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

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INSTRUCTIONS

1. In the event this claim involves travel under secret or confidential orders, or orders from which the location of the old or new duty station is omitted for reasons of security, or under orders effecting assignment to or from sea duty or to or from a place to which dependents are not permitted to go, careful attention should be given to SecNav letter of 23 December 1944, particularly paragraphs 2, 3, 6 and 10.

2. If your claim is not submitted under SecNav letter of 23 December 1944 (Instruction 1, above), the original and two certified copies of all orders involved, with all endorsements, must accompany claim.

3. Claim should be prepared and forwarded to BUREAU OF NAVAL PERSONNEL, Washington 25, D. C., in accordance with Article 2513, U. S. Navy Travel Instructions.

4. CLAIM MUST BE SUBMITTED IN QUADRUPLICATE. The original is to be on NAV. S. and A. Form 912—Rev. and signed in ink on the face. Three copies (unsigned) to be on NAV. S. and A. Form 913—Rev.

5. SECURELY STAPLE ALL PAPERS TOGETHER.

6. The space below is to be used for any additional information by claimant which is necessary in settlement of this claim.

I certify except as noted hereon that no prior claim has been presented by me or by any member of my family for the reimbursement for my transportation of dependents as claimed herein and that no transportation in kind has been furnished therefor.

ИМЕ

ВЕДУЮЩИЙ

ДУЕ ОБ БИЛH ОК СИБЕ

Delbert O. Newhouse,
Lt. USN.

ЛОВАР

БАРМАР

ВИР

ЕКОМ

1

РАБАТЫВАЕ

ВИД ВА CHECK

БОЛТЯР

СЕУЛ

АУТОПИТ

(For use of Paying Officer)

CERTIFICATE OF DEPENDENCY OF CHILDREN

(Note: To be used only for adopted or step children)

I, _ certify that _ is (are) my (adopted) (step) child (children) and is (are) member(s) of my household; that said child is (children are) not possessed of property or income adequate for its (their) support and education; that it is (they are) not the beneficiary or beneficiaries, either directly or through others, or any trust or estate entitling it (them) to income adequate for its (their) support and education; that said child is (children are) in fact now and at all times solely dependent on me; that in all respects I maintain the child (children) at my own expense and from my own resources and am not reimbursed therefor directly or indirectly in any manner or form whatsoever; and that evidence of the child's (children's) dependency on me and my maintenance of it (them) has been filed with my pay accounts and is hereby made a part thereof. (See special requirements, Art. 2513, U. S. Navy Travel Instructions.)

SIGNATURE

U. S. GOVERNMENT PRINTING OFFICE 16-44895-1