[1]Date : 01/14/98
[2]Page : 1
[4]JFK ASSASSINATION SYSTEM °
[5]IDENTIFICATION FORM
[7]AGENCY INFORMATION
[9]AGENCY : INSCOM/CSF
[10]RECORD NUMBER : 194-10003-10338
[11]RECORDS SERIES : INTELLIGENCE/COUNTERINTELLIGENCE SOURCES
[12]AGENCY FILE NUMBER : PAGES 8-9 ,
[14]DOCUMENT INFORMATION
[16]ORIGINATOR : USA
[17]FROM : 59TH ORD GP.
[18]TO : USA ADVANCED WEAPONS SUPPORT COMD
[19]TITLE : [ RESTRICTED ]
[20]DATE : 09/16/71
[21]PAGES : 2
[22]SUBJECTS : KACZMARCYYK, GEORGE -.
[24]_ DOCUMENT TYPE : PAPER, TEXTUAL DOCUMENT
[25]CLASSIFICATION : UNCLASSIFIED
[26]RESTRICTIONS : 3
[27]CURRENT STATUS : RELEASED WITH DELETIONS
[28]DATE OF LAST. REVIEW : 03/09/95
[29]OPENING CRITERIA :
[30]COMMENTS
[32]NW 88613 Docid:34529171 Page 1
[34]MA c C Use Only.
[36]NATIONAL AGENCY CHECK REG
[38]. on ~ = 4, -
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[43]DEPARTMENT OF DEFENSE
[45]a ArT nes yt
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[49]3 ALIAS(ES) AND ALL
[51]N ONE:
[53]Aug @6, 47 oe, ' | Bomblitz,
[55]RETURN
[56]RESULTS
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[60]Cade} -
[62]a@ FATHER ; ;
[63]KACZMARCEYK, Josef
[64]b. MOTHER (Full Maiden Name}
[65]TNANOVA, Dorota.
[67]1s SPOUSE (Full Moider Wavie) :
[68]. Ann.
[71]dun 65 OP.
[72]Web 69 OPR”
[73]~ jJan 68 POPR
[74]Mar 69 UPR OTs
[75]Mar 74 . OPR
[77]: Pee 71
[79]1. LAST NAME - FIRST NAME ~- MIDDLE NAME
[80]SAGE ROSYE, iEedwerd
[82]S MONTH, DAY, YEAR OF BiiiTH 76. PLACE OF BIRTH — T
[84]c. NUMBER AND STREET
[86]4313 i Ros € Terrece_
[88]FORMER NAME(S)
[90]AST,
[94]“est Germany Orb.
[96]Support Command —
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[104]Cothen, Ala,
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[107]ACCT# 6124
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[110]“A 12972 1692"
[111]wa SECURITY PROGRAM
[113]2] MILITARY
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[116](3A OGIAL SECURITY NUMBER
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[131]fal LOCAL FILES CHECKED
[132]WITH FAVORASLE RESULTS
[134]c. INITIATOR OF
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[137]11... .,, PRESENT ADDRESS 12,
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[271]NW 60613 Docid:34529121 Page 3