[1]JFK Assassination System: Date: 10/2/201
[2]Identification Form
[4]Agency Information
[6]AGENCY: HSCA
[7]RECORD NUMBER: — 180-10072-10186
[9]RECORD SERIES: NUMBERED FILES.
[10]AGENCY FILENUMBER: 010313
[12]Document Information
[14]ORIGINATOR: SOCIAL SECURITY ADMINISTRATION
[15]FROM:
[16]TO: HESS, JACQUELINE.
[18]TITLE:
[21]PAGES: 64
[23]SUBJECTS : r
[24]OSWALD, MARINA; FINANCES, INCOME TAXES.
[26]OSWALD, LEE; PRE-RUSSIAN PERIOD, MILITARY SERVICE,
[27]COURT-MAR
[29]DOCUMENT TYPE: REPORT.
[30]CLASSIFICATION: — Unclassified
[31]RESTRICTIONS: 3
[32]CURRENT STATUS: —Redact
[33]DATE OF LASTREVIEW: 07/10/1996
[35]OPENING CRITERIA :
[37]COMMENTS : Includes insurance forms, death certificate, & military documents of Oswald. Box 189.
[39]v9.1 ]
[40]NW 88326 Docid:32245128 Page 1
[42]DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
[43]SOCIAL SECURITY ADMINISTRATION
[44]BALTIMORE, MARYLAND 21235
[46]JUL 28 1978
[50]“Ms. Jackie Hess
[51]Select Committee on Assassinations
[52]U.S. House of Representatives
[53]3331 House Office Building, Annex 2
[54]Washington, D.C. 20515
[56]Dear Ms. Hess:
[58]This is in response to Mr. Blakey's May 15, 1978, request for access
[60]to all files and documents concerning or referring to Lee Harvey Oswald
[61]and Marina Oswald. The following documents are enclosed:
[63]1. Form 8s-5, Application for Social Security Account Number, completed
[64]by Lee Harvey Oswald.
[66]2. Form ss-5, Application for Social Security Account Number, completed
[67]by Marina Oswald.
[69]3. Numident showing name changes for Marina Oswald.
[71]. Form 0A-C5, Application for Survivors Insurance Benefits, completed
[72]by Marina Oswald.
[74]5. Certificate of Death issued by the City of Dallas for
[75]Lee Harvey Oswald.
[77]6, Marriage certificate (and translation) for Lee Harvey Oswald and
[78]Marina Nikolaevna Prusakova.
[80]7. Birth certificate (and translation) for Marina Nikolaevna.
[82]8, Birth certificate (and translation) showing child born to
[83]Lee Harvey Oswald and Marina Nikolaevna Oswald.
[85]9. OA-C70h, Certification of Contents of Document(s) or Record(s),
[86]: re birth of child to Lee H. Oswald and Marina Nikolaevna Prusakova.
[88]NW 8376 Docid:32245178 Page 2
[90]“10.
[92]ll.
[93]12.
[94]13.
[95]1h.
[96]15.
[98]16.
[100]17.
[101]18.
[102]19.
[103]20.
[105]21.
[106]22.
[108]23.
[110]2h.
[111]25.
[112]26.
[114]2
[115]Form OA-C65l,.Certification By Uniformed Services, for Lee Harvey Oswald.
[117]Letter dated 7/25/63 from the Department of the Navy to
[119]‘Lee Harvey Oswald.
[121]Form DD-214, Armed Forces of the United States Report of Transfer
[122]or Discharge, for Lee Harvey Oswald.
[124]Undesirable Discharge from the Armed Forces of the United States,
[125]issued to Lee Harvey Oswald.
[127]Forms OA-C668, Claimant's Report to Social Security Administration,
[128]completed by Marina Oswald on 3/27/64 and 5/1/65.
[130]Form OA-C669, Claimant's Report About Work to the Social Security
[131]Administration, completed by Marina Oswald on 10/8/64.
[133]Form SSA-1425, Reporting Card, completed by Marina Porter on 5/4/66.
[135]Forms OA-C777, Annual Report of Earnings, completed by Marina Oswald
[136]for 1964 and 1965.
[138]Form OAC-1001, Statement of Employer, completed by Jaggars-Chiles-Stovall,
[139]Inc.
[141]Form OAC-1001, Statement of Employer, completed by Texas School Book
[142]Depository.
[144]Form OAC-1001, Statement of: Employer, completed by William B. Reily,
[145]Company, Inc.
[147]OAC-5002, Report of Contact, re contact with Jaggars-Chiles-Stovall, Inc.
[148]OAC-5002, Report of Contact, re earnings under Jaggars-Chiles-Stovall, Inc.
[150]Copies of three pages of the Warren Commission Report re employment of
[151]Lee Harvey Oswald prior to service in the Marine Corps.
[153]Form OA-C790, Request for E/R Action.
[154]Memorandum dated 6/3/65, re remarriage of Marina Oswald.
[156]Forms SSA-L735 sent to Marina Porter and completed by Mrs. Porter.
[158]NW 88326 Docid:3272451278 Page 3
[160]27. Forms OA-C107, Determination of Resumption of Award.
[162]28. Forms OA-C528b, Determination of Termination of Entitlement or
[163]Suspension of Payments Based on Supporting Evidence on File.
[165]29. Forms OA-C610, Payee, Address Change, or Hold Check Request.
[166]30. Form OA-C526, Benefit Summary.
[168]31. Form OA-C101, Determination of Award.
[170]32. Form OA-C589, receipt for check.
[172]33. Form 0A-C596, 1965 Conversion of Benefit Rates.
[174]3h. Form AC-512, Appointment of Representative,* completed by
[175]‘Marina N. Oswald and James H. Martin. ,
[177]35. Form OAC-5002, Report of Contact, with James H. Martin.
[178]36. Form OAC-5002, Report of Contact, re Lee Harvey Oswald's death.
[180]The above-mentioned documents are being sent to you in their entirety.
[181]We have withheld only the records of wage and self-employment income
[182]maintained under the direction of 42 U.S.C. 05(c)(2). ‘This record is
[183]_ ereated.on the basis of tax return information received from the Internal
[184]Revenue Service. Under 26 U.S.C. 6103, this information is given to the
[185]Social Security Administration for the administration of the Social
[186]Security Act and redisclosure is prohibited. -You may request this
[187]information directly from the Internal Revenue Service.
[189]I understand that the Dallas Region has already sent you the local
[190]folder on Lee Harvey Oswald. We are also checking with the National
[191]Archives to determine if it may have further social security records
[193]on Lee Harvey Oswald or Marina Oswald. To date, we have found no
[194]records under the aliases you provided. We will contact you if further
[195]documents are located.
[197]Sincerely yours, -
[199]Associate Commissioner
[200]for Program Operations
[202]Enclosures
[204]NW 88326 Docld:32245128 Page 4
[206]capes EPR ESS earmnn APPLICATION FOR SOCIAL SECURITY ACCOUNT NUMBER 433-54-3937
[207]: base REVENUE SERVICE REQUIRED UNDER THE FEDERAL INSURANCE CONTRIBUTIONS ACT DO NOT WRITE IN THE ABOVE SPACE .
[209](Revised 7-48) READ INSTRUCTIONS ON BACK BEFORE FILLING IN FORM
[211]FILL IN EACH ITEM. PRINT IN BLACK OR DARK BLUE INK OR USE TYPEWRITER FOR ALL ITEMS EXCEP” *. TURE, IF THE INFORMATION CALLED F
[212]. RIDDLE NAME OR INITIAL, DRAW A LINE ——
[214]OR IN ANY ITEM IS NOT KNOWN, WRITE “UNKNOWN.”
[216]TNT NAME YOU GAVE YOUR PRESENT FIRST NAME MIDDLE NAME, (IF Y¢~"
[218]EMPLOYER. OR If UNEMPLOYED, THE LZ, 44
[220]NAME YOU WILL USE WHEN EMPLOYED
[221]MAILING ADDRESS iho. AND ST., P,Q. BOX, OR RFD) (ZONE) (STATE)
[223]—,
[225]PRINT FULL NAME GIVEN YOU AT BIRTH
[227]Ke LOK
[228]PLACE OF BIRTH (CITY)
[230]CE EAM
[232](city)
[234]3
[236]DATE OF BIRTH (MONTH) (OAY) (YEAR)
[240]FATHER’S FULL NAME, REGAROLESS OF WHETHER LIVING OR DEAD
[242]Abk, LE LEWA ° Bf Ai-hk t”
[243](MARK (X) WHICH) COLOR (MARK (X) WHICH) (IF OLMER, SPECIFY, HAVE YOU EVER BEFORE APPLIED
[244]5) MALE FEMALE 10 OR WHITE NEGRO OTHER FOR OR HAD A SOCIAL SECURITY OR YES
[245]sx FM ec Pf —} Oo RAILROAD RETIREMENT NUMBER? Oo
[247]IF ANSWER 1S “YES” PRINT THE STATE
[248]V1) STATE IN WHICH YoU FIRST ra
[249]APPLIED AND WHEN oe!
[251]ALSO PRINT YOUR ACCOUNT : DA Fah hep cm
[252]NUMBER IF YOU KNOW IT
[254]AME AS USUALLY, WRITTEN ‘DO NOT PRINT}
[256]BUSINESS NAME OF EMPLOYER. IF UNEMPLOYED, WRITE “UNEMPLOYED”
[258]EPLOYER'S ADDRESS (Ko. AND STREET) (city) (ZONE) (sTaTE)
[260]WRITE ¥
[263]2
[264]‘1
[265]e
[266]g
[268]13
[270]TODAY'S DATE.
[272]NW 80326 Docid:32245128 Page 5 :
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[313]NW 60326 Docld:32245128 Page 6
[315]OFFICIAL RECORD FOR SOCIAL SECURITY NUMBER 467 82 4034° PRINTED ON 071978
[317].
[318]i
[319]I
[320]|
[322]© —C¢
[323]FORM 1: APPL/CYCLE 08 64 ENTRY 0 -  -REF# 65163940518 -
[325]© ; a C
[326]NAME LINE MARINA NIGHOLAEVNA OSWALD 243
[328]© _ | C
[329]SIGNATURE . . CODE §
[331]© BIRTH DATE 0717941 ; SEX 2 RACE 1 CC
[333]© © MOTHER CLAUDIA V PROOSAKOVA FATHER NICHOLAI- - UNKNOWN C
[334]BIRTHPLACE - ARCHANGEL © UR* oe
[336]©) C
[338]© > REQ BY BR 032 SEC UNIT CLERK 00827 DATE 195 PAGE 10F 3 C
[340]. \
[342]© > OFFICIAL~RECORD FGR SOCIAL SECURITY NUMBER | 467 82 4034 PRINTED ON 071978 ¢
[344]O DO. IRS FORM 2 APPL/CYCLE 121175 ENTRY 2 REF #: 75165960637. -O
[346]© NAME LINE MARINA " NIKGLAEVNA ~ PORTER 636 CC
[347]2ND NAME MARINA NIKOLAEVNA OSWALD 243
[349]O 7 : C
[350]SIGNATURE Do ‘CODE. $
[351]BIRTH DATE 0717941; SEX 2 RACE 0
[353]e) Cc
[354]MOTHER KLAVDIA _ PROOSAKOVA FATHER - ALEXANDR MEDVEDEV
[356]© BIRTHPLACE «© ARCHANGEL UR* . Cc
[358]Oo | C
[359]REQ BY BR: 032 SEC UNIT CLERK 00827 DATE: 195 PAGE 2 0F 3
[362]OFFICIAL RECORD FOR SOCIAL SECURITY NUMBER 467 82.4034 PRINTED ON 071978
[364]@) 7 ° C
[366]DO COO FORM 8 APPL/CYCLE 011976 ENTRY 2 REF#. 76010006538
[368]a a C
[369]NAME LINE. M N PORTER 636
[370]2ND NAME MARINA “NIG OSWALD oe 243
[372]2) | . . . — ¢
[373]SIGNATURE CODE OD og
[375]© BIRTH DATE 0717941 Sex 2 race-o. &
[377]© C
[379]© C
[381]Nw 883BE DoBM-sBBistRe PSG; UNIT CLERK 00827 DATE 195 PAGE 3 0F- 3 -
[383]“ . Soctat Security ADMINISTRATION
[385]ce Mf
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[409]NW 88326 "Bocti:$2245128 Page 8.
[411]“NOTICE. — Whoever (a) makes or causes to be made anyf false eae oF 4
[413]‘other than the person for whom it is received, is subject, under the Social Security Act, to a fine of
[414]~ -pot more than $1,000 or | year’s imprisonment, or both.
[416]DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Form approved. -
[418]DALLAS, TEXAS | Budget Bureau No. “Fa. R094. IL.
[419]Bureau of Old-Age and Survivors Insurance ewe .
[421]APPLICATION FOR SURVIVORS IN: URANG A, BERNER TS * *
[423]AI] items on this form requiring an answer roust be inswered or marked “Unknown.”
[425]-—.
[426]‘representation
[428]material fact for use in determining the right to or the amoynt of,
[429]individual’s disability, under Title IT of the Social Security Act, o1 a who-!
[431]‘ment for the use and benefit of another person, knowingly willfully uses such p paymen
[433]eendcennende
[435]_ Bocial security account number) .
[437]| hereby apply for all i insurance ¢ benefits ‘payable to
[439](Full dame of applicant)
[441]; ‘me under Title II of the Social Security Act, ‘as amended, and to the children listed in item 14 below.
[443]“1. When was the deceased born? Month_._........- 2 Day ..../.7... ceceeeeees Year PF cececeeeee
[444]2. In what State or foreign country did th: eceased have his fixed, permanent home when he died? CoA ae
[445]3. (a) Did the deceased ever serve in + .. .nilitary or naval service of the United States?........ oO
[447]_ Yes No
[449]_ Uf “Yes,” answer (6).
[450](b) Was the deceased in active service after September 7, 1939, and before January 1, 1957?..
[451]Uf “Yes,” answer (c) and (d). . : a Ly:
[452](c) Give dates of service during the period specified in a (b) above i$ eles Je Gy
[454](¢@) Has anyone. (including the deceased) received, or does anyone expect to receive, from any .
[455]Federal agency other than the Social Security Administration, a benefit based on the em- ~
[457]Yes No
[459]If "Yes,” name such person(s ) _22..2-2-2-.---yp-eeneeneeee eee en
[463]4. Did the deceased work in the railroad industry at any time on or after January 1, 1937?...... oO Mw
[464]Yes No
[466]5. Give the names and addresses of the deceased’s employers during the 12 months before his death, if the
[467]deceased worked in agricultural employment, give this information for the year of death and the year
[468]before. (If self-employed, write ‘‘Self-employed.’’)
[470]NaME AND Appress OF EMPLOYER
[471]c Year
[472]Vandi Ad -C feck ete a ofeaendls Saas eden elise A Son De eS a ee 67...
[473]Zz ff. Se a amare Bese: € “etgclen ne .
[474]6. If the was ee last“yéar or the year before, gives
[476]Year ; Kind.gf Trade or Business OO "Amount of Ne et Earnings
[477]_C]Less than $400 .$400 or moreL]
[479]OlLess than $400 $400 or moreL]
[481]-7. About how much did the deceased earn from employment and self- employment during
[482]the year in which he died?. . wc he ene cic e ce C ee nese eens 4 2620. O°
[484]8. Give the following information about each marriage of the deceased, including his marriage to you.
[488]meen ne
[490]DaTE AND PLace OF MARRIAGE(S) MarrIaGE ENDED
[492]Month, Day, Year
[494]How MarRIAGE
[496]To Wom MaRRIED
[497]Date Place
[499]9. What was your maiden name?* Tssinas fick te <4 S .
[500]10. When and where were you born? __. RZ. | hevero! Llnak, asain?
[501]th, day, : :
[503]nd year) {State or foreign country)
[505]* This may also be considered an application for survivors benefits under Section 5 of the Railroad Retirement Act and for Veterans Administration
[506]payments under Title 38 USC., Veterans Benefits, Chapter 13 (which is, as such, an application for other types of death benefits under Title 38).
[509]11. Indicate by ()) whether your marriage to the deceased was performed by: Le we
[510]'. Clergyman or authorized public official ial or Other oO
[512]13. (a) Were you and the deceased living together at the same address when the deceased died?. Ke O
[513]es No
[514](6) If cither you or the deceased was away from home (whether or not temporarily) when the deceased —
[516]“died, give thé following: which of you was away; date last home; reason absence began; reason you -
[518]were apart at time of death; if hospitalized, name of hospital and nature of confinemen
[520]Rete. UflP@ YG. 3... ethane. AM
[522]LNA ALE AK Ad Mewibtticas Lie LAD Ae
[524]14. Was the deceased survi¥ed by any unmiarried children (including ste 5 tar
[525]illegitimate aaeiee (a) who were > under 18 years of age when he died; or (b) who were 18
[527]Hf your answer is “No,” leave out the next questions and continue with question 21.
[528]_ Lf your answer to question 14 is “Yes,” give the following information about each such child.
[530](If uncertain as to name, date of birth, or whereabouts of any of these children, explain under “Remarks” on last page.)
[531]Show relationship to you and the deceased by placing ()/) in the proper c column,
[533]Date oF BIRTH RELATIONSHIP TO DE To DECEASED | ReLaTionsmiP To You
[535]Stepchild “doped”
[537]Fut. Name or C
[538]AME OF CHILD Stepchild
[540](If you are e not filing this ‘application on behalf of any “child listed above, give under “Remarks” on last page the name
[541]of each such child and the reason(s) for not filing. If a child of the deceased is born after this application is filed, notify
[542]your office of the Social Security Administration promptly, as such child may receive benefits.)
[544]15. Has any child listed in item 14 ever been adopted by anyone other than the deceased?...... |
[545]Yes No
[546]Uf “Y, es,” give the name of child, by whom adopted, and when.______._... 02. .2..-2022-22ee-2nveneeceenenenneenleceeneceeleceeeetes
[547]16. (a) Were all the children listed in item 14 living with the deceased at time of death?....... O
[548]cs 1
[550]~If “No,” and the deceased was the FATHER or ADOPTING FATHER who died before September 1960, answer (b).
[552](6) “Which of the children listed in item 14 were living with their STEPFATHER when the deceased died? .____-
[554]17. Are all the children listed in item 14 now living with you?.... lceeeeees eet - ne pd O
[555]- : Yes
[557]_YfNo, ”” give the following information about each child not sme with you now.
[559]NIOWVW NI FLIYA LON Od ISVATd
[561]WL ub Lateibta libs cnaanatebnonbatii Sera eal
[563]ay
[565]“’.°™ 19. Do you understand that all Payments made to you on behalf of a child must be spent or saved ”
[566]: for his use and benefit, and do you agree to so apply the benefits?......................... vd ‘a
[568]es No
[570]O
[572]No
[574]20. Do you agree to notify the Social Security Administration promptly when you no longer have
[575]responsibility for the welfare and care of any child for whom you are filing this application? . . pa
[577]21. Have you or any children listed in item 14 married since the death of the deceased?......... O id
[580]If “Yes,” give name of person who married and date of marriage
[584]z .
[585]o)
[586]& ‘Answer questions 24 and 25 ont if you are within 3 months of age 62 or older.
[587]3 q Y ge
[588]Z 24. Were you in the active military or naval service of the United States after September 7, 1939,
[589]v and before January 1, 1957720000002 cece ect e cnet tebe tec b eee e cece.
[590]. 5 Yes No
[591]B 25. Did you work in the railroad industry at any time on or after January 1, 1937?........00.... O a
[592]Yes No
[594]. 5 Deductions are made from the benefits (other than disability benefits) of any person under age 72 who earns more than
[595]Z $100 a month in employment or renders substantial services in self-employment, and has earnings in excess of $1,200 for the
[596]g taxable year.* This applies to all employment and self-employment, whether or not covered by the Social Security Act. |
[597]2 26. (2) Are you or any of the children for whom you are filing now earning more than $100a
[598]gq - month in employment or rendering substantial services in self-employment?..............
[599]Be Yes No
[600]. Tf “Yes,” give the name of each such person .......---.-22.-2--- pote e nee een enn nner ee nee eee ene renee enneererceneeeeee:
[601]<q (6) Do you expect your total earnings or the total earnings of any child for whom you are
[602]filing to exceed $1,200 this year (count all earnings beginning with the first month of this
[604]If “Yes,” give the name of each such person and the amount of his expected earnings. If “‘No,”’ Yes Ne
[606]PERSON ExPEcTED EARNINGS
[608]Yes No
[609]Tf “No,” give the name of each person and the months of this year in which the person did not earn more than $100
[610]a month in employment and did not render substantial services in self-employment. If any such person was self-
[611]employed, show the number of hours he devoted to self-employment opposite each month listed—if none, show “None.”
[613]PERSON MontTHs
[615]The -yearly period referred to in this and subsequent items is the same 12-month period used in figuring income taxes. If vou or any of the children
[616]use a fiscal year (one that does not end on December 31), enter here the name of such person and the month the fiscal year ends
[617]’ .
[622]~NW'88326—Boeldid2245128-Raged Wer:
[624]Answer item 27 only if the deceased died before this year. ‘ .
[625]27. Did you or any child for whom you are filing earn more than $1,200 last year?.............. ia I
[626]Yes No
[627]Uf “Yes,” give the name of each such person, show his total earnings, and list the months of last year in which the person
[628]did not earn $100 a month in employment and did not render substantial services in self-employment. Lf any such person
[629]- was self-employed, show the number of hours he devoted to self-employment opposite each month listed—tf none, show ~
[630]“None.” (Do not list any month before the month the deceased died. )
[632]PERSON | EARNINGS MonrTHS
[636]Ano annual report of earnings must be filed with the Social Security ‘Administration within 3 months and 15 days after
[637]the end of any year in which you, while under age 72 at least one full month of that year, or any child for whom you are
[638]filing, earned more than $1,200. Also, your benefit is not payable for any month you do not have in your care a child of
[639]the deceased entitled to a child’s benefit unless you are receiving. benefits because you are a widow age 62 or over.
[641]FAILURE TO REPORT THESE EVENTS MAY RESULT IN THE LOSS OF ADDITIONAL
[643]MONTHLY BENEFITS.
[645]O
[647]Yes No
[649]O
[651]“Yes ” No
[653]A widow's entitlement to benefits ends: with the month before the month in which: (a) she remarries, with certain excep-
[654]tions (however, all marriages must be reported); or (6) she is under age 62 and no child of the deceased is entitled to >
[655]child’s insurance benefits. ;
[657]A child's entitlement to benefits ends with the month before the month in which the child: (a) attains age 18 (unless the
[658]child has a physical or mental impairment which began before age 18, is expected to be long-lasting, and prevents any sub-
[659]stantial gainful activity); (6) dies; (¢) marries, with certain exceptions where the child is disabled (however, all marriages
[660]must be reported); or (d@) is legally adopted (unless the adoption is by the child’s stepparent, grandparent, aunt, or uncle
[661]after the death of the parent on whose record the child’s claim is based).
[663]If the child is age 18 or over and is receiving benefits as a disabled child, his entitlement to benefits also ends with the
[664]second month after the month in which his disability ceases.
[666]30. Do you agree to notify the Social Security Administration promptly if any of these events occur
[668]and to return promptly any check for benefits received by you if you or any of the children are & O
[670]not entitled to it? ee nee e ete t enter rnc e lees Yes No
[671]REMARKS: (This space may be used for explaining any answers to the questions. If you 1 need more space,
[673]attach a separate sheet.)
[675]FD ecw. Mediate Le AECE. ‘Apoalingy weceeee i Elan, Madize heal 5 = ti fee
[677]MIDUVW NILA LON Od 3SV91d
[679]ORDER DES SARE AREER SOROS AS ESE ARRAS ARADO ADA EREDAR RE ARMA,
[681]Knowing that anyone making 3 a false s statement or representation of a material fact for use in determining the right to
[683]or the amount of Federal old-age, survivors, or disability insurance benefits or in determining an individual's disability, com-
[684]mits a crime punishable under Federal law, I certify that che above statements are crue.
[686]If this application has been signed by mark (X), two wit- Signature of applicant (Write in ink):
[688]nesses who know the applicant must sign below, giving their
[691]Here aes Vv.
[693]full addresses.
[694](First name) (Middle indial) (Last name}
[696]EX Beh aT |
[698]a (Street and number) : -
[700]Lg A ae Cn S05 €
[702](City) (Zone number}
[704](City) (Zone number) (State) : Xx ann nn ne eee eee een ee ee ee eee ee cece enn e enon anes
[705](Month) (Day) (Year)
[707]U.S. GOVERNMENT PRINTING OFFICE : 1961 OF —S8a33B
[709]NW 60226 Docid:32245128 Page 11
[711]STATE OF TEXAS CERTIFICATE OF DEATH STATE FILE NO. ao 2
[713]1. PLACE OF DEATH : 2. USUAL RESIDENCE (Whore deceased lived, If institution: residence before admission} O?
[714]a. COUNTY - Dallas estate Texas bcouty Dallas a)
[715]b. CITY OR TOWN [If outside city limits, give precinct co) «. ae OF STAY: © c. CITY OR TOWN (if outside city limits, give precinct no} oN
[716]- . i)
[717]Dallas *,” 13 MO. -- + Dallas )
[718]d. NAME Gf (IF not in hospital, give street address} d. STREET ADDRESS (If rural, give location)
[719]HOSPITAL OR
[721]1026 N. Beckley
[723]. (S RESIDENCE INSIDE CITY LIMITS? {,1S RESIDENCE ON A FARM?
[725]wsimunon” Parkland Hospital
[726]«15 PLACE OF DEATH INSIDE CITY LIMITS?
[728]: * Yesox _ nop YES BY. NO Yso Noy
[729]1 NAME or (e] First {b) Midaie {e) Last 4. DATE OF DEATH *
[730]is) : :
[731][Type or print} Lee - » Harvey - .+ ‘Oswald November 24, 1963
[732]‘5, SEX @. COLOR OR RACE i: Maried}® Never Manied[] 1% DATE e BIRTH GE in agen ui oni : YEAR (alll al HE
[733]. 2 jeri jever Marri. ley! jontl ys lowrs iw
[734]Male White a ee, Petober 19,193 Sys | |
[735]‘10s. USUAL OCCUPATION [Give Kind ol wor done] (Ob, KIND OF BUSINESS OR INDUST® G L | 11. BIRTHPLACE (State or foreign country) Vig. CITIZEN OF WHAT COUNTRY?
[736]ri {of working li n if retin . .
[737]aborer™ Printing,Book,Metal New Orleans,La USA
[739]14. MOTHER'S MAIDEN NAME
[740]Margeruite Claverie
[742]33. FATHER'S NAME
[744]Robert Edward Lee Oswald
[746]‘15. WAS DECEASED eee iN U5. ARMED Fonts?
[748]16. SOCIAL SECURITY NO.
[750]a
[752]nwt o OF HEALTH — BUREAU OF VITAL STATISTICS
[754]INTERVAL GETWEEN
[756]18. CAUSE OF DEATH [Enter only one cause per fine for [a]. (b]. and (e)-]
[758]‘ONSET AND DEATH
[759], rhe PART 1. DEATH WAS CAUSED BY: ;
[760]ws IMMEDIATE 4." ict.
[761]ea Conditions, if any,
[762]ra which gave rise to
[763]= above cause {a}, DUE TO a&
[764]ht stating the under- .
[765]43 lying cause last. j
[766]DUE TO. (cl
[767]Zz PART Il, OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH BUT NOT RELATED TO THE TERMINAL DISEASE CONDITION GIVEN IN PART Haj
[768]5
[769]120s. ACCIDENT SUICIDE HOMICIpE [20b. DESCRIBE HOW INJURY OCCURRED. [Enter nature a in Part | or Part Il of Item 18.)
[771]re] o
[772]8 4 CROAK donG0
[773]G| 20c. TIME OF = Year
[774]g jury f f
[775]ra /qa L3 Wana asa rt jum ©
[776]20d: INJURY 2 RRED e PLACE OF INJURY (2.9. net Homettoama, bt "CITY, Heth OR LOEATION
[778]street, office building, atc] *
[780]we" SPB BA,
[781]2. a eZ =>
[782]. thereby certify tht | etic sherdocon ste M+ | Gee sstom tne Zeit - Dp (Casement
[783]ase L19 ron ae ot 22 *£,53 Fim. on the date steted sbove. ond to the. jhe best of my knowiedge, from TRE Covies stated
[784]2a. SIGNATURE | 7) 7, 8 (Degree or fiie} 22h. ADDRESS 2ic. DATE SIGNED
[785]Weide 260 byth 45-63
[786]LAVAL 4 Pav “i AM SAA, [a>
[788]23a. BURIAL, CREMATION, REMOVAL [Specify} 23b. DATE 123c. NAME OF CEMETERY OR CREMATORY
[791]H
[792]4
[794]a - oe
[796]_| _ 33MnKY REMOVAL November 25,1963 Rose Hill BuyfaDP:
[797]Net 23d. LOCATION (City, town, or county) ‘[State) 24. FUNERAL DIRECTOR'S SIGNATURI é
[798]e: Fort Worth Texas Miller Funeral Hom
[799]Oy 258. REGISTRAR'S FILE NO, 25b. DATE REC'D BY LOCAL REGISTRAR 2 Goa BY
[801]3 67127 | pee 6 is6s Ya"
[803]DALLA 1S, TEXAS” Jan, 2, 1964 . a
[805]T HEREBY CERTIFY THAT THES IS A TRUE COPY OF DEATH
[807]_OBRIEFTCATE oF oNs._Lee Harvey Oswald
[809]vA AS IS RECCRDED IN ‘PEIS OFFICE IN THE CIty OF DALIAS,
[811]oe, COUNTY OF DAIZAS, S7@M_OF TEXAS, © | ;
[812]oh “Wb ote, 7 oe
[814]aoe Ve, i
[815]. BY ba ——
[817]ACTING A257 STERE -
[818]DALLAS, TEXAS...
[820]ae ee a te ee, =
[822]NW 883.26 Docld:32245128 Page 12 ~
[824]A. REQUEST FOR ASSISTANCE
[825](Complete only if document is sent to
[826]another office for translation.)
[828]TRANSLATION
[830]NAME. OF [INSURED INDIVIOU AL
[832]2. LANGUAGE OF DOCUMENT:
[836]« PERSON(S) FOR WHOM PROOF we
[837](If married woman give maiden name)
[839]SOCIAL SECURITY ACCOUNT NUMGER
[841]733-S¥-3937
[842]TRANSLATING OFFICE
[843]Social Security Administration : “|
[845]. Fact(s) TO 3F PROVED:
[847]» ALLEGED DATE EVENT IN ITEM Aad
[848]OCCURRED:
[850]B. TRANSL ATION
[851](To be filled out by official translator)
[853]1. TYPE OF DOCUMENT: |" DATE EVENT RECORDED,IF 3. DATE COCUMENT
[854]SHOW: Is :
[855]Mnanile Cnty VW 30/, LG £ 73 0/6 f
[857]4. TITLE OF OFFICER Nn ECUTING rtf Cele AME OF ISSUING “Bee YG —_— ’
[858]lute oy wegen C od ) Bevo et} wa hog t ep ib CM 3h
[859]. Does this wes Vi appear tbe genuine and _ ond to Brrr be 407 °
[860]mode at the time purported? . 0 ees im YES ] NO
[862]7. Is Foreign Service post verification stamp
[863]shown on document... . 0. eee cece eee Le ee eens [_] ves [_] no
[865]8. Describe and explain any irregularities in document:
[867]Q. The document, which is in the____———SS cnguage, contains the following pertinent information:
[869]gq ben Osun hE, See. Honey, Baru 10/16/39 en,
[871]New ORheAUS
[873]And
[874]GN
[876] “Puzpeamern, Mauna Ohuxelaone, Lorn
[878]Deby 1, 190) pre Omelrlevrc , Gat. Cbtchangolare
[880]AOAZ MAidrucsd on ,3e_ 1
[881]RQ Me, HE . Cut Tho. 3327
[883]TRANSLATOR
[885]Va .
[886]| Social Security Administration | I 404 7 re V, Vi
[888]Lo _| 73 /f
[890]NW 88326" Hogi get 120—Page 1a NN eee 0
[892]BILE
[894]sutra FUL OMDB
[896]ee souuee Bil
[898]Bits me OOH. icvined,
[900]=.
[901]- (FLAG .
[903]ee ROD: ye ae 4 fos
[905]SRIF SEE Lol,
[907]ca Pe LD, JO, Lemasinmed orga sungnecudare
[908]whe et? es
[910]a wT fecha oe ION
[911]. er KUTCH COL
[913]Boro Werte we;
[915]aia are oe a ws
[918]werrbomass lo ZL away uu aH 1 ary
[920]Via:
[921]se peaee
[922]sacees mbesoiees tues Ce bhieDHwOd BYOT
[924]cae a se oeeriemes evot
[925]oe o te’ oh ‘
[927]Aiecmed |
[928]” wmneiened af
[930]athe. ce a Ver ewe!
[932]"adit
[934], ie Sree
[936]hate
[938]ieee. or
[944]NW 88326 Docid:32245128 Page 14
[947]‘the artginal dooumoent, of
[948]8 photaaepy., appears to
[949]“unaltered and to hava been
[950]time purported,
[952]me ayn ES Ee TE ee,
[954]i)
[956]t
[957]if
[958]t
[960]t
[963]a Oe Ne a en A ne Fe ty ee
[965]SERIO TUES -ennenentinmtei omen cnc anincil
[967]os PO renee LLB nen
[969]Hf. oa Ft . Paece: Cette 2 :
[971]es | — 4 Agi fag eee eo
[972]Baek cape Abe iS
[974]Cyt: Fikert Gee 7
[976]A oF “Tow a peer LP e pe bg .
[978]a
[980]Tice CFU at =
[983]pee 2 os “glace
[985]7 . 4 _ ce 1 —_
[986]f Ate ct. Je uw .
[987]EY ane a é — weal ov ey |
[988])
[990]ee teem ee ewe ee
[994]ie BO
[996]iL Lega sp Velie ommee 3
[998]¢ | fesepyeck = 1 * ees IIT TET oe ey
[999]Wee 6 Tosa 1b " a
[1001]: eT ad ea at ee
[1003]. w? . i
[1004]i
[1009]RA ee er ea Te ce ne ee tee etree nak aan le» mem .
[1011]we
[1015]fee te ey ieee pee
[1017]NW 88326 Docid:32245128 Page 15
[1019]A. REQUEST FOR ASSISTANCE
[1020](Complete only if document is sent to
[1021]another office for translation.)
[1023]TRANSLATION
[1025]NAME. OF INSURED INDIVIDU AL
[1027]2. LANGUAGE OF DOCUMENT:
[1029]KvussiAal
[1031]3. PERSON(S) FOR WHOM PROOF SUBMITTED:
[1032](If married woman give maiden name)
[1034]SOCIAL SECURITY ACCOUNT NUMBER
[1036]433 -5Y-3937
[1038]TRANSLATING OFFICE
[1039]Social Security Administration
[1041]. FACTIS) TO 3E PROVED:
[1043]. ALLEGED DATE EVENT IN ITEM A-4
[1044]OCCURRED:
[1046]B. TRANSL ATION
[1047]C (To be filled out by offtetal translator)
[1049]1. TYPE [eto} NT * 2. DATE EVENT RE “/
[1050]Be ut SHOWN: /
[1051]DAT UKLC
[1052]MN cafo
[1054]4. TITLE OF OFFICER EXECUTI
[1056]F NAME ISSUING ¥f
[1057]6. Does this document appear to be genuine and unaltered, and to have te
[1059]3. DATE DOCUMENT
[1061]ISSUED: WHSEL.
[1063]made at the time purported? . 6... ee tts im yes [ ]no
[1064]7. Is Foreign Service post verification stamp
[1065]shown on document... ee ee ee tenes (-j ves [-] no
[1067]8, Describe and explain any irregularities in document:
[1069]9. The document, which is in the__. _——Ianguage, contains the following pertinent information:
[1070]layme-' We LM Ce Nukelnouna 2 lod eras
[1071]€ CHe, waste) P VT, '¢4¢/ Ae 7A te ve
[1073]Hlece ef Bieth;: (oity tHe EGt thle ) PuBis Onkhangibe, nepee
[1074]Fathcn, ( Ohl)
[1076]NHoChea' (. %
[1078]Res vo, 1295 | Gt Mo, (Ubcrbh)
[1079]a. Notunetta fl aeons ef lege thowt aaa eral AUTH RIZED
[1081]ZA C5 Ppeene
[1083]Social Security Administration
[1085]AD ( Gre
[1087]<0 ats A
[1089]DATE
[1091]L | Y2VEY
[1093]NW 88326° DB4Kii39945728 Page 16 PO: 1082 © -e4erta
[1095]ag ta
[1097]ON whee phere ae
[1099]( wo ¢
[1101]. r
[1102]are 7° of,
[1104]ele w
[1105]pec). THs ¥ .
[1106]Qo vel 8 a en be err |
[1107]bay :
[1108]0 ly tao :t 7 ~ a Cee er
[1109]ve tia A on seid pe She eee .
[1110]ane : elena COOTE. YE. “oe
[1111]u ok mj on ™
[1112]IISA Dit
[1114]Nw 88326 Docld:32245128 Page 17
[1116]| A. REQUEST FOR ASSISTANCE
[1117](Complete only if document is sent to
[1118]another office for translation.)
[1120]2. LANGUAGE OF DOCUMENT:
[1122]Kussianuy
[1124]3. PERSON(S) FOR WHOM PROOF SUBMITTED:
[1125](If married woman give maiden name)
[1127]TRANSLATION
[1129]NAME. OF INSURED INDIVIDU AL
[1131]SOCIAL SECURITY ACCOUNT NUMBER
[1133]4 83-54-3937
[1135]TRANSLATING OFFICE
[1136]Social Security Administration
[1138]4. FACTIS) TO 3& PROVED:
[1140]LL
[1142]S. ALLEGED DATE EVENT IN STEM Acd
[1143]OCCURRED:
[1145]B. TRA SL ATION
[1146](To be filled out by official translator)
[1147]: 2. DATE EVENT RECORDED,IF ii DATE DOCUMENT
[1149]sown: 2125/62. | 22 SED
[1151]5S. NAME OF ISSUING AGENCY:
[1155]. PE OF OCUMENT:
[1156]12 tT a
[1157]Bith oct fuate.
[1158]4. TITLE OF OFFICER EX UTING DOCUMENT:
[1159]Bureau end. GO”) (clo ) | Me cts cof, hegegtnah Cie
[1160]6. Does this document appear to Ke genuine and unaltered, angtd Hk: S747 ce
[1161]made at the time purported? .. 6... ee ee eee i, Ky: PeoT 7. LYES [j NO
[1162]7. Is Foreign Service post verification stamp
[1163]shown on document... 6 eee ee eee ees rr [J ves [_] no
[1164]8. Describe and explain any irregularities in document:
[1166]9. The document, which is in the_ SI mquage, contains the following pertinent information:
[1168]Fount Name OsusAed [-AThée ‘5 MAME! Pz
[1169]y, 2
[1170]Anat, Name ; Mame, t KOE WARE
[1172]Ry,
[1175]Kg OM aN ey NIKOLACVKE
[1177]‘ ¢ a’ 6 (96D
[1178]DA eR s BATICUALITY * RVESTA 4)
[1179]Pic © oF B tRth- Mimak UMNE Rosman Sa!
[1181]RECUESTING OFFICE: . SIGNATURE OF AUTHORIZED
[1182]TRANSLATOR
[1184]i
[1186]| Social Security Administration | (~] z KX E y 0S
[1188]“3 Ae
[1189]GAA
[1191]DATE
[1193]NW 88326 HSA SERRE? Page 18 . GPO: 1962 O- 64n7t0-
[1195]a eee
[1197]Place % Reqitaat ion $ Gums k Cut Lenin
[1199]Offre 06 Requtnation
[1200]Cockficate Mo, {23610
[1202]NW 88326 Docld:32245128 Page 19
[1204]O
[1206]. 7 ee woth ba lad ee ie a ~ ; ~ “ . - fares
[1207]_ DUA OBE MU MEME ce aaa
[1208]Qs ARAN one _ Pome
[1210]_ CBMRETEALCTBO O POW AEN HH ; Bauhxa
[1212]a _— Ore - — a
[1213]rp. ; Oebaneg "Yu tape MEE cee leaseneresmeme : ~ wanes ne
[1215]len flue ne Gnuney — wae m oTrvecTao }
[1217]ave Se — Rie gana eee nae
[1219]4 seenieee iwe Ube pa Goueay- ee taney a7 *n 7 Maul —_€ 8 A os , -
[1221]ran ” wh Pe Meh IOS bua, P was wr Piesen. setiiceg’ key rone ead Cun
[1223]LA 39 mor. we PEP IA MautUAHa.YUNICU | LP EX ep nL
[1224]metas GES EEE St fusion,
[1225]weer 63 ee Ls Riper. 20gn, Me Drove. (mare 4 Crees —
[1228]Mecua napaaaonia asiuaui: reopaa, O10 Pa Meng, glegeneey
[1230]Mecto poaacHun petenxa: ropea, C20 —_ -_ rete nee ce een Gene etree |
[1231]oa flow oo anne AG OE 98. .. i
[1232]sos ae pubadtie,. —
[1234]poGiadp, BCL . ae “9 ae Mel :
[1235]Gaara . " ; Fa gio oN . LOS f
[1236]7 = us OF f
[1239]- Hapa ae} it “ i
[1241]en) eo
[1243]© YeM B KM 3amHceN AXTOB FPUAAANCKOTO COCTOAHHA Si) Pas ylV- VA x 4 2 23610 c
[1244]0 poxacHHm : ae : fee! H oe a
[1245]19623, BOA!» . MecAua WE vsser yg Qh OM oa b
[1246]roa” “aeeuya NCA tee! 1 ppb hedunk Oppo sanicay ; i"
[1248]. apobaen aananeani sanic 3a Ne dogs arcdegid bropo sanuced” ;
[1249]Mpovtspeacna CournereT uy mula Jatt 3 . 3 aRmDE PTR amcnoco cocmoanus Fe
[1251]. . . : : wn oe 2%. toe - “a ma N eee : i
[1253]- . '
[1255]eemtemnmnemataatenednnebnemantaatemmanatterttenetoamie eae an
[1257]Ree eee ey aS ee Ridin waistieads, Aide .
[1258]tebe oe Bates ARE Ls ae alia Hie abt 2a. Ree et wen ee te
[1262]NW 60226 Docid:222745128 Page 20
[1264]DEPARTMENT OF
[1265]HEALTH, EDUCATION, AND WELFARE
[1266]Soctat Security ADMINISTRATION
[1267]Bureau OF O1D-AGE 4ND Survivors INSURANCE
[1269]CERTIFICATION OF CONTENTS OF DOCUMENT(S) OR RECORD(S)
[1271](This form must be executed by an authorized employee of the Social Security Administration)
[1273]Soria) security account number
[1274]Y3 SY- 3737
[1276]Every item in a block at filled out with exact excerpts from the paper certified or the item must be marked “not shown.”
[1277]If the date on which an entry was made in a family record is “not shown,” indicate under “Remarks” any allegation as to when the
[1278]document or record was established. CROSS OUT ALL UNUSED SPACES.
[1280]A. AGE (OR RELATIONSHIP) OF:
[1282]1, NaMe oF Person as SHOWN ON EVIDENCE
[1284]iy Kh t Ctuwelel
[1286]Name of pvage ony r self-employed wee CO
[1288]BinTHDAY AT WHICH AGE SHOWN Date RECORDED
[1290]= Last NEAREST ia
[1292]Not GIvEeN
[1294]Poe OF ia NAME OF wot i : .
[1295]Not SHOWN A Not Shown
[1296]Mi, Onde tl Mase Pusha lesene Vsece depth
[1297]Lee Havinc Custopy, RELATIONSHIP TO APPLICANT, AND ADDRESS: N. TURE OF EvIDENCE
[1298]C A ~ OL K ly _& A
[1299]wae AND ADDRESS Da AGENCY Cer a Bible, give date of publication) ° [] Custopian 1a) 3:
[1300]Make, 15.3
[1302]2. NAME OF os AS SHOWN ON Ei ipence Born Ace | BiratHDay aT Wuicn AGE SHOWN Date RECORDED
[1304]O Last NEAREST CJ
[1305]O Next Not Given C]
[1307]NaME OF MOTHER
[1309]NAME OF FATHER AGE
[1311]C] Not SHown CJ Not SHown
[1313]NaTURE OF EVIDENCE
[1315]Person Havinc Custopy, RELATIONSHIP TO APPLICANT, AND ADDRESS:
[1317]‘a APPLICANT
[1319]NAME AND Appress OF IssuInG AGENCY (If certifiing from a Bible, give date of publication ) Document No.
[1321]O CusTODIAN
[1323]3. Name oF Person as SHOWN ON EviDENCE S 3E | BirtTHDAY aT WHICH AGE SHOWN Date RECORDED
[1325]i Last NEAREST C
[1327]: i Next Not GIVEN O
[1329]AGE Name OF MOTHER
[1331]NAME OF FATHER AGE
[1333]i= Not SHowN | Not SHown
[1335]Person Havinc Cusropy, RELATIONSHIP TO APPLICANT, AND ADDRESS: NaTuRE OF EVIDENCE
[1337]oO APPLICANT
[1339]NAME AND ADDRESS OF IssurnG AGENCY (If certifying from a Bible, give date of publicatron } Document No.
[1341]J CusToDIAN
[1343]£ 4. Name oF Person as SHOWN ON EVIDENCE Born AGE | BirtHDay aT WHICH AGE SHOWN Date RECORDED
[1346]NS ° CL] Last NEAREST O
[1348]O NEXT Not Given O
[1350]NaME OF MOTHER , O Not SHowN AGE
[1352]Person Havinc Custopy, RELATIONSHIP TO APPLICANT, AND ADDRESS; A " oF EVIDENCE
[1353]PPLICANT
[1355]NAME OF FATHER AGE
[1357]| Not SHown
[1359]NaME AND ADDRESS OF IssutnG AGENCY (Jf ceritfying from a Bible, give date of publication) Document No.
[1361]Oo CusToDIAN
[1363]B. MARRIAGE OF;
[1365]BIRTHDAY AT WHICH AGE SHOWN
[1367]L] Last NEAREST im
[1369]NEXT - Not GIven
[1371]NO. OF PREVIOUS MAR-
[1372]RIAGES (1, 2, ETC}
[1374]Name OF HusBAND AS SHOWN ¢ ON EVIDENCE
[1376]a Not SHown
[1378]NO. OF PREVIOUS MAR-
[1379]RIAGES (1, 2, ETC.)
[1381]BirTHDAY AT WHICH AGE SHOWN
[1383]ia Last NEAREST im
[1385]Next
[1387]NaME OF WIFE as SHOWN ON EVIDENCE
[1389]im Not SHOWN Not Given
[1391]NaTuRE OF EVIDENCE PLACE OF MARRIAGE
[1393]im MARRIAGE CERTIFICATE
[1395]Person HavinGc Cusropy, RELATIONSHIP TO APPLICANT, AND ADDRESS:
[1397]. C] APPLICANT
[1399]DaTE OF MARRIAGE
[1401]NAME AND AppREss OF Issuinc AGENCY (If certifing from a Bible, give date of publication } DocumEnT No.
[1405]Form OA-C704
[1407](OVER)
[1409]NW 88326 “Docld:32245128 Page 21_
[1411]“YUCATION, AND WELFARE
[1414][Social SecuRniy AbMuNiorA ’ CERTIFICATION BY. UNIFORMED SERVICES
[1416]a!
[1418]Bureau of Old-Age and Survivoygrence sang:
[1420]The information requested below is for“use in connection with
[1421], a claim for social security benefits based at least in part on active
[1422]‘ service in the armed forces after September 7, 19389.
[1424]5 emce _FNEBE, Se POM ona a/o fo
[1425]PART I—TO BE COMPLETED BY SOCIAL SECURITY ADMINISTRATION
[1427]DATE OF BIRTH
[1429]10/19/39
[1431]FROM: Social Security Administration
[1432]Division of Claims Policy
[1433]Entitlement Branch, Room 645
[1434]Baltimore, Md. 21235
[1436]as
[1437]SOCIAL SECURITY NUMBER
[1439]433-5h
[1441]DATE OF DEATH
[1443]11/24/63
[1445]LAST NAME - FIRST NAME - MIDDLE NAME
[1447]Oswald, Lee Harvey
[1449]BRANCH OF SERVICE DATE(S) OF ENTRY INTO SERVICE | DATE(S) OF SEPARATION PLAGE() OF SEPARATIO,
[1450]Marine Corps
[1452]RATE OR RANK _ 10/24/56 9/11/59
[1454]SERI ‘ .
[1456]1653230
[1458]Part II . .. Part III [1 below to be completed by the service department
[1460]REMARKS;
[1462]PART II—-SERVICE DEPT. CERTIFICATION ABOUT ACTIVE SERVICE AFTER SEPTEMBER 7, 1939. .
[1464]1. DATE(S) OF ENTRY INTO 2. DATE(S) OF SEPARATION 3. CHARACTER OF SEPARATION(S) * (If Bad Condw?  uiGATE IF GIVEN
[1465]ACTIVE SERVICE FROM ACTIVE SERVICE AS A RESULT OF A General COURT MARTIAL)
[1466]240ct56 H -115ep59 Honorable
[1468]*IF CHARACTER OF SEPARATION WAS NOT Honorable, Under
[1469]Honorable Conditions, Dishonorable, non Bad Conduct as A RESULT
[1470]oF a General COURT MARTIAL, CHECK REASON FOR SEPARATION BELOW:
[1472]a. If period of service was less than 90 days, WAS INDIVIDUAL DIS-
[1473]CHARGED OR RELEASED FROM ACTIVE SERVICE AS RESULT OF INJURY
[1474]OR DISABILITY INCURRED OR AGGRAVATED IN SERVICE IN LINE OF DUTY?
[1476]im} YES D NO
[1478]@. [] DESERTION.
[1479]b. 1] RESIGNATION FOR THE GOOD OF THE SERVICE (Officers Only).
[1481]c. Oo CONSCIENTIOUS OBJECTOR WHO REFUSED TO WEAR THE UNIFORM
[1482]OR OTHERWISE TO COMPLY WITH (LAWFUL ORDERS OF COMPETENT
[1484]B. IF A PERIOD OF SERVICE HAD AN ENTRY DATE AFTER 12/31/46 AND . MILITARY AUTHORITY.
[1485]BEFORE 12/16/50, BY WHICH OF THE FOLLOWING WAS ENTRY EFFECTED?
[1487]a0 CONVICTION BY A CIVIL COURT FOR TREASON, SABOTAGE, ESPIO-
[1488]NAGE, MURDER, RAPE, ARSON, BURGLARY, ROBBERY, KIDNAPPING,
[1490]( inpuctep OO CALLED FROM O ENustep ASSAULT WITH INTENT TO KILL, ASSAULT WITH A DANGEROUS
[1491]INACTIVE SERVICE WEAPON, OR OF AN ATTEMPT TO COMMIT ANY OF THESE CRIMES.
[1492][1] RE-ENLIsTED [J ‘COMMISSIONED €. [J] NONE OF THE ABOVE.
[1494]PART IH—SERVICE DEPT, CERTIFICATION ABOUT RETIRED OR RETAINER PAY (See instructions on reverse side)
[1496]IF THE VETERAN WAS NEVER RETIRED or TRANSFERRED TO THE FLEET RESERVE, check this box. . . . im
[1497]Sign and return the form without answering items 1, 2 and 3 below.
[1499]1. (a) Was this veteran an enlisted member of the Army, Air Force, Navy, Marine Corps, or
[1501]Coast Guard and retired after September 15, 1940, and before October 1, 1949, because ;
[1502]of disability? 2... 6 6 ee ee ee ee ee ee ee ew ee ee tw O Yes ia No
[1503]Pe (b) Was this veteran ever retired or transferred to the Fleet Naval (or Marine Corps) Re-
[1504]" serve after September 15, 1940, for any reason other than disability which is the proxi-
[1505]; mate result of the performance of active duty? . 2... 1 eee ee ee ee ee ee Ci Yes CO No
[1506]“3 If answer to 1 (a) or 1 (b) is “Yes,” answer (c) and (d). :
[1507](c) Was active service after September 15, 1940, and before July 25, 1947, used to establish
[1508]eligibility to receive retirement or retainer pay? 2... ees cn ee CY Yes CT No
[1509](d) Was active service after July 24, 1947, and before January 1, 1957, used to > establish
[1510]- eligibility to receive retirement or retainer pay? ........ oe oO Yes oO No
[1511]2. (a) Has the retirement (or retainer) pay of this individual ever been fixed under a formula
[1512]which includes a multiple of active service? . 2. 2. 2 ee ee ee ee ee ee | Yes O No
[1514]If answer is “Yes,” answer (b) and (c).
[1515](b) Was this multiple increased because of active service occurring after September 15, 1940,
[1516]im Yes | No
[1518]and before July 25,1947? 2 2 6 1 6 ww we ee ee .
[1519](c) Was this multiple increase because of active service occurring after July 24, 1947, and
[1520]before January 1,1957? ......2...684 7. ee ee ow. | Yes N
[1522]3. Did the veteran have active duty or active duty for training after December 31, 1956? ... TC Yes im No
[1523]REMARKS BY CERTIFYING AGENCY:
[1525]Served in an inective status in the Marine Corps Reserve from 125ep59
[1527]to 13S ep60 when dischargbd as Undesirable, CPNTINUED ON REVERSE SIDE
[1528]oncanzation Records service section SIGNATURE Lk).
[1529]Hq. U: .S. Marine Coprs
[1531]27J an64 Head of Section
[1532]. Form OA-C654
[1533](2-61)
[1535]"NW 88326 Docld:32245128 Page 22
[1537]DATE
[1539]RANK OR TITLE
[1542]“Woo oq UF MAE LE Hod ME ere Tet oe ro - _
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[1556]as req [IU Yor toy (QS6T ‘TS TequIED:9q ~~“ LPGT ‘om ATRL) IT ZFM POM 480
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[1560]ULSNI
[1563]Per o7o0 wee meee So
[1565]_-» avtecom. with Marine Corps 1/24/64
[1566]and attached OA-C654 completed 1/27/64.
[1568]Attached OA-C654 reflects DWE's honorable
[1570]active service 10/24/56 - 9/11/59 which
[1572]confirms telecom. with Marine Corps
[1574](W. C, Keene, Record Service Section,
[1576]Hdqs. Marine Corps, Washington, D.C.) on
[1578]1/24/64. The DWE's discharge as Undesirable
[1580]was from his inactive status in the Marine
[1581]Corps Reserve from 9/12/59 to 9/13/60, which
[1583]discharge did not affect the character of
[1585]separation from earlier service.
[1587]MS wage credits for 10/56 - 12/56 are not
[1588]precluded by type of discharge from later
[1589]period of service. See CM 1823.
[1593]Lorene B. Benning (
[1595]Claims Policy Examiner
[1596]| lie Bet dee a” ppl swirly
[1597]Aerie, oP AE [Gm i
[1599]they "pevurieh bn (962 Aa (FES é
[1602]igethe foley OO"
[1604]i
[1606]i
[1608]“-
[1610]88326 Docld:32245128 Page 23
[1612]. DEPARTMENT OF THE NAVY Ny
[1613]WAVY DISCHARGE REVIEW BOARD -
[1615]WASHINGTON 28,D.6..
[1617]: | IM REPLY REFER TO
[1618]> “EX0S:Q8(33)
[1619]'. JAPsgjo
[1621]Pee
[1623]oi neces
[1624]LENZ
[1625]Fie Tor
[1627]u.
[1629]ene “Seal
[1631]UL 25.1983.
[1633]Mre Lee He Oswald —
[1635]P. Oj Box 3 ; :
[1637]New Orleans, Lae “ 4
[1638]- |. ; .
[1640]Dear Mr, Oswaldr
[1642]your discharge has been comploted in —
[1643]rerulations governing tho procedures ©
[1645]> of this Boarde Ceroful. consideration was given to the Soebls
[1647] gyidenco presented 4n your behalf as well as that contained | : a
[1649]»- 4n your official records. Tho Sccrotary of the Navy has.
[1651]dings of the Board. Soe op EY
[1653]a Tho review of
[1654]accordance with tho
[1656]7 . reviewed the procsec
[1657]/ Sa It is the decision that no changes correction or
[1658]}  : podification is warranted in your dischargoe BO
[1659]| | : Sincerely yours,
[1661]| 2 | y
[1662]-D, W. BOVIAN ~
[1663]Captoin, USN 7
[1664]Presidont a
[1665]Navy Discharge Review Board a
[1667]Ose
[1669]Ord Discharge certificate. : ; - -
[1670]Two (2) letters dated 31 Jan 1962, 13 Nov 1961. -
[1672]>. ~Enelss
[1673]| - Information on Reenlistment =
[1675]NW 88326 Docid:32245128 Page 24. -
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[1914]ADIAWAS 20 ANIMJZIVIS “or
[1917]: _ SOxoL *SUTTa CRA TI ; / UNO |
[1918]- — . POAWAE TAILDV ANWWUND OLN ANANZ - ; ' :
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[1932]38 AON Me
[1933]SI HOTHM 29 IN $30 NOIIGT S3Dv1094 Pe GO
[1935]NW 88326 Docld:32245128 Page 26
[1937]UNDESIRABLE
[1938]DISCE iA\ RG EO
[1940]~ FROM THE ARMED FORCES OF THE
[1942]UNITED STATES UF AMERICA
[1944]THIS I$ TO CERTIFY THAT ae pear
[1946]| PRIVATE FIRST CLASS LES HARVEY OSWALD 1659290 0
[1947]| WAS DISCHARGED FROMTHE =,
[1948]UNITED STATES MARINE CORPS: - ee
[1949](ON THE _13th_ DAY OF StS 1950 :
[1951]_ AS UNDESIRABLE
[1953]se
[1954]My Gs LETSCHER, FIRST LIEUTENANT, USNC
[1956]NW? 68326 Docld:32245128 Page 2?
[1962]day of
[1964]at on the
[1966]|
[1967]i
[1969], 19__, to serve —— years. |
[1971]old on discharge \, . ; | .
[1972]_ : ‘ . a ee sot (Dashe @f ren
[1974], occupational specialty
[1976](sea, foreign, battles, c gagements, expeditions) ne eee ;
[1979]i t;
[1981]i ¥
[1983]UT i
[1987]f discharge
[1989]yt thai che ubove ts correct according to the servi
[1991]* t
[1993]» HAS, GLENVIEW, ILL. 26 Sepéo
[1994]non-delivery of Discharge
[1995](address unkown) : ‘-
[1996]“ Fw! BY
[1999]Form OA-Cs91
[2001]; . (8-58)
[2002]* INCOMING CORRESPONDENCE ASSIGNI|
[2003]i (MalIL anp DisrrisuTion Supunir)
[2005]DEPARTMENT OF
[2007]Form Approved
[2008]HEALTH, EDUCATION, AND WELFARE Budget Bureau
[2009]SOCIAL SECURITY ADMINISTRATION No. 72~-R597,)
[2010]BUREAU OF OLD-AGE AND SURVIVORS INSURANCE
[2012]CLAIMANT'S REPORT TO
[2013]SOCIAL SECURITY ADMINISTRATION
[2014]om
[2016]¢ I | “RINT NAME OF PERSON ABOUT WHOM REPORT IS MADE
[2017]we er i
[2019]a . t .
[2020]Final disposition | Wa pivn Oniuetf
[2021]| SOCIAL SECURITY CLAIM NUMBER
[2023]“433-S54-R2RIBPE CG >
[2025]| aaron Fill-in Only the Item(s) being reported.
[2027]1. CHANGE OF ADDRESS. (Fill'jnnew address of bottom | i
[2028]Cheek if change is for: fore than 6 months. (2'6 months or tess :
[2030]To avoid delay in receipt of checks you should also file a regular change :
[2031]of address notice with your local pest office. Hy
[2033]Enter date of marriage ;
[2034]Enter date of death, 7
[2036]Enter date decree fing!
[2038]4. DIVORCE OR ANNULMENT OF
[2039]MARRIAGE (of spouse be ficiary from
[2040]insured individual)
[2042]5. CHILD OR OTHER CLAIMAN
[2043]YOUR CARE
[2047]Enter date child teft your
[2048]core
[2050]6. CHILD LEGALLY ADOPTED
[2051]bY
[2053]C1 Stepparent Grandparent [) Aunt
[2054]7. WORK OUTSIDE THE DNL ED STATES:
[2056]| was employed or self-employed outside
[2057]the United States beginning with the
[2058]month of
[2060]Or
[2062]SIGNATURE of person making this report
[2064]j Date signed
[2069]NW 68326 Doeld:32245128 Page 29 . 4
[2071]NW 8326 Dochd:32245178 Page 30
[2073]Saar mig cto
[2075]“tranhe epo ee ea renin,
[2077]i
[2078]4
[2079]i
[2080]f
[2085]UNIT DES'
[2087][_] PES
[2090]["] cas |
[2094]Form OA-C6591
[2095](2-64)
[2097]INCOMING CoRR repannes.
[2099]sre or form Approved.
[2100]HEALTA, EDUCATION, AND WELFARE Budget Burecu
[2101]SOCIAL SECURITY ADMINISTRATION No. 72-R597.2
[2103]LAIMANT’S. REPORT TO
[2104]SOCIAL SECURITY ADMINISTRATION
[2106]"PRINT NAME OF PERSOM O€ PERSONS ABOUT WHOM REPORT IS MADE
[2108]JtareNaA Mo Oswaar
[2110]SOCIAL SECURITY CLAIM NUMBER(S) FF
[2112]HS P-SYER3GRI-E
[2114]Fill in Only the Item(s) being reported.
[2116]1. CHANGE OF ADDRESS. (Fill in new oddress ot bottom.)
[2117]Check if change is for: 2 more than.6 months (2 6 months or tess
[2118]To avoid delay in receipt of checks you should also file a regular change
[2120]of address notice with your local post office.
[2122]Enter date of marriage
[2124]2. MARRIAGE ©. 00. ek eee
[2126]Show New Nome
[2128]3. DEATH OF (Show Name) . Enter date of death
[2130]« & DIVORCE OR ANNULMENT OF MARRIAGE |Enter date decree final
[2131]{of spouse beneficiary from insured indi-
[2135]Enter date child left your
[2137]5. CHILD OR OTHER CLAIMANT LEFT YOUR care
[2139]Show Given Name(s) of Person(s) Who Left;
[2141]Date of departure from
[2142]U.S.A.
[2144]RIS RO RRR TEN yey “smgtae: | fr qe merge | meray tif jac eeor ERT
[2146]. GOING OUTSIDE THE U.S.
[2147]Name of country to which going
[2149]segees
[2151]Given Name(s) of Person(s) Going
[2155]ven
[2157]Enter date of adoption
[2159]7. CHILD LEGALLY ADOPTED............
[2160]Show Given Name(s} of Chiid(ren)
[2162]PRN Sapa ee
[2164]BY (J Stepporent [[] Grandporent [J Aunt [Uncle  ((] Other
[2166]SIGNATURE of person making this report
[2168]» Gyles. Qlaritrs  keetef
[2170]P.O."Box or Street
[2172]°) eS) Dowwsa DRWE
[2174]State Zip Code
[2176]AICHARDSON , TEXAS 75050
[2178]. inty, WF any, in which you live le Signe
[2179]- QALLAS COUNTY | S-1- 6S”
[2180]* GPO : t963 OF —696-004
[2182]FORM OA-C 668 (6-63)
[2186]— .
[2188]Form OA-C669 Form Approved.
[2189](11-60) Budget Bureau No. 72-R598
[2191]CLAIMANT'S REPORT ABOUT WORK TO °
[2193]SOCIAL SECURITY ADMINISTRATION
[2194]PRINT AME OF PERSON ABOUT WHOM REPORT 15 MADE
[2195]MARINA LV. (QS WALD.
[2196]SOCIA SECURITY CLAIM NUMBER
[2197]S3R—5 of GET -LE
[2199]Fill in Only the item being reported.
[2201]REPORT HERE IF YOU WORK
[2202]and expect to eam more than $1,200 during this taxable
[2203]year.
[2204]Iam working for wages of more
[2205]than $100 (or rendering substan-
[2206]tial services in self-employment)
[2207]beginning with the month of. . —_,/-
[2209]Sevaakten Syren ARIE OC unamm el gga a voto lece at O
[2211]oF
[2213]Fill in both boxes >
[2214]Ne)
[2216]I estimate that my total eamings for }
[2217]a
[2218]this taxable year will be... . age Y
[2219]Your estimate will be used to schedule benefit payments 2
[2221]to you during the year. At the end of the year an annual
[2222]report of actual earnings is required, at which time ad-
[2224]Longe
[2226]Justments, as necessary, will be made. ie 7
[2227]b ww
[2228]i s
[2229]t REPORT HERE IF YOU STOP WORKING
[2230]. r for wages of more than $100 a month (or rendering substan-
[2231]+ ‘ tial services in self-employment).
[2232]: ' w
[2233]i %
[2234]é The last month I worked for wages a
[2235]a 4 of more than $100 (or rendered
[2236]: g substantial seeds in self- Month & Year
[2237]; employment) WGS «1.6... me
[2238]H REPORT HERE TO REVISE AN ESTIMATE
[2239]- - ‘ of eamings you previously gave for this taxable year.
[2241]. l estimate that my total earnings
[2242]i for this taxable year will be . —=jpe
[2243]. F *If $1,200 or less, show ‘'$1,200 or less'"'
[2244]‘ t Your benefit payments will be rescheduled in line with
[2245]. the changes in your work activity reported above.
[2247]: SIGNATURE of person making this report Date signed
[2248]: . . - ? :
[2249]\ < Vhs Merine © ed OL. 8, SHY.
[2251]t P.O. Box or street
[2253]‘ 629 S227 Line KoAo
[2255]KICHARDSON, TEXAS 75080
[2257]‘ GPO: 1960 0—S72939
[2259]NW 68326 Docid:32245128 Page 31
[2262](2-64)
[2263]Wave whee
[2265][_] PES | C1 oor
[2266][_] cc | (1 Recon
[2267]Do Leas | (Ree
[2269]uf J
[2270]INCOMING CORRESPONDENCE ASSIGNMENT RECORL
[2272]-- (MalIL_anp DISTRIRUTIAN.Crrne-———
[2274]oo - ‘
[2276]REPORTING CARD Neeser
[2278]| form Approved.
[2279]H a GEOTT WHOM FEPORT (5 MADE
[2280]| PRINT NAME OF PERSON OR PERSONS ABOUT WHOM REPORT |S MADE
[2282]efered vo M, : Pore Ter
[2284]ARING AVA
[2285]“— ENTER SOCIAL SECURITY CLAIM SAUASBER_IN, THIS SPACE . i
[2288]‘=: Received by ......-- 33 #3737 bh See
[2289]ee | ’ heck or All in ONLY the information being reported. ’ :
[2290]Searcher __..----.----2 1.38 CHANGE OF ADDRESS (Print Tew gddress at bottom) ate...
[2291]Final di \ . Check if change is for: [|More than 6 mos. (16 mos. orless -
[2292]inal disposition | gf". “YING AND WiLL EARN OVER $1,500 THIS YEAR: ,,
[2293]| To. sedeing for wages of more than wal)
[2294]cre cecn ne ncenen rene nceenanney 4 $122 a month (or rendering substan- MONTH AND YEAR| To neeonone renee
[2295]. tial services in self-employment) be- Loe be
[2296]seen ee ee eee nnn ee ence ene ginning with the month of... - | ¢ $ J roman ntaneanecnconcamesnnne
[2297]al i 5 eas
[2298]REMARES: _. f Fill in both boxes ef osition _..............-
[2299]ee | estimate that my total earnings for Fe
[2300]eee ‘ this taxable year will be....---——e ae denoeeneeececeneenceeseneee
[2301]a ancencennennaneen aa
[2302]4 7
[2303]_. ! 3. LJ STOPPING WORK: $8) cee
[2304]werrerecececeneeccccect The last month I worked for wages of Be _
[2305]i more than $125 lor rendered sub- | nnn
[2306]correct ee et stantial services in self-employment) i en
[2308]‘ 2 ON. _
[2309]ADASIGNIFICANT CHANGE IN ESTIMATE: #3 US. GOVERNMENT PRINTII
[2310]wh.
[2311]i | estimate that my total earnings for AMOUNT og
[2312]this toxoble year will ee ze
[2313]4
[2314]6 LJGOING OUTSIDE THE U.S. BATE GOING
[2315]' Name of country to which going SATE EXPECT TO RETURN
[2316]- Y
[2317]7. L] MARRIAGE SATE OF MARRIAGE
[2318]Place of marriage (City, County & State) .
[2319]@, [] DIVORCE OR ANNULMENT. —>- DATE DECREE TiNAS
[2320]: 9. LJ CHILO LEGALLY ADOPTED BY OF pare oF
[2321]: Stepparent (1) Brother or ADOPT!
[2322]: Aunt or Uncle Sister
[2323]i Other (1 Grandporent
[2324]i 70. [_] CHILD OR OTHER CLAIMANT en DATE HE LEFT YOUR
[2325]Hy LEFT YOUR CARE ...----- —
[2326]: SIGNATURE OF PERSON MAKING THIS REPORT ;
[2328]1
[2329]: NUMBER AND STREET, P.O. BOX, OR ROUTE
[2330]GEYB Dow stan lawe
[2331]i city STATE ZIP COPE
[2332]BSBLY
[2333]{ DATE SIGNEO
[2334]. S- 4-66
[2335]° i ENTER NAME OF COUNTY, IF ANY, 1N WHICH YOU UVE
[2336]i . PALlLas
[2337]: FORM SSA-1425 (12-65) Kc
[2338]i .
[2340]NW 80326 Doeld:327745128 Page 32
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[2355]200 NOA GIG WHOM IVA
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[2389]SPF JIC Ua py Wa} ParamsUe MOK) KUO JOMsY Pecestey evry
[2391]“AUN Yo4e9 y34je01 NOLL ae SNI Pasojzua peas asearg
[2392]VIG! - SONINYVSse 1NOdTH TVONNY
[2394]NOLLVUISININGY AlIeHag WIGS Ss
[2396]at
[2398]NW 88326 Docld:32245128 Page 33
[2400]“S97 /ELE-FE SEF
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[2404]3MGH NOES
[2405]GONV 31v0
[2407]MIGWNN WIVTD ALIYNDIS TVID0S
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[2414]MOvWe OF aH OF
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[2424]Sppussna 10 apent jo pury aves
[2425]2e961 NI
[2427]JAOBAWI-JTIS NCA 2UIM_ Z
[2431]vrs trstee (unowe ayy Jaye ,,1,, aysM ‘Ssoj ee mgsson yg” SOuyusea yu 9g MOUS “G
[2433]tresses (Sujoud ssos6 moys ssawses) sidtayes 1210) 796T MOUS e
[2435]DOS EY) JOU UJea JON pip NoA
[2436]yoy ur “Aue ji ‘yyuoul «ea 40) x0 UL .X,, 2921d
[2438]cee ewer non : Se i a
[2440]wan
[2442]NW 88326 Docld:32245128 Page 34
[2445]Form OAC-5002
[2446](1-64)
[2448]REPORT OF CONTACT
[2449](USE INK OR TYPEWRITER) Bille, Tee ,
[2451]DATE: 7, p~ C f
[2452]a, Lhe Bh cue 4 ps lrwelh Ps -SY-39I37
[2454]NAME AND ADDRESS @F PERSON(S) CONTACTED:
[2456]hie flor, , Clewir/! — tps
[2457]Ly oT Jigen Mla all dra ia kt SSO
[2458]CONT. A MADE: PLACE OF x Lad
[2460]EN PERSON im TELEPHONE KE
[2462]He is, Py as Chak. He oe.
[2464]gated x hose te
[2466]: LIES SS Me, 7 a hried 23 SY 8729
[2467]awe tcand, ia 433 -s¥ — BI £
[2469]was Fig = gee atte
[2471]«(5 . ‘
[2472]ar ais a st er .
[2474]1 ae Ae a x .
[2475]Saat Tye v : : 7
[2477]CONTACT MADE BY %
[2479]ra
[2480](SIGNATURE)
[2482]eae E)
[2483](FOR CONTINUATION OF THIS REPORT, TURN PAGE. KEEP MARGINAL SPACE AT RIGHT FOR BINDING
[2485]U, S. GOVERNMENT PRINTING OFFICE ; 1958 O ~486513
[2487]NW 88326 Docld:32245128 Page 35
[2489]Oa a
[2491]ORR OAH Titan coum emgiice rea eal ae REE sae aN daicieeigonrcn’
[2493]XFL NOSGUVHIIY
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[2496]. J
[2498]L
[2499]| “3CIS YIHLO NE i |
[2500]SNOI1S3ND YAMSNV NIHL ‘NMOHS AVIA
[2502]RON 4! MOTI9 SSIVGGY Cy IWYN Angad i i
[2503]. J f yi aan — cami - we tee
[2504]ryL'AWEV; ~ “Ayeuad e
[2505]iM 0) 21GeI] St sodas $1) YM LOL DaULOD UI yUATWAIEYS asyjey & Sayeul oo ADILON
[2507]“200 AOA Gia WOM LVM
[2508]AGRA
[2510]se lee RATION NOK JO (HUIS JAUMO
[2512]“Ayinyo.sed JaJ24] NOLLONALSNI pasoiaua pees
[2514]cree on GQBL - SONINUY] #) 1Yod3d TWANNY
[2516]PLSUTL “ON
[2518]roontwes MOUVULSINIWG My ALIYAIIS 1¥1I 0S
[2519]4
[2521]3 LE6E-9S
[2523]|
[2525]i
[2526]i
[2528]pAOA SUOM TRUM MONS
[2530]in NOK WE AUO JOMSUY 'F
[2532].
[2533]6
[2534]ir :
[2535]I; 1 |
[2536]43 ee i
[2537]: Os0Sp ff i
[2539]32245128 Page 36
[2541]PNW 88326 Docld
[2544]pores
[2546]ova
[2548]a a ae Awe oe
[2550]SEPT seperate
[2552]RE Ch t& Lak TROCEA Uf OU LY 774
[2554]UIAWAN WIVTD ALDINDIS WIIOS
[2556]DAALYNDIS iva
[2557]éjuamAo;dwa-ypas ur sagiagas reinueysans Furs ypuas
[2558]YO Yyuow e& G2ZI$ Jano jo sahem soy Hulysom MANET] Mou nok asy-q
[2559]oy $ret tees Gog: 10; sBULusea 1P}0) payradxa uNnok MOUS ‘8
[2560]ZL “OPIS JAW1O AU) UO YRAtt9Y! arayduod pur ssauisne-anok
[2561]: x ; > UE SADIA IAS lenueisqas JANI LON PIP NOK anaijaq
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[2580]29961 NI OOS'T$ UIAO
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[2616]eo 8596
[2618]HAO TA Ng NV NOA 3
[2620]NW 88326 Docid
[2622]32245128 Page 37
[2625]DEPARTMENT OF HEALTH, EDUCATION, AND WELPARE Form approved.
[2627]SOCIAL SECURITY ADMINISTRATION
[2629]Bureau of Old-Age and Survivors Insurance Budget Bureau No. 72—R247.12
[2630]In replying, Address: Sociay Security ADMINISTRATION
[2632]. a6 Rawlins St. P.
[2634]“a
[2636]We have received an application for social security benefits based upon the wages s paid t to «Gs ‘indi-
[2638]vidual named below. We need a statement of wages to process this claim. Your cooperation in promptly
[2640]v~.-» filling out and.cetuming.this, statement will be appreciated. An. envelope ‘tequiring no postage is enclosed
[2641]for your use. (The filing © of an application does not necessarily mean that a currently employed wage eamer
[2643]— to quit working) ° et STS Lo -
[2644]T saa gAes- Clhices- Svdvace Thue.
[2646]ee 3: Tegwd ©. KR, SX.
[2648]ong RAL
[2650]Enclosure.
[2654]STATEMENT OF EMPLOYER
[2656]~~~ This is te ‘certify ‘that wages in the amounts shown have been PAID during the calendar year(s) to—
[2658]1 AEE HARVEY Oswaehd 33-54-3937
[2660](Name of wage earner) (Social security account number)
[2662]Include the value of all remuneration before withholding of tax whether paid in cash or kind (bur for
[2663]' sérvicéSperfoftied in a private home as'a-domestic, or in work not in the course of the employer’s trade
[2664]or business, show only the cash amount paid). If no wages were paid in the periods checked below, write
[2665]“None’’; if the amounts are unknown, write ‘‘'Unknown."’ If you believe any of the amounts shown are
[2666]not wages or any of the employment is not covered under the Social Security Act, outline your reasons
[2667]under ''Remarks’’ on the back of this form.
[2669]PLEASE DO NOT WRITE IN MARGIN
[2671]2. Waoes Pap Waces Paip Waces Paip Waces Paip
[2672]Prziop >,
[2673]YER 19.47 “> Year 0.62 Yzar 10.....__. Year 19__.._.--
[2674]January 1-March 31, inclusive............... $....MONeE. $...945 269... [a e ,
[2675]April 1-June 30, inclusive.....................- $.... RODE... $..123.067 0200) 8. | ee
[2676]July 1-September 30, inclusive.._...........- $....0) One. vecee-| $ NONE... $0. eee |
[2678]October 1-December 31, inclusive_..........! $...0.700.7i_...! $.... QMe. $l Be
[2680]In item 3 below use specific terms such as file clerk, taveling or city salesman, maid, plumber,
[2681]attorney, etc. In item 7 use specific terms such as radio manufacturing, wholesale drugs, retail grocery
[2682]store, physician’s office, private home, etc.
[2684]3. EMPLOYEE'S OCCUPATION 7. NATURE OF BUSINESS,
[2686]Camera Dept.
[2687]4. BUSINESS NAME OF EMPLOYER ( Ty pe or print)
[2689]Jaggers-Chiles-Stovell, Inc.
[2691]5. STREET ADDRESS OF EMPLOYER : . TITLE OF PERSON SIGNING ABOVE
[2693]___522 Browder St, Secretary~Treasurer
[2694]6. CITY STATE 10, EMPLOYER'S FEDERAL | 11, DATE THIS STATEMENT FILLED ouT
[2695]SDENTIFICATION NO,
[2696]Dallas, Texas 75 0359250 | 1-10-64
[2698]OCAC-1001
[2700]NW 88326 Docid:32245128 Page 38
[2703]DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Form approved.
[2704]OCIAL SECURITY ADMINISTRATION .
[2705]Bureau of Old-Age and Survivors Insurance . Budget Bureau No. 72—R247.12
[2707]3716 Rawlins 8 goPgins. Address: Sociau Security ADMINISTRATION
[2708]1.0. Box 6556.
[2709]=e 219 -
[2711]Dallas, .
[2712]=RI.:9-28g5°*
[2714]Tape, 9-299] ate AIS
[2715]Ve have received an application for social security benefits based upon the wages paid t6..the 4ndi-
[2716]vidual named below. We need a statement of wages to process this claim. . Your cooperation in promptly
[2717]mating out ang retuming this statement will be appreciated. An envelope fequiring :no ‘postage.is enclosed
[2718]..for your use. (The filing of of a an n Spplicacion does: WOt'necessarily. mean that a a currently employed wage earner
[2720]~me ~ alee to quit working.) v.:2
[2722]TEXAS Schore gore
[2723]DEPesy TORY
[2725]oat nom “ECM Ae teas! “Ugys Treas
[2727]~~ DALLA > TE RAS.. wp gprs oe:
[2729]Enclosure.
[2731]q. _ STATEMENT OF EMPLOYER
[2733]“This ig te. er ty that. ages in t the amounts shown have been PAID during the calendar year(s) to—
[2735]z
[2736]tc} (Name of wage earner)
[2737]& Include the value of all remuneration before withholding of tax whether paid in cash or kind (but for
[2739]Ss Services: performed ‘in'a private home as a-domestic, or in work not in the course of the employer’s trade
[2740]or business, show only the cash amount "paid). If no wages were paid in the periods checked below, write
[2742]Zz.
[2743]™ None’; if ‘the amounts are unknown, write ''Unknown."’ If you believe any of the amounts shown are
[2745]f not wages or any of the employment is not covered under the Social Security Act, outline your reasons
[2746]fz d eR ke? h back of thi fe % y
[2747]f under ''Remarks’’ on the back of this form.
[2748]id 2. Waces Palp WaGEs Palp ‘Waces Parp Waoes Paip
[2749]fh PERIOD
[2750]3 YEAR 19.497.-4% YEAR 19....--.. YEAR 19.....-.. YEAR 19...-..--
[2751]z
[2752]& January 1-March 31, inclusive............-.. sMOnNe=.. ceeeeeeeeeceececeeeeee , Boece cee
[2753]i<>y —
[2754]@ April 1-June 30, inclusive...._....--..-.------ sNIVE wecee| Gocccececeeeeeeeeeeeeee Boece cceceeeeeteeeeeeee an
[2755]f
[2757]€ & July 1-September 30, inclusive............... sM OME. eeeeeeeeeceeeeeeeeeeee , ee $e eee cette eee
[2759]October 1~December 31, inclusive...........' $..77@ 6.4 @.. 7 » Boo! Bee eee eee
[2761]In item 3 below use specific terms such as file clerk, traveling or city salesman, maid, plumber,
[2762]attorney, etc. In item 7 use specific terms such as radio manufacturing, wholesale drugs, retail grocery
[2763]store, physician’s office, private home, etc.
[2765]3. EMPLOYEE'S OCCUPATION 7. NATURE OF BUSINESS
[2767]4. a NAME OF EMPLOYER (Type C
[2769]fas 5
[2770]TREET ADDRESS OF EMPLOYER 9. TITLE OF SON SIGNIN:
[2771]-
[2772]f Ge. SG _
[2773]| V1, DATE THIS STATEMENT FILLED OUT
[2775]10. EMPLOYER'S FEDERAL
[2776]IDENTIFICATION NO.
[2778]O7S- 0U9/ 3 Be | [-19- CY
[2780]1 MRICS In 1 peop meio meie aercran conan eget iceenmen meetin meecenjime ee
[2782]NW 88326 Dochd:s 2245028 vRage 3 ;
[2784]DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Form approved,
[2785]OCIAL SECUAITY ADM UMLETAATION . Budect Bureau No. 72—R247.12
[2786]Ureau of Old-Age and Survivors Insaranee ea TARE
[2788]In replying, Address: Socrau Security ADMINISTRATION
[2790]ellen Geleana, Ea roxas
[2791]. Telephone... p2ia29e2 Date. F¥E le fe
[2792]Ve have received an application for social ‘security benefits based upon the wages paid té th
[2793]vidual named below. We need a statement of wages to process this claim. Your cooperation in promptly
[2794]filling out and retuming this statement will be appreciated. An envelope requiring no postage is enclosed
[2795]for your use. (The filing of an application does not necessarily mean that a currently employed wage eamer
[2797]plans to quit working.)
[2799]Vy tha Beck, b,,ue
[2800]‘ie AOL aH, CDE
[2802]L , J (Mrs. ) Martha A. McSteen “
[2804]Enclosure.
[2806]STATEMENT OF EMPLOYER
[2807]t Avages in the aed have been PAID during the calendar year(s) to—
[2809](Name of wage earner) (Soci
[2811]G)
[2812]a
[2813]N
[2815]unt number)
[2817]Include the value of all remuneration before withholding of tax whether paid in cash or kind (but for
[2818]services petformed in a private home as a domestic, or in work not in the course of the employer’s trade
[2819]or business, show only the cash amount paid). If no wages were paid in the periods checked below, write
[2820]‘None’; if the amounts are unknown, write Unknown.” If you believe any of the amounts shown are
[2821]not wages or any of the employment is not covered under the Social Security Act, outline your reasons
[2822]under ''Remarks”’ on the back of this form. :
[2824]Waces Paip Wacrs Paro Waces Paip
[2827]et YEAR 19_.....-- Yuar 19........ _ YzEar 19. a
[2828]January 1-March 31, inclusive. $ $ | $
[2830]PLEASE DO NOT WRITE IN MARGIN
[2832]In item 3 below use specific terms such as file clerk, traveling of city salesman, maid, plumber,
[2833]attorney, etc. In item 7 use specific terms such as radio manufacturing, wholesale drugs, retail grocery
[2834]store, physician’s office, private heme, etc.
[2836]3. EMPLOYEE'S OCCUPA 7. RATUAE OF BUSINESS
[2839]4, BUSINESS MAME OF EMPLOYER (Ty pe of print)
[2841]Wb éiky ry DUpd be dur deh
[2842]bd Maye FE
[2844]6. CITY ST,
[2846]8. WRITTEN ApTURE OF EMPLOYER OR AUTHORIZED EMPLOYEE OF FIRM
[2848]eT aS
[2849]10. EMPLOYER'S FEDERAL 11, DATE THIS ~
[2850]eee TON be. STATEMENT FILLED OUT
[2852]nw 88326 DoctsDpasize Paoka Mn, 0. ZL. JorFa | rofl
[2854]va t i ”
[2855], ra
[2856], !
[2859]ai
[2861]vt Dee Me bbted VES 243
[2863]Understanding that this statement is for the use of the Social Security
[2864]Administration in the administration of the Social Security Act, Title IT, I
[2865]hereby certify that the following information is correct:
[2867](1) Were the wages shown on the attached statement of employer
[2868]reported to the Director of Internal Revenue?
[2870]Yes No
[2872](2) If wages were reported, please, give date(s) reported and undgr
[2873]what employer's name the report(s) was made:
[2875](3) If the wages were not reported, please give reason for failure
[2876]to report:
[2878]Signature
[2880]Attachment to Form OAC-1001
[2881]NOLA-7/63
[2883]NW 88326 Docid:32245128 Page 41
[2888]Bo 64 CSL9 ;
[2890]DEPARTMENT OF aa
[2892]HEALTH, EDUCATION, AND WELFARE = Alms sive 4355439370
[2894]SOCIAL SECURITY ADMINISTRATION Claim No.
[2895]when writing about your claim
[2897]10-14-64
[2898]mowledged of the flowing, LENO
[2899]DESCRIPTION OF REMITTANCE AMOUNT SCHEDULE NO. "
[2900]sonar cneck date 106-64 |e
[2901]Forwarded by: .
[2902]~ . Previous balance §
[2904]Mrs. Marina Oswald ACKNOWLCDGED
[2905]629 Belt Line Road ; QT bb at Current remittance
[2906]Richardson, Texas 75080 poe eg low
[2907]fp Current balance $
[2909]—_ Next date for payment
[2911]NW 88326 Docid:32245128 Page 42
[2914]Form OAC-5002
[2915](1-64)
[2917]CONTACT ° a
[2918]REPORT OF CON ______DalTas y Texas
[2919]S//6 LE #
[2921]NAME AND ADDRESS OF Leave COPPACTED:
[2923]CONTACT MADE: PLACE OF CONTACT:
[2925]IN PERSON QO TELEPHONE im
[2927]—a sas acti A LAAP IE Gd
[2929]J epegpae = Chates ~ brn El, Sore, was Agee
[2930]A ae aestwu~ny tafe 2 Cett2e of 4 kerry)
[2931]72 LD aed ieee, ¥ eee. Agee AL2D vaste
[2932]Cat Chee LAA ELA Gee ALLEL ane
[2933]_déeides ger cores Pra Je a2,
[2935]fin him g CCl f= ELL OPA
[2936]a, Lelia. ee
[2937]hcde Lert awe cee LE Mi Baton Ad
[2938]Lee ete LE. .
[2940]eee Lott Ct a BLE a gp -
[2942]Cehaantate,
[2944]hay ore
[2946]CONTACT MADE BY
[2948]Gléing Bop,
[2949]pee (TITLE)
[2950](FOR CONTINUATION OF THIS REPORT, TURN PAGE. KEEP MARGINAL SPACE AT RIGHT FOR BINDING)
[2952]U. 8. GOVERNMENT PRINTING OFFICE: guy = 678492
[2954]NW 68326 Docid:32245128 Page 43
[2957]: : MILITARY OCCUPATIONAL SPECIALTICS ‘
[2958]. on [mea | er “eer
[2960]| 61h) - === {Av loner / __|GiG Spd lie DFl-nad-12 of 27Mays7
[2962]HL
[2964]-_ — “_ CIVILIAN OCCU PATIONS " f i
[2967]3
[2969][roe tLe (Mein ocrn pasion) ©
[2973]|
[2975]- 0 {]
[2979]WG SOMO, | __Aead 2. och | ans nwore Performed various clerical duties
[2981]Teme | |" H Buch as distributing mati, delivering mes-
[2982]Helped file !
[2984]. ee et
[2985]LIT
[2988]Taape—pusierss Tr pees & answering telephone.
[2989]CLT Mifecords & operated ditto, letter opening &
[2991]ealing machines.
[2993]eT:
[2995]hoceibe
[2997]Hl
[2998]Boalt
[2999]| Bele |
[3000]i A
[3001]i
[3002]i
[3004]i
[3006]eS = ‘ANI ECIAL QUALIFICATIONS
[3008]|
[3009]|
[3011]q
[3012]6
[3013]3
[3016]Maintensnce A
[3018]pomrrerery wscTUL AtoUS ALTAIR . .
[3020]23Kor$9 Gat peseod USAFI HS ORD’ PI. 146, 2657. 3-550 458, $~52
[3022]OTR FTE ONS OF LINAC 114 (0-PO ANO MEV 118 (4)-78 tf OTRO
[3024]RIE U8 QD-PO CAEN. -) (RIMERSTE mayer wia—eD (EY. Oat) wrech WEL Ot USTo. Uwe Mt
[3025]wore wn h OT AU .
[3027]Forsom. Exursit No. 1—Continued (p. 7)
[3029]NW 68326 Docld:32245128 Page 44
[3031]wehbe st
[3033]ran e. The sarine has no firm .offer of employment he has
[3034]jindicated that his former esoloyer will entertain offering
[3036]\enploy..ent with a suitable selary to provide the necessury
[3037]‘suport of his wether. a =
[3039]3. In eval:ation of all facts available, it is the opinion
[3040]of the Board that Private First Class OSWALD meets the —
[3041]requirements of p-r/zraph 10273 «is .for release from
[3043]acvlive datz. ne
[3045]4. The Board recommends that Private First Class Lee ii.
[3046]CSWALD be released from active duty with the iarine Corps
[3048]for reasons of dependency.
[3050]Py SAG ate _
[3051]« J. KOZAK’ - ‘
[3052]Lieutenant Colonel, U. S. Warine Corps
[3054]a oa
[3056]FotsoM Exuisit No. 1—Continued (p. 80)
[3058]10:GCKz:wdp | .
[3059]26 Aug 1959 |
[3061]THIRD ENDORSEMENT on Pfc OSWALD's ltr of 17 Aug 1959
[3063]From: Commanding General, 3d Marine Aircraft Wing |
[3064]To: Senior Member, 3d Marine Aircraft Wing Hardship/
[3065]Dependency Discharge Board. .
[3067]Subjz Dependency Discharge; request for; case of Private
[3068]_ First Class Lee H. OSNALD 1653230/6741 USMC
[3070]Refs (b) Para 10273 MarCorMan: | ; ;
[3071](c) CG 34 MAW ltr to LiCol KOZAK.10;RH:d1n of 30
[3072]Jul 1959
[3074]2. In accordance with the provisions. of subparagraph 9c of
[3075]reference.(b), you will convene the 3d Marine. Aircraft Wing
[3076]Hardship/Dependency Discharge Board, as designated by ref- ~
[3077]erence (c), as-soon as practicable. for the purpose of con- .
[3078]sidering the subject case. ee . .
[3080]Te eet
[3082]l. Delivered, ; — a |
[3084]3. The recommendations of the Board will be returned to this
[3085]Headquarters by endorsement hereon as’ expeditiously as possible.
[3087]|
[3088]|
[3090]W. A. CLOMAN, JR.
[3091]By direction °
[3093]Fotsom Exnisrr No. 1—Continued (p. 81) . : . ,
[3094]726
[3096]a )
[3098]NW 88326 Docid:32245128 Page 45
[3100]Pz
[3104]AUR 28 1259.
[3106]FOURTH ENDCKSSsENT on Pfe OSWALD's 1te of 17 aug 1959
[3108]From: Senior ember, 3d marine Aircraft Wing Hardship or
[3109]Dependency Discharge .soara ;
[3110]To: Commanding General, 3d.marine Aircraft Wing’
[3112]Suoj: Discharge by reason of dependency; request for case of
[3113]Private First Class Lee H. OSWALD 1653230/6741 USC
[3115]1. Guided vy the provisions of reference (a) and in compli-
[3116]ance with Third Endorsement hereto, the Hardship or Dependency
[3117]Discharge Board met at_ 1530, 27 August 1959 to consider the
[3118]case of Private First Class Lee d. OSWALD 1653230/o0741 USAC.
[3119]The wiarine had submitted an official request for a devendency
[3120]discharge in accordance with reference (a). The following
[3121]members were present: ; .- : . :
[3123]Lieutenant Colonel Bolish J, KOZAK 07108 USHC +{.WHG-3)
[3124]major George E, MC CLANE 016430/7335 USMC” (is1AG-36)
[3125]ajor Eugene T. CARD 035129/7304 USC (#:WHG-3)
[3126]2. Upon examination of the basic request, supporting encl-.
[3127]osures and Service necord, Private First élass Lee H. OSWALD
[3128]was interviewed by the Board.. fhe following facts were
[3129]then considered: soe ; : .
[3131]a. Private First Class Lee H. OSWALD, not married, on
[3132]his initial three (3) year enlistment in the Marine Corps
[3133]is obligated to serve on active duty until 7 December 1959.
[3135]b. ‘the Marine submitted his request for a dependency |
[3136]discharge in order that he may provide physical and = ~..
[3137]financial assistance to his invalid mother residing in ~
[3138]Fort ‘forth, Texas. re a
[3140]ce. The home situation of. Private First Class OSWALD nas -
[3141]been aggravated subseouent to-his enlistment date through
[3142]incavacitation of his mother as a. result of an industrial. |
[3143]accident. The mother is no longer gainfully employed due -
[3144]to her physical conditi:n znd “has no source. of income... The.
[3145]presence of her son,’ Private -First Class OSWALD, is required -
[3146]for physical and financial. assistance. ; Lo!
[3150]d. One son, married and residing in Fort Worth is
[3151]unable to provide either financial or physical assistance
[3152]to the ‘iarines mother due to his marital responsibilities .
[3153]and the inability of the two families to maintain a comuon
[3154]MOhES, Another son, married, with the U. S. Air Force on
[3155]uctive duty in Japan, cannot furnish’financial support.
[3157]FoisoM ExHIBIT No. 1—Continued (p. 79)
[3159]NW’ 80326 Docid:32245128 Page 46
[3161]DISTRICT OFFICE
[3163]DALLAS TEX
[3165]MULTIPLE A/N
[3167]RIOR CERTIFICATION
[3168]SEE OVER)
[3170]PLEASE ADVISE CURRENT DISTRICT OFFICE
[3171]CC] oF CLAIMS STATUS (PREPARE 0A.C556)
[3173]PAYMENT CENTER
[3175]FAMILY COMPOSITION PRIOR CERTIFICATION
[3177]AUXILIARY OR SURVIVOR DATA
[3178]DATE OF BIRTH
[3180]P MO. ELECT.
[3184]IDENTIFYING INFORMATION -- ACCOUNT NUMBER UNKNOWN
[3186]Pm
[3188]o
[3190]ig]
[3191]a.
[3192]a
[3193]_
[3194]ts]
[3195]5
[3196]be
[3200]NW 88326.
[3202]OPTIONAL FORM NG. 10 50V0-~107
[3203]MAY 1962 EDITION
[3204]GSA GEN. REG. NO. 27 ——
[3206]UNITED STATES GOVERNMENT
[3208]Memorandum
[3210]TO : Kansas City Payment Center DATE: June 3, 1965
[3212]FROM : Jess C. Carter, Assistant Manager
[3213]Dallas, Texas
[3215]SUBJECT: Lee Harvey Oswald - A/N 433 54 3937
[3217]Our newspaper has reported the re-marriage of the wage earner's
[3218]widow. Since the language barrier is still a problem with her
[3219]it is possible she will overlook making a proper report.
[3220]Reportedly the marriage took place on Tuesday June 1, 1965.
[3222](Asve's,
[3223]RCE!
[3224]U flag
[3225]it
[3226]i .
[3227]rf Buy U.S. Savings Bonds Regularly on the Payroll Savings Plan
[3229]NW 88326 Dochd:22245128 Page 48
[3231]CONFIDENTIAL - ADMINISTRATIVE
[3233]rol 626
[3235]kee , Le a
[3236]S79 fei
[3238]cere te a en ee OPO TT NRE TE
[3240]wy see meneame
[3242]XX
[3244], Lie - re 2
[3245]: . - wet he ‘2peas
[3246]/ 7 - , ets “ afin & po
[3247]. te aa oom 8 . ~ = wast oy ‘ ;
[3248]N DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 90, yo.
[3249]: SOCIAL SECURITY ADMINISTRATION . De Je foe §
[3250]LV be chce WAGE EARNER:
[3251]~ “ . Tir 3 . *
[3252]: Se 37 16 Rawlins Street When writing about your claim
[3254]FO. Fox 6556 always give Claim No.
[3255]Dellas, Texes 75219
[3257]7, p, ‘ Gok
[3258]les paras
[3260]fritharhoe) At 75°40
[3262]This will acknowledge your inquiry regarding the check(s) for the _
[3263]month(s) of Get /G 69 Lt Ge pee’ “Ww eng
[3265]The Treasury Department desires that each person promptly receive the
[3266]amount due him but wishes to avoid unnecessary expense in record search-
[3267]ing which results in many instances in finding the check was correctly
[3268]paid. On a notice, such as you have furnished us, the Treasury Department
[3269]must necessarily search its payment records from the date of issuance of
[3270]the check until the date that a substitute check will be issued. Because
[3271]of the large volume of payments, the searching operation entails a heavy
[3272]expense for each item. Accordingly, it is requested that you fill out
[3273]the questionnaire on the reverse of this notice and RETURN IT IN THE .
[3274]ENCLOSED ENVELOPE. UNLESS THIS QUESTIONNAIRE IS RETURNED NO FURTHER
[3275]ACTION WILL BE TAKEN. :
[3277]If you receive the check before hearing from the Treasury Department
[3278]you should notify the social security district office shown above. -ex—
[3280]“cara to notify usy After sending in this noti-
[3281]fication, you may cash the check.
[3283]Upon receipt of this questionnaire, action if necessary, will be taken
[3284]by the Treasury Department to place a stop payment on the check and to
[3285]refer the case to the United States Secret Service for investigation and
[3286]clearance so a duplicate check can be sent to you. The Treasury Depart-
[3287]ment will get in touch with you if it needs further information.
[3289]Sincerely yours,
[3291]District Manager j
[3292]Enclosures: ,
[3293]Envelope
[3294]Post—Card_OA-C1O47-
[3295]DO NOT WRITE BELOW THIS LINE
[3296]Check Number ‘ Date
[3298]NW 88326 Docid:32245128 Page 49
[3300]av
[3302]3d ~ SH. 9730 —
[3304]os
[3307]i
[3308]t
[3310]i) SSA-L795 (10266)
[3311]RMERLY. OA-CL735)}
[3313]nes mn EHTEL WEED EET TIEN! ITE eT NG
[3315]Form Approved.
[3316]Budget Bureau No. 72-R417.7
[3318]Boo : A PROMPT REPLY WILL EXPEDITE ACTIO#
[3319]QUESTIONNAIRE
[3320]1. Have you received the check described on the other side of this sheet?.......ssssu . (Yes 7 CARS
[3321]If your answer is ‘'Yes”’ destroy this form; fill out-and mail the enclosed post card.
[3322]2. If your answer is ‘'No,’’ have you asked your local: ‘post office about the check? L. *
[3323]- (If your answer is ‘‘No,’’ this should be done.) rrreceirseesinescdbernsssnerseesseessessnsseesnanae [i7Ves CJ No
[3325]3. If you recently changed your mailing address, have you tried to find out whether
[3327]the check is being held there for you at your old address or was returned to the post _-,
[3328]office? (If your answer is ‘‘No,’’ this should be done. )........cucessssessssseseeeeseeesneee Lessee Aires
[3330]{_] No
[3332]4. Have you any information which you think might assist the Treasury Department
[3333]in locating the check? (If your answer is 'Yes,’’ please give such information
[3334]matnder “Remarks. )acssssssssssssssesusssassssssstssesssssunstssnsssnssstesasessasessatuastssesisesassnan [7 Yes Corfe
[3336]; De possible that you received the check and cashed it, thinking it was issued
[3337]for another purpose? (If your answer is ‘‘Yes,’’ please explain under ‘‘Remarks.’’) [_]Yes , Cao
[3339]6. If this check was illegally cashed, you will be entitled to payment of the amount of the check; however,
[3340]another check in place of it will not be issued until the case has been fully investigated by the United States
[3341]Secret Service. As it may be necessary to contact you for further information, please furnish on the line below
[3342]the address at which you may be reached during the daytime, if such place is different from your residence.
[3344](Number and eee (City, State and ZIP Code)
[3345]7. If shie check was mailed to a different address than shown below, please fumish that address.
[3347](Number and Street)
[3349]8. After reviewing all circumstances, I/we wish to make formal claim to the Treasury Department for stoppage of
[3350]payment of this check and the issuance of a substitute check. _ yes
[3352]9. REMARKS (State any other facts which may aid in locating the Check): ... sssssssssssscsserssosersessssssecseeniecsenseneeneeneensesea
[3354]. . . SIGNATURE OF PAYEE OR CLAIMANT
[3355]If this questionnaire has been signed by mark (X), two witnesses
[3356]who know the person must sign below, giving their full addresses.
[3358]1. NAME
[3360]— Piss . fants fark? .
[3362]SIGNATURE OF CO-PAYEE (Both husband and wife must sign if Or
[3364]ADDRESS (Street number, City, State and ZIP Code)
[3365]. Ipayees of e combined check)
[3367]RESIDENCE NUMBER AND STREET
[3369]2. NAME —
[3370]ADDRESS (Street number, City, State and ZIP Code) eivy, STATE AND Zip CODE AND ZIP CODE
[3371]a ond
[3372]C.
[3373]pare (Mo., Day, end Year) TELEPHONE NUMBER
[3374]t
[3375][Sug 12 964 | P D /- o 720
[3377]U.S. GOVERNMENT PRINTING OFFICE : 1966 O—238-966
[3379]NW SEIZE ~ Bice cl SPA GARG Pea eg ep nnn oem cee renee meme
[3381]2SS/
[3383]SOCIAL SECURITY ADMINISTRATION a
[3385]3716 Ravlins Street .
[3387]P,0, Box 6556 WAGE EARNER: Le Onsen
[3388]Dalles, Texes 15219
[3390]When writing about your claim
[3392]always give Claim No. SE ?- ao “YO 3 y
[3394]OFFICE
[3396]V7 lio. barter
[3398]732
[3400]hoke
[3401]Liha Lon, Len,  7IPSO
[3403]This will acknowledge your inquiry regarding the check(s) for the nonthls
[3404]of ni. lgoF
[3406]The Treasury Department desires that each person promptly receive the
[3407]amount due him but wishes to avoid unnecessary expense in record search-
[3408]ing which results in many instances in finding the check was correctly
[3410]paid. On a notice, such as you have furnished us, the Treasury Department
[3411]eS must necessarily search its payment records from the date of issuance of
[3412]tf) the check until the date that a substitute check will be issued. Because
[3413]o, of the large volume of payments, the searching operation entails a heavy
[3414]= D expense for each item. Accordingly, it is requested that you fill out
[3415]=e. : io the questionnaire on the reverse of this notice and RETURN IT IN THE
[3416]= -_ ; ENCLOSED ENVELOPE. UNLESS THIS QUESTIONNAIRE IS RETURNED NO FURTHER
[3417]Gs <2 7 ° ACTION WILL BE TAKEN.
[3418]a
[3419]Ee ey If you receive the check before hearing from the Treasury Department
[3420]— wh you should notify the social security district office shown above. Yeu
[3421]. league . ‘ . . .
[3422]ce es ~may—use_the enclosed postcard to notify us. After sending in this noti-
[3423]ca) SS fication, you may cash the check.
[3424]Qe
[3427]Upon receipt of this questionnaire, action if necessary, will be taken
[3428]by the Treasury Department to place a stop payment on the check and to
[3429]refer the case to the United States Secret Service for investigation and
[3430]clearance so a duplicate check can be sent to you. The Treasury Depart-
[3431]ment will get in touch with you if it needs further information
[3433]Sincerely yours, L a ;
[3434]nine TH ot lel
[3436]District Manager
[3437]Enclosures: .
[3438]Envelope
[3439]—Fost Card OA-CLau7. :
[3440]DO NOT WRITE BELOW THIS LINE
[3441]Check Number Date
[3443]Amount
[3445]Ty Of D . A - : (FORMERLY OA+cL7s8!
[3446]G
[3447]NW 88326 Docid:32245128 Page 51 7
[3449]fe. Form Approved
[3451]woo? . a i a Budget Bureau No. 72-R417.7
[3452]ee - A PROMPT REPLY WILL EXPEDITE ACTION o~
[3453]# QUESTIONNAIRE
[3454]1. Have you received the check described on the other side of this sheet? (_]Yes FES No
[3455]{f your answer js "Yes" destroy this form, fill out and mail the enclosed post card.
[3456]2. If your answer is ‘‘No,”’ have you asked your local post office about the check? sia Yes ; [J No
[3457](If your answer is ''No,” this should be done). . wees _ . PMD veneer ree a
[3459]3, If you recently changed your mailing address, have you tried to find out whether
[3460]the check is being held there for you at ‘your old address or was retumed to the
[3461]post office? (If your answer is tNo,’? this should be done.) cc. cece eters : L_]Yes Bet No
[3463]4, Have you any information which you think might assist the Treasury Department
[3464]in locating the check? (If your answer is ‘tyes,’’ please give such information
[3466]under Remarks.) ...sc0eceeeecste teers sere er se sss ese eee (_] Yes ial No
[3467]. Is it possible that you received the check and cashed it, thinking it was issued
[3468]for another purpose? (If your answer is ''Yes,’”’ please explain under “Remarks.”) [_] Yes BA No
[3470]_ ff this check was jMegally cashed, you will be entitled to payment of the amount of the check; however,
[3472]7 nother check in place of it will not be issued until the case has been fully investigated by the United States
[3473]Secret Service. As it may be necessary to contact you for further information, please furnish on the line below
[3474]the address at which you may be reached during the daytime, if such place is different from your residence. y
[3476](Number and Street)
[3478]7. If the check was mailed to a different address than shown below, please furnish thar, addiess. oS
[3479]4 »
[3480]a
[3482]a
[3484](Number and Street) (City, State and Z
[3486]oe . a . oa :
[3488]g. After reviewing all circumstances, I/we wish to make formal claim to the Treasury Department for stoppage of
[3489]. : . 2
[3491]payment of this check and the issuance of a substitute check.
[3493]‘9, REMARKS ( State any other facts which ma) aid in locating the check):
[3495]i)
[3497]324
[3500]e
[3502]” ; ; ; 5 SIGMATURE OF PAYEE OR CLAIMANT
[3503]If this questionnaire has been signed by mark (X), two witnesses
[3504]who know the person must sign below, giving their full addresses.
[3506]1. NAME - . g
[3507]Mle . foerin 2th Prskewe a
[3509]ADDRESS /Street number, City, State and ZIP Code) SIGNATURE OF CO-PAYEE/Both husband and wife must sign If co é
[3510]payees of a combined check) i
[3511]733 Tock; fsdatie cl ;
[3513]2. NAME RESIDENCE NUMBER AND STREET
[3515]ADDRESS (Street number, City, State and ZIP Code) City, STATE AND ZIP CODE
[3517]DAY “Mou Day, and Yeer) TELEpP ONE NUMBER
[3518]y on Up ‘ 6 .
[3519]Geely 6 GEG JAD -f> C720
[3521]# U. S, GOVERNMENT PRINTING OFFICE : 1967 O- 265-973
[3523]NW 68326 Docld:32245128 Page 52
[3525]Do eliarilscv7 LORE S PSO 0 !
[3527]. . Department of
[3528]Form OA-C107 (5-64) o DETERMINATION OF Health, Education, and Welfare
[3529]Hanne Mae rs Comptroller General, U.S. a RESUMPTION OF AWARD é : "Social Security Administration
[3531]DISTRICT OFFICE
[3533]Big RAWLINS ST)
[3534]RAECCAS j;§ TE
[3536]THE FOLLOWING DETERMINATION IS BASED ON SUPPORTING EVIDENCE ON FILE AN
[3538]MAEIVA WW POR TERA
[3539]5. RONWA BR
[3541]RICHARASON , TX 75630
[3543]ACCOUNT NUMBER
[3545]Lana
[3547]ERTIFICATION OF PAYMENT IS RECOMMENDED AS FOLLOWS:
[3548]FOR MINOR CHILDREN OF :
[3550]a“
[3552]GUARDIAN OF
[3554]CJ 1. TEMPORARY DEDUCTIONS EMPLOYED, oe
[3556]aL
[3558]t
[3559]Lo ; “
[3560]2. PERMANENT DEDUCTIONS EMPLOYED
[3562]on, CHARGEABLE, \ TOTAL
[3563]fyexce 3 ( g O EXCESS iy \ © 6 MONTHLY 0, ae
[3564]EARNINGS s ARNENGS $ EARNINGS $5, BENEFIT{S] $
[3566]| oO MOTHER HAS A CHILD IN
[3567]3. EMPLOYED OUTSIOE THE U.S. 4. HER CARE BEGINNING
[3568]ty HAS BEEN DETERMINED THAT THE ABOVE AGE 65. TO CORRECT NAME. oR SOCIAL
[3569]QJ S. Penson Is NOW THE PROPER PAYEE. im 6. RECOMP. im Je SECURITY ccol 8, NEW ADDRESS
[3570]ue 202 (T) Exc
[3571]ATTAINED TO COMBINE
[3572]CJ 9. AGE 72 10. A & B BENEFITS 11. OTHER AG anal
[3574]of ¥ CONDITIONA
[3575]N¢ onty B i Cl AWARD C] ADJUSTMENT C] SUPP L/S L FOLDER
[3577]ADJUSTMENT REFERENCE
[3579]$8 7(31307aN\C Vy. sol suse) kus (40.30) ies-ales,
[3581]MONTHLY BENEF| ACCRUED BENEFIT arene
[3582]PMT. | SEN,
[3584]. PERIOD | errectve |
[3585]CODE | CODE . AMOUNT [rem [| AMOUNT
[3586]Se \
[3587]| 40) < ess, oS iGT.00
[3589]NET
[3590]AMOUNT
[3592]DUE
[3595]fe
[3596]oO
[3598]a | ~ ABS CS
[3601]Department of
[3603]Form OA-C107 (2-64) ler G L Us DETERMINATION OF Health, Ee cation. and Welfore
[3604]orm Ppprove y omptro er eneral, ave Oca ecurity ministration
[3605]Janvory 28, 1955 RESUMPTION OF AWARD
[3607]DISTRICT OFFICE . CLAIM NUMBER
[3608]3716 Rawlins St.
[3610]Dallas, Tex, 75219 433-5)-3937
[3612]THE FOLLOWING DETERMINATION IS BASED ON SUPPORTING EVIDENCE ON FILE AND CERTIFICATION OF PAYMENT IS RECOMMENDED AS FOLLOWS:
[3613]FOR MINOR CHILDREN OF
[3615]4.
[3617]NAME AND ADDRESS
[3619]FOR
[3620]Marina N, Oswald
[3621]629 Belt Line Rd, [GUARDIAN OF
[3622]Richardson, Tex. 75080
[3624]9/64 ON (Partial)
[3626][x] 1. TEMPORARY DEDUCTIONS E EMPLOYED
[3628]im 2. PERMANENT DEDUCTIONS EMPLOYED
[3630]TOTAL CHARGEABLE TOTAL ’
[3631]TOTAL EXCESS EXCESS id MONTE. #
[3632]BENEF tre |
[3634]EARNINGS $ EARNINGS $ EARNINGS $ _
[3636]MOTHER HAS A CHILD iN
[3637]3. EMPLOYED OUTSIDE THE U.S. 4. HER CARE BEGINNING
[3639]LTHAS BEEN DETERMINED THAT THE ABOVE AGE 65, TO CORRECT NAME OR SOCIAL {=|
[3640]5S. PERSON IS NOW THE PROPER PAYEE. 6. RECOMP. 7. SECURITY ACCOUNT NO, 8. NEW ADDRESS
[3641]ATTAINED TO COMBINE —— 202 (T) Exc
[3642]9. AGE 72 10. A&B BENEFITS 11. OTHER
[3643]ONE CHECK . CONDITIONAL FOLDER
[3644]ONLY [] A- Cy AWARD ADJUSTMENT | SUPP L/S ADJUSTMENT im REFERENCE
[3645]BENEFICIARY NOTICE:
[3647]MONTHLY BENEFIT ACCRUED BENEFIT DEDUCTIONS |
[3648]PMT. |BEN. A Ww NET
[3649]IDEN.HDEN. PERIOD EFFECTIVE AMOUNT
[3650]covr|cone| pate | Rate. AMOUNT AMOUNT ry DUE
[3651]FROM TO FROM TO DB Cc
[3653]E 37.60 9/6) 9/6, | 37.60
[3654]E 37.50 | AK 37.50
[3655]E | 20/64 31eh0 | 9/64 9/6, | 31.40 2) 31.30
[3657]| 1
[3659]ms
[3662]oT r F
[3663]REMARKS aa ; J
[3664]"71.00 AA=Excess refund received on
[3665]MA. 106460 Schedule #7, dtd. 10/15/6h
[3669]C2 37,60
[3671]C1-37.60 — 37 CC B8Kog
[3673]PREPARED BY-EXAMINER
[3675]“A / Lif F °
[3676]Nw esaze- picld:d2245128 Page 54
[3678]cco entintanen eine Ne Ate Nn eke Ea Sante AE MN a et actenrcenpmetens onan tale Ls tendencies teehee
[3680]Form OA-C107 (5-64) rf DETERMINATION OF
[3682]Department of
[3683]Health, Education, and Welfare
[3684]Form Approved by Comptroller General, U.S * en Socig! Security Administration
[3685]Januvory 28, 1955 RESUMPTION OF AWARD
[3687]DISTRICT OFFICE
[3689]THE FOLLOWING DETERMINATION IS 5 jPASED ON SUPPORTING EVIDENCE ON FILE AND CERTIFICATION OF PAYMENT 1S RECOMMENDED AS FOLLOWS!
[3691]Ma FI WD W D5wako | | aoa CHILDREN OF .
[3693]FOR
[3695]‘TCUARDIAN OF
[3697]x 1. TEMPORARY DEDUCTIONS Z EMPLOYED Vos On/ (press)
[3698]Gal 2 renmanens DEDUCTIONS &: EMPLOYED We f— LY os (pad (44 a
[3700]G pores °“-*®RGEABLE POLY ZS. .
[3701]TOTAL Fg ; 2 ACESS “CEES 7 L, y MON “7
[3702]EARNINGS $ 779 oF EARNINGS $ LARNINGS $ © BENEFITS) $ ‘ 2o
[3704]MOTHER HAS A CHILD IN
[3705]3 EMPLOYED OUTSIDE THE U. S. 4. HER CARE BEGINNING
[3706][J IT HAS SEEN DETERMINED THAT THE ABOVE AGE 65, TO CORRECT NAME OR SOCIAL C
[3707]S. PERSON IS NOW THE PROPER PAYEE. 6. RECOMP. 7. SECURITY ACCOUNT NO. . 8B. NEW ADDRESS
[3708]ATTAINED qo COMBINE —_- 202 (T) Exc
[3709]9. AGE 72_. 10. BENEFITS 11, OTHER
[3711]ONE CHECK
[3712]ONLY A-
[3714]WL
[3716]MONTHLY BENEFIT
[3718]CONDITIONAL
[3719]im AWARD Cl ADJUSTMENT | SUPP L/S ADJUSTMENT
[3721]ACCRUED BENEFIT . DEDUCTIONS
[3723]PMT. | BEN.
[3724]IDEN.|IDEN. BEGIN.
[3725]CONDE |CODE DATE
[3727]PERIOD EFFECTIVE
[3729]AMOUNT AMOUNT
[3731]MONTHLY
[3732]RATE
[3734]REMARKS
[3736]PIA 7/,00
[3738]NW 88326 Docid:32245128 Page 55
[3740]j
[3742]ce BRA tA arAae alge hn ened cae ania ina tele TER LN eS Meena net a NA ash mee Se Belt rere cee cad mene ceimanemene
[3744]FORM OA-C528b (4-64) EC
[3746]DISTRICT OFFICE
[3747]DETERMINATION OF
[3749].) CLAIM NO. PIC
[3750]TERMINATION OF ENTITLEMENT ‘is 4 54 -3937-E E
[3752]WwW. E.
[3756]& . : OR SUSPENSION OF PAYMENTS
[3757]BASED ON SUPPORTING EVIDENCE ON FILE
[3761]Marina N. Oswald | B= 2.08 JUN 65 KC
[3763]DATE OF BIRTH
[3767]INITIALS
[3771]PAYEE FILE
[3773]Le MONTHLY RATE SHOULD wave BEEN {SHOULD BE) STOPPED we
[3774]ks 31.40 6/65 DIARY FILE
[3776]® SPA LAST SCHED. NO. TREASURY REQUESTED TO DISCONTINUE PAYMENT CROSS-REF.
[3777]9A 6/65 ACCOUNT No.
[3779]0. Investigation pending determ. of cont. disability (_] 4. Failure to have a child entitled C 7. Refused VR Services
[3780]1. Worked outside the United States to benefits in your care O 8. Payee not determined
[3781]2. Worked and expects net earnings to exceed ["] 5. OAIB worked outside the Ole.
[3783]$1200 United States
[3785]3. OAIB worked and expects net earnings to exceed
[3787]$1200 me, LAS yr frle a bye;
[3789]Oo oo0
[3792]a (Clerk) ~~ ates (Reviewer) Date)
[3793][1 o. Benefits payable by some other agency (7 6. Death Marriage of child
[3794]® [] 1. Death of beneficiary ©
[3795]OO 2. Dependent terminated due to death of insured individual . ( 7C. Adoption
[3796]x] 3. Siewesxoxdoniege 4 Remarriage L] 7. Adoption of child
[3797]2 CO 4¢. Attained age 18 and not disabled f ] [ é
[3798]( 4. Child attained age 18 and not disabled ] [] 8H. DIB no longer disabled
[3799]® () 5. Beneficiary entitled to other benefits C 8. Mother terminated- le
[3800]2 (J 6C. Child no longer disabled Child no longer disabled iy
[3801]. CL s. ( X. DIB attained age 65 $
[3803](J RB. Claim withdrawn
[3805]rN
[3807]MONTE f+ reggremaannegagEn ae coe emcemeem! ceeqmaenn neeee + AOR Mesa erp See amen mee . nee a
[3809]peste ry lent tae 8 eather een eee age
[3811]NW 60326 Doeld:32245128 Page 56
[3813]wn Rane ee a Ee eg ke haere
[3815]FORM OA-C528b (4-64) KC
[3816]_ DISTRICT OFFICE
[3817]: DETERMINATION OF
[3819]TERMINATION OF ENTITLEMENT
[3821]OR SUSPENSION OF PAYMENTS
[3822]BASED ON SUPPORTING EVIDENCE ON FILE
[3824]ADJMT. CODING
[3826]A
[3828]CR. BLOCK NO.
[3830]Marina N. Oswald
[3832]PAYEE FILE
[3834]MONTHLY RATE SHOULD HAVE BEEN (SHOULO BE) STOPPED
[3836]DIARY FILE
[3838]DATE OF BIRTH
[3840]|
[3842]LAST SCHED. NO. TREASURY REQUESTED TO DISCONTINUE PAYMENT
[3844]9A 10/64
[3846]CROSS-REF.
[3847]ACCOUNT NO.
[3849](J 4. Failure to have a child entitled
[3850]to benefits in your care
[3852]C1 5. OAIB worked outside the
[3853]United States
[3855]Do. Investigation pending determ. of cont. disability
[3856]OD 1, Worked outside the United States
[3858](1) 2. Worked and expects net earings to exceed
[3859]$1200
[3861](CD 3. OAB worked and expects net earnings to exceed
[3862]$1200
[3864](] 0. Benefits payable by some other agency
[3866](1 1. Death of beneficiary
[3868]OD 2. Dependent terminated due to death of insured individual
[3870]0 3. Divorce Marriage Remarriage
[3872]UO) 4c. Anained age 18 and not disabled :
[3874]CD 4. Child attained age 18 and not disabled ]
[3876]Os. Beneficiary entitled to other benefits
[3878][J 6C. Child no longer disabled
[3879]Os.
[3881]TN pete ste eee Se ebtmen smal
[3883]NW 88326 Dochd:32245128 Page 57 ‘
[3885]--- Fed -; , tL
[3887]C] 7. Refused VR Services
[3888](J 2. Payee not determined .
[3890]Os.
[3892][] 6. Death Marriage of child
[3894]7C. Adoption
[3895]7. Adoption of child
[3897]{[] 8H. DIB no longer disabled
[3898]8. Mother terminated-
[3900]X. DIB attained age 65
[3902]. Claim withdrawn
[3904]- Lb ep sa
[3906]Child no longer disabled .
[3909]Se a TO EE ERE PRE So,
[3911]PREVIOUS DISTRICT OFFICE NEW DISTRICT OFFICE
[3913]DEPARTMENT OF
[3915]‘ HEALTH. EDUCATION. AND WELFARE
[3917]4 . SOCIAL SECURITY ADMINISTRATION &@
[3918]' PAYEE, ADDRESS CHANGE, OR HOLD CHECK REQUEST
[3920]5/1 SP. = _ s :
[3921]: | Marina N Oswald © 433 54 3037 B
[3923]+ {TR “1 CODE
[3925]i fae cone _ 12h5 Donna Pr
[3927]‘| OA Us Richardson Tex 75080
[3929]; ADDRESS CHANGE
[3931]i | [J HOLD ck patep________
[3933]i PAYEE CHANGE
[3934]REPLACE CK DATED 6/3/65 %
[3935]DRAWN PAYABLE TO
[3937]Mariana N Oswald
[3939]FORM OA-C610 (2-64) FILE COPY
[3940]av)
[3942]NW 68326 Docid:32245128 Page 58 .
[3944]DEPARTMENT OF
[3945]HEALTH. EDUCATION, AND WELFARE
[3947]NEW DISTRICT OFFICE
[3949]SOCIAL SECURITY ADMINISTRATION ST tS RAH SST
[3950]PAYEE, ADDRESS CHANGE, OR HOLD CHECK REQUEST
[3952]DATE WAGE EARNER . PIC . CLAIM NO.
[3954]O5/05/65 06 °
[3955]FLOA LLOA MBA .
[3957]> | 3 | C20 naan 433 54 3937 E
[3958]TR FILE CODE cLc 3 & C CODE o br] A hid N OSWALD
[3960]GHA Ys WSFIOW, 1245 DONNA DR
[3962]MariadA Y Oswate penyrecten
[3965]FORM OA-C610B (6-64) FILE COPY ,
[3967]-| (7) appress CHANGE RICKARDSON TEX ————— 75080 y é a
[3968](J Hotp cK DATED . a oy
[3969]Diravee CHANGE . ; z\
[3971]REPLACE CK DATED
[3972]DRAWN PAYABLE TO——————— . .
[3974]eee ene cere yee i en AG A TRC
[3976]NW 88326 Docld:32245128 Page 59
[3979]US DISTRICT OFFICE
[3981]DEPARTMENT OF NEW DISTRICT OFFICE
[3982]HEALTH, EDUCATION, AND WELFARE —
[3984]SociaAL SECURITY ADMINISTRATION "4
[3985]PAYEE, ADDRESS CHANGE, OR HOLD CHECK REQUEST
[3987]he3-6k
[3989]WAGE EARNER
[3991]iy | es760 | Marina N Oswald 433 54 3937 E
[3993]CODE cic
[3994]A.
[3996]DRESS CHANGE
[3997]-D CK DATED
[3998]‘EE CHANGE
[4000]*7LACE CK DATED
[4001]AWN PAYABLE TO
[4003][p=°) 629 Belt Line
[4004]ths Richardson Tex 75080
[4006]A-C610 (6.63)
[4008]NW 60326 Docld:32245128 Page 60
[4010]FILE COPY
[4013]Form OA-C526 (1-61) y ry
[4014]( -i
[4015]BENEFIT SUMMARY 7 Department of Health, Education, and Welfare
[4018]——— Form approved by Social Security Administration
[4019]Comptroller General, U. S., October 25, 1950 Bureau of Old-Age and Survivors Insurance
[4020]CLASS OF ACTION ACCOUNT NUMBER
[4021]'
[4022]FFF —fY- 3937
[4023]MONTHLY BENEFIT ACCRUED BENEFIT DEDUCTIONS
[4024]IDEN. DEN. 6 NET
[4025]-| IDEN, PERIOD EFFECTIVE R w AMOU
[4026]CODE|cope| BEGIN. |MONTHLY |_______) AMOUNT AMOUNT F 1 DUE
[4027]DATE RATE FROM D c
[4030]E Ye 3760 153 | Wet | 1.2.86
[4031]Z| | ___ (413.0 AS. 213.00 396-96
[4033]ei “Ne | 9s:90| Yea Yo 2AFLO || 22560
[4035]|
[4037]REMARKS
[4039]era)
[4041]137 P74KCFEB
[4043]CLERK DATE REVIEWER DATE
[4045]Fr Ewbof af fee I? (Like aa C7
[4047]ve U.S. GOVERNMENT PRINTING OFFICE: 1962-666121
[4049]NW 60226 Docid:32245128 Page 61
[4051]Fer Off -CvYO/ Desermi aateon ie Award
[4053]oo Form approved by Comptrofier Generarr wes ee ep eu eee ee .
[4054]January 23, 1958 resem tem temd ee  aee
[4055]RSE RISO | ToaTE:
[4056]Lee H Oswald RACE we NTP! 10/19/39 | 11/2/63
[4057]2. REQUIRED QTRS. HAS AT LEAST CURRENT QTRS. | 3. First Base Yr. Or Starting Date LAST BASE YR. OR CLOSING DATE] 4. LUMP SUM AMOUNT
[4058]6 1951 1963 213.00
[4059]5. TOTAL EARNINGS DISABILITY PERIOD EXCLUDED ELARSED VRS OR DIVISOR INCREMENTS PRIMARY AMOUNT
[4061]& NAME DATE OF | DATE CLAIM | ORIGINAL ANY OTHER | ADJUSTED RELATIVES ACCT.
[4062]SYMBOL BIRTH FILED BENEFIT BENEFITS BENEFIT NUMBER (IF ANY)
[4063]GL 7/17/41 | /9/6h
[4064]E " 53.430 37.60 ge fg Fe
[4065]c2 | June L . | 2/15/62 53.30 -60
[4066]Cl | Audrey M 10/20/63 53.30 60
[4068]7, MAXIMUM PAYABLE
[4070]REMAINS UNPAID
[4072]8. REIMBURSABLE F. H. EXPENSES ARE PAID AS FOLLOWS
[4074]Tl. REMARKS | 0.0. CODE
[4075]3716 Rawlins St 814
[4076]Dallas Tex 75219
[4078]X87 PZ7AXCFEB
[4080]12. CERTIFICATION OF PAYMENT ENTE ENT MONTHLY LUMP-SUM
[4081]MONTHLY GEATH
[4082]TO, MONTH BENEFIT PAYMENT
[4084]BENEFITS
[4086]slaimant or as representative of the claimant
[4088]Symbol Name and address of payee as *-
[4090]ge |'Marina N Oswald 11/63 | 37.60 | 213.00
[4092]Bx 11,07 .
[4094]Grand Prairie Tex 75050
[4096]Marina N Oswald for minor children of L H Oswald 11/63 | 75.20
[4098]Pursuant to lawfully delegated authority, | certify that, on application by { certify that pursuant to lawfully delegated authority | have verified the
[4099]or on behalf of the claimant(s) named above as payee(s) and the supporting above statements with the supporting evidence on file in this office; that t
[4100]evidence forwarded herewith, the foregoing statements are my determination have computed aft ae in and fat Sah marten a showns and that ou
[4101]vei ' . . . ne fitis, in accordanca Avi ‘ovisions tie of the
[4103]of fact and decisions as tg-fhe benefit(s) to be paid as indicated. Social a a ;
[4105]By. Ze * ? Approved. S. ‘ " tren
[4107](Claims Representative) 1/16/64 (Claims Authorizer) a
[4108]Dates . Date.
[4110]NW 88326 Docid" age G2 WaPo 1962-36878
[4112]FAMILY
[4114]ACCOUNT NUMBER .- mo
[4115]. o MAXIMUM |
[4117]me oe
[4119]433-54 3937, | o9765R \
[4120]oe, @
[4121]BENEFICIARY'S NAME MONTNY RATE
[4122]@ oSwacp AUDREY 57.009
[4123]01 37,60 01 37,68 01 53.30
[4127]PD 3.70 PD 3.70
[4130]OSWALD JUNE 57.00
[4131]e 01 37,60 O01 37.60 O14 37.660) 04 37,60 O14 37.60 Of 53.30@
[4132]PD 2.70, PD. 2.70, PD 2.70 PD 2.70 PD 2.70 PD 3.70
[4134]01 53.30 04 53.30
[4135]PD 3.70 PD 3.70 oye
[4136]@ 57,00. . 57.00 oe ©
[4137]e TOTAL PAYMENT AMOUNT 49.2 114.00
[4138]‘OSWALD MARINA N & ec T3 10.0 33.40
[4139]e 24 $1+4q 21 34640 24 3416406 24 31-40 21 34.40 TO 31.40 @
[4140]PD 2.00 PD 2-08 Pp 2.00 PD 2.00 FD 2.600 NP 2.00
[4142]e
[4144]e@ )
[4147]Cc a | , ' iwereaee R Ww B OLD MBA R Ww B ; OLD MBA R | w B&B OLD MBA Ww B OLD MBA R Ww B OLD MBA co
[4148]In F i P INCREASE NCREA i] P INCREASE P INCREAS! F ! P i] ASE 7
[4149]o c fay NEW MBA Le] c D NEW MBA 4 c i" NeW MDA ble ie] NEW MBA 4 BD NEW Mon c B new won ‘ :
[4150]7 renw OA-C596 5-05) 1965 CONVERSION OF BENEFIT RATES
[4152]"NW 88326 Docld:32245128 Page 63
[4154]! oe
[4156]DEPARTMENT OF
[4157]HEALTH, EDUCATION, AND WEL FARE
[4158]SOCIAL SECURITY ADMINISTRATION
[4160]APPOINTMENT OF REPRESENTATIVE
[4162]Llili sentative)
[4164]sentative with respect to my claim under the Social Security Act, based on the eamings record of
[4166]I appoint ate fO act as my repre:
[4168]Lee Harvey Oswald cecccseessetseessteey tosses 4330 54=3937
[4170]a “(fame o: of wage earner or ‘pelt employed “individual) (Social security account number)
[4172]The above-named representative is authorized to obtain from the Administration informa
[4174]tion conceming my claim; and it is understood that any notice - ““quest sent to him shall have
[4176]the same force and effect as if sent to me.
[4178]Ades. om tung waging MC Csurahee
[4180]Serene nee nee (Signature)
[4182](Address)
[4184]ss) ACCEPTANCE OF APPOINTHENT
[4186]T accept the above appointment. I am a person in good standing in my community and I am
[4188]able to assist and advise the above party in this case.
[4190]“(Union representative, relative, etc.)
[4192]~ “(Addreas)
[4194](SEE REVERSE SIDE FOR REGULATIONS AS TO FEES OF REPRESENTATIVES FOR SERVICES TOA
[4195]PARTY AND INFORMATION ON CONFLICT OF INTEREST)
[4197]Form AC-512
[4198](3-60)
[4200]NW 88326 Docid:32245128 Page 64
[4202]9 pe gros
[4204]Form OAC-5002
[4205](1-64)
[4207]REPORT OF CONTACT
[4209](USE INK OR TYPEWRITER)
[4211]W/E OR S/E aa She ve, litevath Mh 23 sh - 3 93 7
[4212]NAME AND ADDRESS OF PERSON(S) CONTA£TED:
[4213]Fp, he meter 2¢-, Plhativ) ~ Cowen
[4214]2
[4216]¢ ij Ugiaett. eee? FU A (ee eh ’ Loe Le '
[4217]CONTACT MADE: fi PLACE OF CONTACT LA
[4218]IN PERSON hd TELEPHONE im Sen
[4219]ee Miseuterhe Pte aw, (LAE AAA
[4221]Low FES eae f ) Ate
[4222]1LC [le LUirk, Ake peat LR: =
[4224]eS fet a abs, Lifoge Leelee
[4226]SD fil BE os han L aagh-
[4228]Aa Leth, FEL fs IVER bh hack
[4229]Eigse /
[4231]CONTACT MADE e uae Beaites am y Grd ‘
[4232]Lo (SIGNATURE) (TITLE)
[4234](FOR CONTINUATION OF THIS REPORT. TURN PAGE. KEEP MARGINAL SPACE AT RIGHT FOR BINDING)
[4236]U, S. GOVERNMENT PRINTING OFFICE : 1958 © -486513
[4238]NW’ 80326 Docid:32245128 Page-Gi-erser wee rs ree
[4241]Form OAC-5002
[4242](1-64)
[4244]REPORT OF CONTACT OFFICE:
[4246](USE INK OR TYPEWRITER)
[4248]DATE:
[4250]W/E OR S/E PERSON AN
[4252]NAME AND ADDRESS OF PERSON(S) CONTACTED:
[4256]PLACE OF CONTACT:
[4258]CONTACT MADE:
[4259]IN PERSON C] TELEPHONE C ~
[4261]fe Ge AeCLe, = genta —
[4263]4
[4265]a ie
[4267]Maz a) ableonaruke
[4268]Thee,
[4270]a)
[4272]tity Lhewt Zhe
[4274](TITLE)
[4276]TGNATURE)
[4278](FOR CONTINUATION OF THIS REPORT. TURN PAGE. KEEP MARGINAL SPACE AT RIGHT FOR BINDING)
[4280]U. S. GOVERNMENT PRINTING OFFICE ;: 1958 O.- 486513
[4282]NW 88326 _Docld:32245128 Page 66 __ 4 a