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

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___
----------- NEWHOUSE.,___Delbert Clement-----­
(Name of officer ; surname first)
Ensi gn
(Rank and c?rps)
W3l/4:3 ·------------- -------------------­
(Date)
REPORT OF DEPENDENTS UNDER ACT OF
JUNE 10, 1922
(Not.e Act of June JO, 1922, defines the term "depen­
dent" a.
wful wife, unmarried children under 21 years of .l f!t',
or the mo 1er of an officer provided she is in fact dependent oa
him for her chief supporL)
Num•-- Three__ ____________________________
No
1lother
(Yes or No)
'IN ife ________y_e,5_____---------- ------____________
(Yes or No)
Age and sex of each child under 21 years of age:
________6 years _- _male ____________________________
.______4 _years _- _female ________________________ _
----
-·----------------------------------------------· ­
---------- .------------------------------------------------­
BENEFICIARY SLIP
Name ._ NEWHOUSE_, Delbert_Clement _____ .
( Print name, surname! to the left)
______ NASL Coco Solo,C ,z. ______ _12.(3.1/43
( Place)
(Dater·
Any change since last report:
~rNO
(Stril,e out one ; if no change, do not fill out remainder of this
report)
Under the provisions o/ the Act of June 4, 1920 (41 Stat. 824),
as amended by the Act of May 22, 1928 (45 StaL 710 ; U. S. C.
Title 34, Sec. 943) , as further amended b:t Public Law 16, 77th
Congress, approved March 17, 1941, direct1ng the payment of six
months' pay to the widow, childrcu, or dependent relative of any
officer, enhsted man, or nurse, on the active list of the regular
Navy or regular ~farinc Corps, or on the retired list when on
active duty, or officer, aviation cadet, midshipman, nurse, warrant
officer, or enlisted man of the U. S. Na,•al Reserve called or
ordered into active naval or militarx service by the Federal
Government for extended naval or nulitary service in excess of
30 days, who dies of wounds or disease not the result of his or
her own misconduct, I give below the name and address of my
wife and that of each of my children:
(Full name of wife; if not married, so state)
(Address of wife)
(Full name of child ; if none, so state)
(Address of child)
(Full name of child; if none, so state)
(Address of child)
(Full name of child ; if none, so state)
i - - --- - - ---------- - - ----- --- - - -·-------- - - - - ·- - ------- - - --- - -­
1
(Address of child)
In the event of my leaving no widow or child or of
•their decease before payment is made, I then desig­
:nate as my beneficiary under the said act the follow­
png dependent relative, my
I
t
I
(Relationship)
I- ------ - - - - - - - -- ---- -- ------------- - - -- -- - -- -- ---- - -------­
;
(Name in full)
I - ------ - -- -- - ---- - ----------------------------------- -----­
' f
'"'""'
;•1:__-.:::::::::::::::::::::::::::::::::::::::::::_:::-::
1
• State briefly wherein dependency exists, such as " allotments
1registered," "monthly contributions by Government check," etc.
(OVER)
REPORT OF NEXT OF KIN
_________ JOO.VJiQtJ~i,__lle.lhe.rt_C.leme.n.t_________
(Name oI officer, surname first)
_________l~/11/43 --- ------------- -- --------- - - -- --­
cnate>
Any change since last report:
'lllSS! or NO
(Strike out one; ii no change, do not fill out rcmainuer of this
report)
Name of next of kin: - -------- ------------------ - -­
(Relationship)
Permanent residence:
Street and No.
City or town
State - - - -------------------- -----------------­
1 Emergency address:
Street and No.
City or town
State -------------- - -- -----------------------­
(Signature)
tRank and corps)