[1]992 (44 USC 2107 Note). Caset: Nw
[2]bib | Date 4-15-21)
[4]AGENCY
[6]RECORD NUMBER
[7]RECORDS SERIES
[8]AGENCY FILE NUMBER
[10]Date
[11]Page
[13]JFK ASSASSINATION SYSTEM
[14]IDENTIFICATION FORM
[16]AGENCY INFORMATION
[18]INSCOM/CSF
[20]194-10001-10496
[22]FOREIGN PERSONNEL AND ORGANIZATIONS
[23]AB632604W - PAGES 76-79
[25]09/30/98
[26]1
[28]ORIGINATOR
[29]FROM
[31]TO
[33]TITLE
[35]DATE
[37]PAGES
[38]SUBJECTS
[40]DOCUMENT TYPE
[41]CLASSIFICATION
[42]RESTRICTIONS
[43]CURRENT STATUS
[45]DATE OF LAST REVIEW
[46]OPENING CRITERIA
[47]COMMENTS
[49]DOCUMENT INFORMATION
[51]EDIFANIO ROMERO-DELGADO
[53]DD FORM 398 -. STATEMENT OF PERSONAL HISTORY
[54]01/18/63.
[56]4
[58]ROMERODELGADO, EPIFANIO
[60]PAPER, TEXTUAL DOCUMENT
[61]UNCLASSIFIED
[63]3
[65]RELEASED WITH DELETIONS
[66]03/07/95
[68]NW 88613 Docid:34528399 Page 1
[70]els CR #53348
[71]STATEMENT Otys t,
[73]INSTRUCTIONS: Read the certification at the end 5 im before entering the required data. Print or type all
[74]answers. All questions and statements must be completed. If the answer is “None,” so state. Do not misstate or omit material
[75]fact since the statements made herein are subject to verification. If more space is needed, use the Remarks section, item 20, and
[76]attach additional sheets if necessary. The information entered hereon is for official use only and will be maintained in confidence.
[78]i} int) FIRST NAME—MIDDLE NAME-~MAIDEN NAME (Jf any)—LAST NAME
[79]2. STATUS
[81]MR,
[83]Oo)
[84]oO Miss Edifanio ROMERO-Delgado [x | CIVILIAN MILITARY ON ACTIVE DUTY
[86]3. ALIAS(ES), NICKNAME(S). OR CHANGES IN NAME (Other than by marriage) 4. PERMANENT MAILING ADDRESS
[88]Piche 1140 SW Sta
[90]' 5. DATE OF BIRTH (Day, month, year) PLACE OF BIRTH (City, County, State, and-Country) PLACE CERTIFICATE RECCRDED
[92]21 Jan 1936 Candelario, PinardelRio, Guba Candelario , Pinardel#io, Guba
[94]RACE HEIGHT WEIGHT COLOR OF EYES COLOR OF HAIR SCARS, PHYSICAL DEFECTS, DISTINGUISHING MARKS
[96]Cau 66 165 Brown -| Brown NONE
[97]6. DO YOU HAVE A HISTORY OF MENTAL OR NERVOUS DISORDERS? [J YES [No ARE YOU NOW OR HAVE YOU EVER BEEN ADDICTED TO THE USE OF HABIT FORMIN RUGS SUCH AS
[98]NARCOTICS OR BARBITURATES? o YES NO ARE YOU NOW OR HAVE YOU EVER BEEN A CHRONIC USER TO EXCESS OF ALCOHOLIC BEVERAGES? O YES NO IF THE
[99]ANSWER TO ANY OF THE ABOVE IS "YES." EXPLAIN IN ITEM 20.
[101]7. U.S. NATIVE #F NATURALIZED. CERTIFICATE NO. IF DERIVED, PARENTS’ CERTIFICATE NO(S), DATE, PLACE, AND COURT
[102]CITIZEN
[104]YES
[105]NO
[107]s
[109]REGISTRATION NO. NATIVE COUNTRY DATE AND PORT OF ENTRY DO YOU INTEND TO BECOME
[111]A13 108 636 Cuba 21 Sept 1962 Texas . AU. S, CITIZEN?
[112]MILITARY SERVICE
[114]ARE YOU PRESENTLY ON ACTIVE OUTY IN THE U. S. ARMED FORCES DRAWING FULL PAY? | vesX] NO IF ““YES,"" COMPLETE THE FOLLOWING: N
[116]GRADE AND SERVICE NO. SERVICE AND COMPONENT ORGANIZATION AND STATICN DATE CURRENT ACTIVE
[117]SERVICE STARTED
[119]ARE YOU PRESENTLY A MEMBER OF A U.S. RESERVE OR NATIONAL GUARD ORGANIZATION? O YES ibe NO IF “YES,"* COMPLETE THE FOLLOWING:
[120]GRADE AND SERVICE NO. SERVICE AND COMPONENT ORGANIZATION AND STATION OR UNIT AND LOCATION
[122]HAVE You PREVIOUSLY SERVED TOURS OF EXTENDED ACTIVE DUTY, DRAWING FULL PAY, FROM WHICH YOU WERE DISCHARGED OR SEPARATED TO CIVILIAN STATUS? [_} YES x NO
[123]IF ''YES."' COMPLETE THE FOLLOWING:
[124]SERVICE COMPONENT [| FROM (Date) TO (Date) TYPE DISCHARGES OR SEPARATIONS—GRADE AND SERVICE NO.
[126]EDUCATION (Account for all civilian schools and military academies. Do not include service schools)
[128]MONTH AND YEAR GRADUATE
[129]NAME AND LOCATION OF SCHOOL, DEGREE
[131]Escuela Publica San Cristobal
[133]FAMILY (List in order given, parents, spouse, guardians, stepparents, foster parents, parents-in-law, former spouse(s) (if divorced give date
[134]and place), children, brothers and sisters, even though deceased. Include any others you resided ‘with or with whom a close relationship
[135]existed or exists. If the person is not a U.S. citizen by birth, give date and port of entry, alien registration number, naturalization certificate
[136]number and place of issuance.)
[138]RELATION AND NAME DATE AND PLACE OF BIRTH PRESENT ADDRESS. IF LIVING U.S. CITIZEN
[140]FATHER date unknown
[141]Felipe Romero Conzolaciondel Sur , Guba DECEASED
[143]MOTHER (Maiden name) date unknown Finca Sabana La Mar
[145]Sagunda Delgado " " a SanCristobalPinardelRio , Cuba
[146]SPOUSE (Maiden name) | 1 Feb 1 6 Candelaria
[148]Iida Martinez ; o, Cuba
[149]OTHER (Specify) lay 19RD See Cristobal
[151]turo Romero ‘imar delRio, Guba
[152]‘inca Sabana Ia MarSan
[156]NFEGETS Dieias SapGREP EJBOUS EDITIONS AhE OBSOLETE. Exception to Standard Form 86
[157]p34 age 2 Approved by Bureau of the Budget June 1960
[159]Pmnt vy
[161]OTHER RELATIVES AND ALIEN FRIENDS LIVING IN FOREIGN COUNTRIES (List grandparents, first cousins, aunts, uncies,
[163]brothers- and sisters-in-law, and other persons with whom a close relationship existed or exists)
[165]RELATIONSHIP AND NAME ADDRESS
[167]CITIZENSHIP
[169]Juan Delgado |
[171]Pedro Delgado
[172]Francisco Delgado
[174]Niebe Delgado
[176]Maria Delgado
[178]FOREIGN TRAVEL (Other than as a direct result of United States military duties)
[180]COUNTRY VISITED
[182]PURPOSE OF TRAVEL
[184]AND YEAR
[186]EMPLOYMENT (Show every employment you have had and all periods of unemployment)
[188]DID ANY OF THE ABOVE EMPLOYMENTS REQUIRE A SECURITY CLEARANCE? [[] YES %] NO DO YOU HAVE
[189]ANY FOREIGN PROPERTY OR BUSINESS CONNECTIONS, OR HAVE YOU EVER BEEN EMPLOYED BY A FOREIGN
[190]GOVERNMENT, FIRM, OR AGENCY? [7] YES [ENO HAVE YOU EVER BEEN REFUSED BOND? OO Yes
[191]§d NO IF THE ANSWER TO ANY OF THE ABOVE IS "'YES,"’ EXPLAIN IN ITEM 20.
[193]M CREDIT AND CHARACTER REFERENCES (Do not include relatives, former employers,
[194]nited States or its Territories.
[196]NAME YEARS STREET AND NUMBER
[197](List 3 credit and 5 character) KNOWN (Business address preferred)
[199]SOCIAL SECURITY NO.
[201]463-74—2051
[203]or persons living outside the
[205]CITY
[207]|
[208]|
[210]Gustado Acosta 0
[212]: ado Aco a
[214]CHARACTER CREDIT
[216]REMARKS.
[218]ed
[219]U.S, GOVERNMENT PRINTING OFFICE : 1960 0—573450
[221]NW 88613 Docld:34528389 Page 3
[224]LIST ALL RESIDENCES FROM 1 JANUARY 1937
[226]TYPE
[228](Social, fraternal, professional, etc.)
[230]NAME AND ADDRESS
[232]ARE YOU NOW OR HAVE YOU EVER BEEN A MEMBER OF THE COMMUNIST PARTY U, S. A., OR ANY COMMUNIST ORGANIZATIONS ANYWHERE?
[233]ARE YOU NOW OR HAVE YOU EVER BEEN A MEMBER OF A FASCIST ORGANIZATION?
[235]ARE YOU NOW OR HAVE YOU EVER BEEN A MEMBER OF ANY ORGANIZATION, ASSOCIATION, MOVEMENT, GROUP OR COMBINATION OF PERSONS WHICH ADVOCATES THE
[236]OVERTHROW OF OUR CONSTITUTIONAL FORM OF GOVERNMENT, OR WHICH HAS ADOPTED THE POLICY OF ADVOCATING OR APPROVING THE COMMISSION OF ACTS OF FORCE
[237]OR VIOLENCE TO DENY OTHER PERSONS THEIR RIGHTS UNDER THE CONSTITUTION OF THE UNITED STATES, OR WHICH SEEKS TO ALTER THE FORM OF GOVERNMENT OF
[238]THE UNITED STATES BY UNCONSTITUTIONAL MEANS?
[240]ARE YOU NOW OR HAVE YOU EVER BEEN AFFILIATED OR ASSOCIATED WITH ANY ORGANIZATION OF THE TYPE DESCRIBED ABOVE AS AN AGENT, OFFICIAL, OR EMPLOYEE?
[242]ARE YOU NOW ASSOCIATING WITH, OR HAVE YOU ASSOCIATED WITH ANY INDIVIDUALS, INCLUDING RELATIVES, WHO YOU KNOW OR HAVE REASON TO BELIEVE, ARE OR
[243]HAVE BEEN MEMBERS OF ANY OF THE ORGANIZATIONS IDENTIFIED ABOVE?
[245]HAVE YOU EVER ENGAGED IN ANY OF THE FOLLOWING ACTIVITIES OF ANY ORGANIZATION OF THE TYPE DESCRIBEO ABOVE: CONTRIBUTION(S) TO, ATTENDANCE AT OR
[246]PARTICIPATION IN ANY ORGANIZATIONAL. SOCIAL. OR OTHER ACTIVITIES OF SAID ORGANIZATIONS OR OF ANY PROJECTS SPONSORED BY THEM: THE SALE, GIFT, OR DIS-
[247]TRIBUTION OF ANY WRITTEN, PRINTED, OR OTHER MATTER, PREPARED, REPRODUCED, OR PUBLISHED, BY THEM OR ANY OF THEIR AGENTS OR INSTRUMENTALITIES?
[249]IF “YES,” DESCRIBE THE CIRCUMSTANCES, ATTACH ADDITIONAL SHEETS FOR A FULL DETAILED STATEMENT. iF ASSOCIATED WITH ANY OF THE ABOVE ORGANIZATIONS, SPECIFY NATURE
[250]AND EXTENT OF ASSOCIATION WITH EACH, INCLUDING OFFICE OR POSITION HELD. ALSO INCLUDE DATES. PLACES, AND CREDENTIALS NOW OR FORMERLY HELD. !F ASSOCIATIONS HAVE
[251]BEEN WITH INDIVIDUALS WHO ARE MEMBERS OF THE ABOVE ORGANIZATIONS, THEN LIST THE INDIVIDUALS AND THE ORGANIZATIONS WITH WHICH THEY WERE OR ARE AFFILIATED.
[253]18. HAVE YOU EVER BEEN DETAINED, HELD, ARRESTED. INDICTED OR SUMMONED INTO COURT AS A DEFENDANT IN A CRIMINAL PROCEEDING. OR CONVICTED. FINED. OR IMPRISONED OR
[254]PLACED ON PROBATION, OR HAVE YOU EVER BEEN ORDERED TO DEPOSIT BAIL OR COLLATERAL FOR THE VIOLATION OF ANY LAW, POLICE REGULATION OR ORDINANCE (excluding
[255]minor traffic violations for which a fine or forfeiture of $25, or less was imposed)? {tNCLUDE ALL COURT MARTIALS WHILE !N MILITARY SERVICE. ¥) YES oO NO
[257]IF “YES,” LIST THE DATE, THE NATURE OF THE OFFENSE OR VIOLATION, THE NAME AND LOCATION OF THE COURT OR PLACE OF HEARING, AND THE PENALTY IMPOSED OR OTHER
[258]DISPOSITION OF EACH CASE.
[260]Has been in Jail without trial in the G2 of Pinar del Rio,Qyba about 18 days from
[261]22 April. 1961 for political reasons.
[263]19. ARE.THERE ANY INCIDENTS IN YOUR LIFE NOT MENTIONED HEREIN WHICH MAY REFLECT UPON YOUR LOYALTY TO THE UNITED STATES OR UPON YOUR SUITABILITY TO PERFORM
[264]THE DUTIES WHICH YOU MAY BE CALLED UPON TO TAKE OR WHICH MIGHT REQUIRE FURTHER EXPLANATION? oO YES i NO IF YES." GIVE DETAILS
[266]NW/ 688613 Docid:34528389 Page 4
[267]H
[269]19. ARE,THERE ANY INCIDENTS IN YOUR LIFE NOT MENTIONED HEREIN WHICH MAY REFLECT UPON YOUR LOYALTY TO THE UNITED STATES OR UPON YOUR SUITABILITY TO PERFORM
[270]THE DUTIES WHICH YOU MAY BE CALLED UPON TO TAKE OR WHICH MIGHT REQUIRE FURTHER EXPLANATION? ([_] YES *) NO IF “YES."’ GIVE DETAILS
[272]20. REMARKS
[274]ITH #10
[276]Fernando Romero B San Cirtobal Pinardel tio .  $an Cristobal Finardelio, Gyba
[279]Sabina Romero 5
[281]Augustina RomeroS
[283]1 CERTIFY THAT THE ENTRIES MADE BY ME ABOVE ARE TRUE, COMPLETE, AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF AND ARE MADE IN
[284]GOOD FAITH. | UNDERSTAND THAT A KNOWING AND WILLFUL FALSE STATEMENT ON THIS FORM CAN BE PUNISHED BY FINE OR IMPRISONMENT OR BOTH
[285](See U. S. Code, title 18, section 1001)
[287]SIGNATURE OF PERSON COMPLETING FORM
[290]TYP) D NAME AND A ADDRESS OF WITNESS.
[291].
[292]. 3 3 1 3 : a
[294]f
[296]RECORD OF PRIOR CLEARANCES
[298]DATE OF CLEARANCE TYPE OF CLEARANCE AGENCY THAT COMPLETED INVESTIGATION
[300]REMARKS.
[303]U.S, GOVERNMENT PRINTING OFFICE :; 1960 O—573450
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