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

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and disclos.;d in the foregoing are true to the best of
,, In the event that payment ~annot be made to the
above-named dependent relative, I then designate as
my beneficiary under the said act the following depend­
ent relative, my
(Rolatlonsblp)
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(Name fn Cull)
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--------- ---------(Address)
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• St.ate briefly wherein dopendoncy exists.
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I do solemhly swear (or affirm) that the facts stated
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-~-<?..~..9~-~.l?J?._~-~-J_~~-~)_______, U. S. Navy.
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(Rank)
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Subscribed and sworn to before me, this ..1..i.tJJ.____
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day of ___:r_~_l?_~~----------------, 19 43, I haviA
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authority-to administer oath~.
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~~~w~
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Commanding Officer.
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INSTRUCTIONS
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This form must be sworn to before on officer of tho United States Navy
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or MRrino Corps authorized to administer ooths, or before a notory­
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nublic.
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Tho full names and addresses of the bcnoficiaries must ho stated
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carefully. If a married woman, ber own given nrune should be stated·
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thus: "Mrs. Anna May Smith," not "Mrs. John Smith."
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New beneficiary slips sbnll be executed and forwarded os above in al1
cases of change of status of the grnntor or in that of his or her bcnofieinrlo,:\. "
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In any event, payment will be mode to tho widow o~ children, II ab!)>
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whether deslsnatod or not.
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* u. ,. COYtRtUtlNT PRINTING c rFICL: 10<12
lli-27700-t
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