PERSONAL EFFECTS FOR
SAFEKEEPING
Commanding Officer
14.
COMMERCIAL INSURANCE COMPANIES TO BE NOTIFIED _IN CASE OF DEATH IN ACTIVE SERVICE
FULL NAME AND ADDRESS OF COMPANY
California Western State Life
Insurance Company
FIRST NAME-MIDDLE NAME-LAST NAME ( Ifdectaaed, ao atatt).
15. FATHER
Noah Franklin NEWHOUSE
16. MOTHER
Edith May RICHTER
17. WIFE OR HUSBAND ( If none, ao atatt)
Norma Isobel NEWHOUSE
18.
NAME OF CHILDREN ( Ifnone, ao atate. Ifatep or adopted, ao atate)
Delbert Carroll NEWHOUSE
Anne Lisbet NEWHOUSE
19. ORGANIZATION AND ADDRESS OF DESIGNATOR
Uti1 i tv Smu:i dron FIVE. NAVY IJ-:~8 ~~..
21. SIGNATURE OF-WITNESS
,f.W~NR-R
ADDRESS OF OFFICE RECEIVING PAYMENT OR HOME OFFICE
POLICY NO.
Sacramento, California
399422
'
ADDRESS
Unknmm
PO Box 127~ Garibaldi~ Oregon
~~81 SE Grant Court. Portland 15. Ore£on
MARRIED
ADDRESS
SEX
DATE OF BIRTH
..
NO
YES
3581 SE Grant Court, Portland,
Oregon
3581 SE Grant Court, Portland,
Oregon
X
M 6-28-38
X
F 3-14-40
20. DATE SIGNED
clo FPO. San Francisco. California .,.
2-911~6
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FORM
For Navy, Marine Corps, and Coast Guard use: Wlll be used in lieu of DD Form 93.
1 OCT 55
DD
93-1