[3]Date : 01/20/98
[4]Page : 1
[6]JFK ASSASSINATION SYSTEM
[7]IDENTIFICATION FORM
[9]AGENCY ‘INFORMATION
[11]_ AGENCY : INSCOM/CSF
[12]RECORD NUMBER : 194-10004-10143
[13]RECORDS SERIES : DOD-AFFILIATED PERSONNEL INCIDENT INVESTIGATIONS
[14]AGENCY FILE NUMBER : PAGES 384-385
[16]DOCUMENT INFORMATION
[18]ORIGINATOR : USA
[19]FROM : HEADQUARTERS, USAINTC
[20]TO :
[21]TITLE : [ RESTRICTED ]
[23]PAGES : 2
[24]SUBJECTS : FROMER, DAVID R.
[26]LEGAL ADVICE
[28]DOCUMENT TYPE : PAPER, TEXTUAL DOCUMENT
[29]CLASSIFICATION : UNCLASSIFIED
[30]RESTRICTIONS : 3
[31]CURRENT STATUS : RELEASED WITH DELETIONS
[32]DATE OF LAST REVIEW : 03/07/95
[33]OPENING CRITERIA :
[34]COMMENTS : -
[36]’ NW 88613 Docid:34520584 Page 1
[39]ete ST
[40]1. DATE OF REQUEST
[41]> LAS, NA fee <n - MIDDLEaN MES  ALIASIES? = NICKNAMES ” CHANGED "NAME 4. SOCIAL SECURITY NO.
[42]FROMER, David Reed “>. 4 «) . 564-58-8137
[43]5. DAY. MONTH, YEAR OF BIRTH 6. PLACE OF BIRTH ; 7. SERVICE NUMBER a
[44][aa duly 1902 _(enteago, Cook, Ta14nots fed
[46]6. RELATIVE'S NAMES 9. OATE AND PLACE OF BIRTH . 19. PRESENT ADDRESS | 11. CITIZENSHIP | | 11. CITIZENSHIP |
[48]0. FATHER 12 Jal 1913 13 Rhonda Way ee |
[49]Mill Valley, Calif. Pe
[51]Irving Fromer Cincinnati, Ohio ]
[52]13 Rhonda Way
[53]12, RESIDENCES (List all from 16th birthday or during last 15 years, whichever is shorter)
[55]Katherine modes [isthervitie
[56]Katherine Rhodes Estherville, Iowa Mill Valley, Calif
[58]¢. SPOUSE (moiden nome}
[60]San Francisco Calif.
[61]Berkeley Calif.
[62]Sen Francisco /|Calif.
[64]None
[66]c. NUMBER AND STREET
[67]1932 Cabrillo St.
[68]2450 Bencroft Way
[69]881 Clayton St.
[71]219 N. Basset Madison Wisconsin
[72]2 ue aire Lawn Ave. Madison Wiscons
[74]Mad son ; Wiscons
[76]iS <I One nid Peichdey or during last 15 years,
[77]Dec 1959
[78]Sumer '6
[80]- 1960
[82]Fairmont Hotel
[83]Foster's Restaurant
[84]Madison Board of fete
[86]San Francisco, Calif.
[87]San Francisco, Calif.
[88]Madison, | Wisconsin
[90]NAME
[92]* University of Wisconsin
[94]a. 1966 b. to
[95]Present
[97]ee f any QUALIFICATION OF DD FORM 398 OR DD FORM 92: -.
[99][ {Xo any annesr on coun eecono? na
[101]16. REMARKS (If additional space is needed, continue on plain paper) .
[103]Item 12. 1966 to Present 13 Rhonde Way, Mil@VaFicy¥ & 1a
[105]1966 to Present 140 Langdon Street, Madigon, Wisconsin
[107]Item 13. Oct 65 50 June 66 Cooks Cupboard, 1718 Walls St., Chicago, Illinois
[108]Employer: Bob Geroge Reason: Return to S. F.
[110]Item 15. Registrant refused to execute DD Form 98 and explained in the remarks sectiog.
[112]Also refused to answer Item 17 and; ‘anewered affirmatively Itemi19“and
[114]explained in the remarks section. Refused to be fingerprinted also. (wer) BB
[116]18. FROM:
[118]HEADQUARTERS, USAINTC
[121]Fort Holabird Md.
[123]21219
[127]FINGERPRINT CARD FD 258 MUST BE ATTACHED CORRE Y
[129]D A nue es 3 O 2 ne termination e tr ’
[131]ag
[133]_ NW 88613 Docid:34528584 Page 2
[136](6353-6004) 18 Jan 67
[137]FROMER, David Reed
[138]DPOB: 21 Jul 423 Chicago, Dlinois
[140]Con't = Item 16 (Remarks)
[142]Item 15 - SUBJECT explained in the "Remarks" section as follows: "(I have not
[143]done anything that I am not proud of) - I have been advised by my attorneys that
[144]I cannot sign this form without placting myself in jeapardy: Peter Franck -
[145]personal attorney, Vincent Hallinan - family attorney."
[147]FBI reports, San Francisco, California, titled: David Reed FROMER, with
[148]Bureau File #: 100-433071, dating from 3 May 1960 to the latest dated 23
[149]November 1966, are in the possession of this office. Request any additional
[150]and/or subsequent information. ,
[153]er
[155]NW 88613 Docid:34528584 Page 3