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

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RECORD OF EMERGENCY DATA FOR THE ARMEQ FORCES OF
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THE UNITED .STAT-ES
'INFORMATION INCLUDED_ ON THIS FORM DOES NOT DESIGNATE OR CHANGE BENEFICIARIES OF LIFE
INSURANCE POLICIES
(S~c, instructions on reverse side, of form prior to makin,i entries)
1. DESIGNATOR'S LAST NAME-FIRST NAME-MIDDLE NAME
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2. SERVICE NO.
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3. GRADE. RANI(. OR RATE
4. SERVICE
OusA
l19USN
OusAF
OusMc
DuscG
IJl1JROQSB. Del.bar\ C1.emsnt.
1"'-83
CIPBOl
5. FIRST NAME-MIDDLE NAME-LAST NAME OF PERSON TO BE NOTIFIED IN CASE OF EMERGENCY
RELATIONSHIP (Iffriend, 10 1tate)
adviaable)
(Peraon with ~:erddru1 i1
Bdith ?&a' Blchtar
llother
ADDRESS (Number, atreet, cil11, zone, and State)
:
General Delivery. Garibaldi. ONacm
THE PERSONS NAMED IN ITEMS 6. 8. AND 9. BELOW ALSO WILL BE NOTIFIED OF THE EMERGENCY.
IF SUCH NOTIFICATION IS NOT DESIRABLE, DUE TO HEALTH OR FOR OTHER PERTINENT
REASONS. PLEASE SO STATE UNDER '"REMARKS" ON THE REVERS~ SIDE.
ADDRESS (Number. 1treet, citp, ZOfle, and State)
atate)
6. SPOUSE ( Firat name, middle 11ame, la1t name) (If none, or (f deceaaed or dioorced, 10
8623 -~ Bi-aneh ·m.,. au-.~~-- .w
lorma Isabel l\Iewhouse
',
CHECK ONE'.
7.
CHILDREN
SEX
ADDRESS
,
AGE
(Number, atreet, citr,, zone, and State)
MARRIED
SINGLE
FIRST NAME-MIDDLE NAME-LAST NAME
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M
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Delberl Carroll Newhouse
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8'23 P!nq Branch Bel.,
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Sllwr Spriag~ Md.,
Anne-Lisbeb Newhome
862J Pioey Branch Bd..1
a
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Silver Spring• Md._
(Continue on reDerae 1ide)
e. NAME OF FATHER (or male guardian) (Firat name, middle name, la,t ,iame)
ADDRESS (Number, atreet, cltv, zone, and Stale)
!Toah Frank Newhouse .
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Delive17• Waldp_..~
ADDRESS (lvumtler,,,treet, cUr,, zon,, and State)
9. NAME OF MOTHER (or female guardian) (Fir1t name, middk name, laat name)
Edith Ma.Jr' ~
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~.. ~ Ol-egoat
IN THE EVENT THAT I AM NOT SURVIVED BY ASPOUSE OR ELIGIBLE CHILD. OR OF THEIR DECEASE OR DISQUALIFICATION BEFORE PAYMENT OF 6 MONTHS' GRATUITY IS MADE. I THEN
DESIRE THAT PAYMENT BE MADE TO THE DEPENDENT RELATIVE SHOWN BELOW. (See imtnadlon -' on rer;ier,e aide ofform)
10. FIRST NAME-MIDDLE NAME-LAs:r NAME
RELATIONSHIP
Jrdlth Ma.v Bicbter
I MtJtliv
ADDRESS (Number, atred, cit11, zone, and State)
General Delivel'J".. Claribaldl. Oreaoa
IN THE EVENT OF DEATH OR DISQUALIFICATION OF THE ABOVE-NAMED DEPENDENT RELATIVE, I THEN DESIGNATE THE ALTERNATE DEPENDENT RELATIVE SHOWN BELOW.
(Other than
1powe or child)
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11. FIRST NAME-MIDDLE NAME-LAST NAME
RELATIONSHIP
Darrel Edw1a Mewhouse
I Brothel'
ADDRESS (Number, 1treet, cit11, zone, and State)
.Ii'. 6 BfE '1§6. Tacoma.. w--L.:l--Lon
VOLUNTARY ENTRIES
I REQUEST THAT THE FOUOWING COMMERCIAL LIFE INSURANCE COMPANIES BE OFFICIALLY NOTIFIED IN CASE OF MY DEATH IN ACTIVE SERVICE.
( The "Policr, Number" ahould be
entered ifpoa,ible, aince thia information will a11illt in expediting action br, the inaurance companu ahould a claim become par,able.)
12.
FUU NAME OF COMPANY
ADDRESS OF HOME OFFICE
POLICY NO.
• (Continue on reverae aide)
IN THE EVENT T-HAT I AM LISTED AS MISSING, OR BY OTHER MILITARl' CIRCUMSTANCE AM UNABLE TO TRANSMIT FUNDS TO
MY DEPENDENTS, IT IS MY DESIRE THAT
RELATIONSHIP
13. FIRST NAME-MIDDLE NAME-LAST NAME
IOIJ28 Isabel Newhouse
WU.
ADDRESS (Number, atrut, citr,, zone, and State)
RECEIVE EACH MONTH
862J P1neJ' BNnoh load. Silvers....:.:._. w....
%OF MY PAY.
MILITARY ADDRESS
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DATE SIGNED
2/6/52
EC• Oakland - Calif.
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REPLACES NME FORM 93.
I OCT 48· NAVMC tu (15 PD): NAVPfRS 60\, PAGES 1 AND 8: AND NCG 2529, WHICH
\6--6H80-1
MAY BE USED UNTIL \ JANUARY 1951. WHEN THEY WILL ALL BECOME OBSOLETE.
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