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

Text

This text came with the file. It may have mistakes. When the text and the image disagree, the image is right.

RECORD 01' EMERGENCY DATA
SEE INSTRUCTIONS ON REVERSE BEFORE MAKING ENTRIES
~~\
1. DESIGNATOR'S LAST NAME-FIRST NAME-MIDDLE.NAME
2. SERVICE NO.
3. GRADE OR RATE
(:1
r
NEWHOUSE,
Delbert Clement
177283
CHPHOT
USN
5. MARITAL STATUS
Married
7. ADDRESS (Numbe', atrtet, cit11, :one, and State)
6. FULL NAME OF SPOUSE
3.581 s.E. Grant Court~ Portland l.51 Ore.
Norma Isobel NEWHOUSE
CHILDREN (List each child of any marrialle. II none, so state)
FIRST NAME-MIDDLE NAME-LAST NAME
ADDRESS
MARITAL STATUS
SEX
DATE OF BIRTH
Delbert Carroll NEWHOUSE
3581 S.E. Grant Court, Portland l!~,
Single
M
6/28/38
Anne Lisbet NEWHOUSE
Oregon
,.
3581 s.E. Grant Court, Portland l!~,
Single
F
3/14/40
Oregon
9. NAME OF IJI FATHER OR O MALE GUARDIAN
10. ADDRESS IF LIVING-IF DECEASED SO STATE
Noah 'Frank NEWHOUSE
Portland, Oregon
11. NAME OF~ MOTHER OR O FEMALE GUARDIAN
12. ADDRESS IF LIVING-IF DECEASED SO STATE
Edith Ma.v RICHTER
Box 127~ Garibaldi~ Oregon
IN THE EVENT THAT I AM NOT SURVIVED BY A SPOUSE OR aIGIBLE CHILD I DESIRE THAT PAYMENT OF 6 MONTHS' DEATH GRATUITY BE MADE TO
THE RELATIVE ~HOWN BELOW. (The namo of lather or mother must be repeated ii it is desired that he or she recoivo payment)
13. FIRST NAME-MIDDLE NAME-LAST NAME
14. RElATIONSHIP
15. ADDRESS
Edith May RICHTER
Mother
Box 127, Garibaldi, Oregon
16. ALTERNATE RElATIVE
17. RELATIONSHIP
18. ADDRESS
Darrel Edwin NEWHOUSE
Brother
Rt 6, Box 756, Tacoma, Washington
19. IN THE EVENT THAT I AM LISTED AS MISSING OR OTHER MILITARY CIRCUMSTANCES PREVENT ME FROM TRANSMITTING FUNDS TO MY DEPENDENTS, IT IS MY DESIRE THAT
FIRST NAME-MIDDLE NAME-LAST NAME
Norma Isobel NEWHOUSE
RElATIONSHIP
Wife '
ADDRESS
3581 s.E. Grant Court, Portland 15, Oregon
RECEIVE EACH MONTH
90
20. I REQUEST THE FOLLOWING COMMERCIAL INSURANCE COMPANIES BE OFFICIALLY NOTIFIED IN CASE OF MY DEATH IN ACTIVE SERVICE
NAME OF COMPANY
ADDRESS OF HOME OFFICE
Pilot Life Insurance Company
California Western States
National Service Life Insurance
Government Life Insurance
Greensboro, North Carolina
Sacramento, California
Veterans Administration, Wash., D.Ct
Veterans Administration, Wash., D.C4
PERCENT OF MY PAY
POUCYNO.
321583
399422
V-77-44-.32
K 948 857
21. DESIGNATION OR CHANGE OF BENEFICIARY-SERVICEMEN'S INDEMNITY (PL BS, sed Cong.)
(Dou not operate a., a designation or change of bemjiciaru of anu insurance contracta faaued bu United Statea Government)
ALL PREVIOUS DESIGNATIONS OF PRINCIPAL AND CONTINGENT BENEFICIARIES, IF ANY, UNDER SERVICEMEN'S INDEMNITY Ar::r OF 1951, ARE HEREBY CANCELED, AND IT IS DIRECTED
THAT SAID INDEMNITY BE PAID TO:
NAME
Norma Isobel NEWHOUSE
. r1
/'\ (/"J
I
WITNESSl~D.'na1~~
.. ~s
G. L. LUCAS
GRADE OR RATE OF WITNESS
ISERVl;E;~572
Lieutenant-USNR- R
RELATIONSHIP
SHARE OR AMOUNT TO EACH BENEFICIARY
Wife
100 per cent
gGNA~~~:Jin L-4J
DATE SIGNED
30 March 1955
l&-67492-1
DD ~~~M
9
3
Replaces ~D Form 93, 1 Jul 50, which may be used.
1
52
j
I