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

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RECORD OF EMER·,1 , CY DATf.. FOR THE ARMED FORCES OF THE UNITED STATES
IN FOR MATION INCLUDED ON THIS F ORM DOES NOT DESIGNATE OR CHANGE BENEFICIARIE S OF LIFE
INSURANCE POLICIES
(See instr uctions on reverse side of for m prior to maki ng entries)
I. DESIGNATOR'S LAST NAME-
FIRST NAME-MIDDLE NAME
I
2. SERVICE NO.
I
3. GRADE. RANK. OR RATE
4. SERVICE D USA
f.i) USN
NEWHOUSE Delber-t
Clement
177281
.....Hll'I
D USAF D USMC
D USCG
5. FIRST NAME-
MIDDLE NAME-L AST NAME OF PERSON to BE NOTIFIED IN CASE OF EMERGENCY (Ptr•on with permanent addrea• i•
RELATIONSHIP (Iffriend, 30 ,tale)
adoitable)
&11t h Mey RICHTER
u ...+i....-
ADDRESS (Numbtr, , treet, citv, zone, and State)
P. o. Box lZ/. Garibaldi. Oren-~n
THE PERSONS NAMED IN ITEMS 6. 8. ANO 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 STAT E UNDER ..REMARKS .. ON THE REVERSE SIDE.
6, SPOUSE (Fir,t name, m idd/t nam,, /art name) (lfnont, or ifd<eta1td or divorced, •o
,tatt)
ADDRESS (Number, ,trut, citv, zone, and State)
Norma Isobel
NEV.HOUSE
Ai•e ~6
8623 Piney Branch Rd.
<H1vPl'r• ~Pina . ™·
7.
CHILDREN
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r
CHECK ONE
SEX
ADDRESS
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AGE
FIRST NAME-
MIDDLE NAME-
LAST NAME
(Number, !Ired, citr,, zone, and State)
MARRIED
SINGLE
M
F
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Delbert Carroll NEWHOUSE
Same as wife
X
X
13
Anne Li.abet NEWHOUSE
It
II
II
X
X
ll
(Conti nue on rectru •ide)
··••.
. ,. ..
8. NAME OF FATHER (or malt guardian) (Fir,t nam,, middlt name, la,t. n ame)
ADDRESS (Numbtr, ,trut, citv, tone, and State)
,,._
9. NAME OF MOTHER (or female guardian) (Fir,t 1iame, middl, name, la,t name)
AD;R:SS~:u:lr:v~··::::o~~~~n
&ii.t h May RICHTER
Age 55
IN THE EVENT THAT I AM HOT SURVIVED BY A SPOUSE OR ELIGIBLE CHILO. OR OF THEIR DECEASE OR DISQUALIFICATION BEFORE PAYMENT OF 6 MONTHS' GRATUITY IS MADE. I T HEN
DESIRE THAT PAYMENT BE MADE TO THE DEPENDENT RELATI VE SHOWN BELOW.
(See imtruction 4 on rev,r,e •ide ofform)
10. FIRST NAME-MIDDLE NAME-LAST NAME
I
RELATIONSHIP
&ii.th
M.av
R1 ,..
1:H
,...__ ,.\. --
ADDRESS (Number, ,trut, citv, tone, and St"te)
P. o. Box 127. r..·u •ibalni . -
I
I N THE EVENT OF DEATH OR DISQUALIFICATION OF THE ABOVE-NAMED DEPENDENT RELATIVE. I T HEN DESIGNATE THE ALTERNATE DEPENDENT RELATI VE SHOWN BELOW. (Other than
, p ou,e or child)
11. FI RST NAME-
MIDDLE NAME-
LAST NAME
I
RELATIONSHIP
Darrel
F.dwin
NEVJHOUSF.
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..._ ,._ __
ADDRESS (Number, ,treet, citv, tone, and Stat, )
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Ortin~. Wlshinv.ton
VOLU NTARY ENTRIES
I REQUEST THAT THE FOLLOWING COMMERCIAL LIFE INSURANCE COMPANIES BE OFFICIALLY NOTIFIED IN CASE OF MY DEATH IN ACTIVE SERVICE.
(The "Policv Number" •hould bt
entered ifpouible, ,ince thi• information will o••i•t in expeditirig aclio11 bv the i11,urance componv •hould o claim become pagablt.)
12.
• FULL NAME OF COMPANY
ADDRESS OF HOME OFFICE
POLICY NO.
California, Western states Life
Sacremento. Calif.
Insurance Co.
(Contimie on revene •ide)
IN Tl-IE EVENT THAT I AM LISTED AS MISSING, OR BY OTHER MILITARY CIRCUMSTANCE AM
MY DEPENDENTS, IT IS MY DESIRE THAT
UNABLE 1'0 TRANSMIT FUNDS TO
13. FIRST NAME-M IDDLE NAME
LAST NAME
RELATIONSHIP
Norma Isobel NEWHOUSE
f;ife
ADDRESS (Number, •trut, citv, , one, and Stole)
RECEIVE EACH MONTH
8623 Piney Branch Rd •. Silver SPrina . llri .•
0n
% OF MY PAY.
MILITARY ADORES5tJ .-S 0 Naval Air sttat.ion
DATE SIGNED
7li!lir
;TOR JG
N:,:vr Number l4 (one four)
I .A ~
'--FJ1A2/
e o F. P.o. San Francisco . Cali£.
11. n ~ t'! 101.n
DD
FORM
1 JAN 50 93
REPLACES NME FORM 93.
I OCT 41: NAVMC Ill (IS PD): NAVPERS 601. PAGES 7 AND S: AND NCG 2S29. WHICH
10- IIHSO- \
MAY BE USED UNTIL I JANUAR¥ 19S1. WHEN THEY WILL ALL BECOME OBSOLETE.