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

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commanding.
r lmm,edlately of any changes In marital status, or con.
dltlons of depe
ency, or of voluntary occupancy of public quarters by my
dependents.
I CERTIFY that there has been no change In condition of dependency
between _ __,_•----~-~~----,-- and curren't date.
(Date of Inst report of beneficia ries )
•
• I do,solemnly S'(1ear (or l\,fflrm) that the facts stated and disclosed In the
f: egolng
~
( Signature)
,-,
ii.
Subscribed and sworn to before me thls,_ ...:=-".c....--­
28
---­
19.12, I having authority
.e
INSTRUCTIONS
• This fiJrm must be sworn to hefore an officer of the
United States Navy authorized to administer oaths, or
before a notary public.
The full names and addresses of the beneficiaries must
be state& carefully. If a marriea ·woman, her own given
name should be stated: thus: "Mrs. Anna May Smith," not
"Mrs. John Smith."
-·-·· •-·­
This slip shall be made out a11,;l__hg_1J_dled as lo/lows:
Officer, Navy: Forward to Bureau of Naval Personnel.
Nurse: Forward to Bureau of Medicine and Surgery.
Enlisted men, Navy: In duplicate: one copy to Bureau
of Naval Personnel, one copy secured inside service rec­
ord. In cases of men entitled. to money allowances for
quarters for enlisted men with dependents, two additional
copies, bearing the required .c~ tificate, to th'? D)sbursing
Officer.
'
New beneficiary slips shall be executed and lorwarded
as above in all cases of change in status of the granfor or
in that of his or her beneficiaries.
In any event, payment will be made to the widow or
children, if any, whether designated or not.
Normally casualty notification will be sent to all the
beneficiaries designated on this form.
If, by reason of
unusual circumstances, other special arrangements ara
desired, a statement should be attached setting forth
full instructions including full names, addresses, and
relationships.
U. S, GOVE:RNl4EHT PRINTING OFFICE.
c0-16-48177-1