[1]|
[3]AGENCY
[5]RECORD NUMBER
[6]RECORDS SERIES
[7]AGENCY FILE NUMBER
[9]ORIGINATOR
[10]FROM
[12]TO
[14]TITLE
[16]DATE
[18]PAGES
[19]SUBJECTS
[21]DOCUMENT TYPE
[22]CLASSIFICATION
[23]RESTRICTIONS
[24]CURRENT STATUS
[26]DATE OF LAST REVIEW
[27]OPENING CRITERIA
[28]COMMENTS
[30]NW 88613 Docid:34528544 Page 1
[32]Date
[33]Page : 1
[35]JFK ASSASSINATION SYSTEM
[36]‘IDENTIFICATION FORM
[38]AGENCY INFORMATION
[40]INSCOM/CSF
[42]194-10004-10135
[44]DOD-AFFILIATED -PERSONNEL INCIDENT INVESTIGATIONS
[45]PAGES 14-14A
[47]DOCUMENT INFORMATION
[49]USA
[50]USAPSG
[52]DCS-OPS USAINTC
[54][ RESTRICTED ]
[55]05/05/67
[57]2
[59]FROMER, DAVID REED
[61]REQUEST FOR AND RESULTS OF PERSONNEL SECURITY ACTION
[63]PAPER, TEXTUAL DOCUMENT
[64]CONFIDENTIAL
[66]3
[68]RELEASED WITH DELETIONS
[69]03/07/95
[71]RECORD REGRADED UNCLASSIFIED ON 2°SEP 94.
[73]01/13/98
[75]Slessed_ onder the John - Kenned Asssssnchor Mecods= Collschom Act o
[77]arenes
[79]1A Ebi Wit TCU ok ee eRe a rE RRM! 8 20
[81]REQUEST FOR AND RESULTS OF PERSONNEL SECURITY ACTION | 5 May 1967
[83]AR 381-130,
[85]FROM: (Requesting Agen cy)
[87]TO: (Control Office)
[88]DCS+OPS
[89]USAINTC
[90]ATIN: OPS III (Mr. Burwasser)
[91]| Fort Holabird, Md.
[93]i (Enter name and address of the ACTION AGENCY fo which results are to be sent, if known by
[94]requester) :
[96]USAPSG
[98]CONTROL OFFICE USE [CONTROL OFFICE USE ONLY |
[99]REQUIREMENT REQUEST NO.
[101]U.5s Army Fevsonnel Security Group
[102]‘Fort Holabird, Maryland 21219 ©
[103]ATTN: “ Adjudications Division
[105]OPENING DATE
[107]_
[109]SECTION | — REQUESTER TO CONTROL OFFICE
[111](1. SUBJECT (Last name oo) pueterteet and 2. ALIAS(ES), MAIDEN NAME 3. SERVICE/SOCIAL SECURITY NO,
[112]@ names. .
[114]FROMER, David Reed None _ §64+58«8137
[116]#4. DATE OF BIRTH 5. PLACE OF BIRTH (City,. State and country) 6 GRADE AND POSITION
[117]} (Day, Month, Year) :
[119]21 July 1942 Chicago, Illinois Registrant
[120]7. REQUESTED ACTION CAINVESTIGATION [_]VALIDATION [_]RECORDS CHECK
[121][8. TYPE OF INVESTIGATION: 9, 2.FOR CLEARANCE AND/OR ACCESS TO:
[123]Cynac [jnact (jet (JOTHER(Explain in Item 15) ([\top secret ([_]secrer ([] CONFIDENTIAL
[124]10. TO DETERMINE SUITABILITY FOR:
[126]b. ["] FOR LIMITED ACCESS AUTHORIZATION
[128]«. ° [_JINTERIM CLEARANCE DESIRED
[129]d. (J OTHER (Explain in Item 15)
[131]P11. JUSTIFICATION
[133]p12. REVIEW OF FILES REQUIRED BY PARAGRAPH ___ AR 604-5, COMPLETED ON REVEALED:
[134]([] No UNFAVORABLE INFORMATION Tounravoraste INFORMATION DETERMINED NOT TO SE A BAR TO ACTION
[135]CONTEMPLATED :
[136]f [] INFORMATION SUMMARIZED IN ITEM 18 . -
[137]ft3. LATEST INVESTIGATION/ CLEARANCE (Type, when, by whom) . ‘ 14. NO BREAK IN FEDERAL SERVICE
[139]EXCEEDING SIX MONTHS SINCE
[141]ts. REMARKS (if unfavorable information catored, iranemit in sealed envelope thru intelligence channels.).
[143]) Request that Headquarters ¢ and Local FBI (S) file checks be conducted on SUBJECT's
[144]| parents.
[145]"Request this investigation be ‘oxpedited as determination under AR 604-10 is
[147]being delayed at | Department of the Arny pending results", : - .
[149]HEGRAL So tiny
[150]ON? CTIFIED
[151]BY CL , + FOUPO
[153]“AUTH Pea vscs BO £200.1R
[155]ot. LH
[157]“Dossier $64588137| 3B PIRNEGAN 14 stonature
[158]re SUBJECT COL AIS
[160]SECTION Il - CONTROL OFFICE TO REQUESTER
[161]‘168. (7 NEW FINGERPRINT CARD REQUIRED . . 4
[163](C] tTems ON SPH (PSQ) REQUIRE CORRECTION AND/OR COMPLETION.
[164]([J INTERIM REPORT FORWARDED.. REQUEST REPORT OF ACTION TAKEN AND RETURN OF INCLOSURES UPON (COMPLETION.
[166]TYPED NAME AND TITLE
[168]DA . "2784
[170]NW 88613 Docld:34528544 Page 2
[173]17. REPORT OF ACTION ry
[174]noon o
[176]CO INFoORMATION NOTED MATION CONSIDERED NO BAR.TO
[178]] SUBJECT REASSIGNED TONON-. =. [J INFOR
[179]SENSITIVE DUTIES, INVESTIGATION CLEARANCE. REQUEST COMPLETION
[181]_MAY BE CANCELED. OF INVESTIGATION,
[183]SUBJECT WAS TRANSFERRED
[185]HEADQUARTERS
[187]REMARKS (If returning corrected forms, state here)
[189]TYPED NAME AND TITLE SIGNATURE
[191]SECTION IV —- CONTROL OFFICE TO ACTION AGENCY
[192]RESULTS OF PERSONNEL SECURITY ACTION
[194]i) NO RECORD “(7 FAvoraBLe
[196]20.
[198](CL) MINOR’ UNFAVORABLE INFORMATION RECORDED IN ITEM 21
[200](FJ PRIOR INVESTIGATION INSUFFICIENT FOR ACTION CONTEMPLATED (CD) FORWARDED FOR SECURITY DETER-
[201]tr NEEDED, INITIATE REQUEST FOR NVESTIGATION.|
[203]MINATION BY CLEARING AUTHORITY
[204]TYPE OF INVESTIGATION
[206]_ [COMPLETED BY
[207](Nac ()Nac1 Cs ([] OTHER
[209]21. REMARKS
[211]DOSSIER NUMBER
[213]a4, THIS FORM, TOGETHER WITH ANY INCLOSURES, REPORT OF ACTION TAKEN AND USACRF COPY OF DA FORM 873
[215](if appropriate) WiLL. BE RETURNED TO THE CONTROL OFFICE WITHIN DAYS AFTER RECEIPT.
[217]IN THE EVENT SUBJECT HAS BEEN TRANSFERRED FROM YOUR COMMAND, THIS FORM AND INCLOSURES WILL BE
[218]RETURNED IMMEDIATELY WITH ITEM 23 COMPLETED.
[219]ATTENTION IS INVITED TO: PARAGRAPHS
[221]AR 604-5; PARAGRAPH___AR 604=11; PARAGRAPH
[222]AR 640-98; AND PARAGRAPH AR 381~130, AS APPLICABLE. ,
[224]TYPED NAME AND TITLE SIGNATURE
[226]SECTION V - ACTION AGENCY TO CONTROL OFFICE
[228]REPORT OF ACTION
[230](CT) FAVORABLE DETERMINATION, USACRF (T] UNFAVORABLE DETERMINATION,
[232]RECOMMENDED ACTION IN ITEM 24
[234](CL) REQUEST ADDITIONAL INVESTI-
[235]COPY DA FORM 873 ATTACHED
[237], GATION AS INDICATED IN ITEM 24
[238]23. SUBJECT WAS TRANSFERRED
[240]TO HEADQUARTERS DATED
[242]REMARKS
[244]“TED
[245]| ang | FOUPD
[246]3 Bp 5200.18
[248]TYBED NAME AND- . SIGNATURE .
[250]a
[252]a
[254]NW 88613 Docld:34528544 Page 3