104 10129 10002

14-00000 104-10129-10002 2025 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992

DO NOT USE THIS SPACE ISSUED BY

PERSONAL HISTORY STATEMENT INSTRUCTIONS

THIS DATE (Fill In) AUGUST 31, 1961

  1. Answer all questions completely or check appropriate box. If question is not applicable, write "NA". Write "Un- known" only if you do not know the answer and it cannot be obtained from personal records. Use blank space at end of form for extra details on any question for which you have insufficient space.

  2. Type, print or write carefully; illegible or incomplete forms will not receive consideration.

  3. Consider your answers carefully. Your signature at the end of this form will certify to their correctness. Careful completion of all applicable questions will permit review of your qualifications to the best advantage.

SECTION I GENERAL PERSONAL AND PHYSICAL DATA

  1. FULL NAME (Last-First-Middle) 2. AGE 3. SEX

RODRIGUEZ, EMILIO AMERICO 33 YEARS & MONTHSX MALE FEMALE

  1. HEIGHT 5. WEIGHT 6. COLOR OF EYES 7. COLOR OF HAIR 8. TYPE COMPLEXION 9. TYPE BUILD

5FT. 10IN. 150165. BROWN BLACK RUDDY MEDIUM

  1. SCARS (Type and Location)

NONE

  1. OTHER DISTINGUSHING PHYSICAL FEATURES

NONE

  1. CURRENT ADDRESS (No., Street, City, Zone, State and Country) 13. PERMANENT ADDRESS (No., Street, City, Zone, State and Country) AND PHONE NO. 9361 S.W. 178 ST. PHONE: 9361 S.W. 178ST. PERRINE 57, FLA. PERRINE 57, FLA. (CEDAR S-8341 4.S. A. 4. S. A.

  2. CURRENT PHONE NO. 15. OFFICE PHONE NO. & EXT. 16. LEGAL RESIDENCE (State, Territory or Country)

CEDAR 5-8341 NA FLORIDA 4.S.A.

  1. NICKNAMES 18. OTHER NAMES YOU HAVE USED

NONE EUGENIO GONZALEZ

  1. INDICATE CIRCUMSTANCES (Including Length of Time) UNDER WHICH YOU HAVE EVER USED THESE NAMES.

FROM APRIL 1960 TO PRESENT IN HAVANA, CUBA AND MIAMI, FLA. AS UNDERCOVER NAME

  1. IF LEGAL CHANGE, GIVE PARTICULARS (Where and by What Authority).

N.A.

SECTION ון POSITION DATA

  1. INDICATE THE TYPE OF WORK OR POSITION FOR WHICH YOU ARE APPLYING

CONTRACT AGENT

  1. INDICATE THE LOWEST ANNUAL ENTRANCE SALARY YOU WILL ACCEPT (You will not be considered for any position with a lower entrance salary). $ 9,600.00

  2. DATE AVAILABLE FOR EMPLOYMENT

CONTRACT ALREADY SIGNED

  1. INDICATE YOUR WILLINGNESS TO TRAVEL

OCCASIONALLY FREQUENTLY CONSTANTLY OTHER:

  1. INDICATE YOUR WILLINGNESS TO ACCEPT ASSIGNMENT IN THE FOLLOWING LOCATIONS (Check (X) each item applicable)

WASHINGTON, D.C. X ANYWHERE IN U.S. X CERTAIN LOCATIONS ONLY (Specify):

OUTSIDE CONTINENTAL U.s.

  1. INDICATE WHAT RESERVATIONS YOU WOULD PLACE ON ASSIGNMENTS OUTSIDE THE WASHINGTON, D.C. AREA.

ADEQUATE PAY AND LIVING CONDITIONS FOR SELF AND FAMILY

FORM 444 USE PREVIOUS EDITION. 11-56 -١٠ (4)

14-00000 -2- SECTION INN CITIZENSHIP

  1. DATE OF BIRTH 2. PLACE OF BIRTH (City, State, Country) 3. PRESENT CITIZENSHIP (Country)

JAN. 27,1928. HAVANA, CUBA U.S.A.

  1. CITIZENSHIP ACQUIRED BY 5. DATE NATURAL- 6. NATURALIZATION CERTIFICATE NO.

BIRTH MARRIAGE XOTHER (Specify): NATURAL IZED DECEMBER 15, 1949 #6799255)

  1. COURT ISSUING NATURALIZATION CERTIFICATE 8. ISSUED AT (City, State, Country)

4.S. DISTRICT COURT OF EASTERN DIST. OF LOUISIANA New ORLEANS, LA.

  1. HAVE YOU HELD PREVIOUS NATIONALITY 10. IF YES, GIVE NAME OF COUNTRY

XYES NO CUBA

  1. GIVE PARTICULARS CONCERNING PREVIOUS NATIONALITY.

CUBAN BY BIRTH

  1. HAVE YOU TAKEN STEPS TO CHANGE YES 13. GIVE PARTICULARS PRESENT CITIZENSHIP Ν.Α.

X NO

  1. IF YOU HAVE APPLIED FOR U.S. CITIZENSHIP, WHAT IS PRESENT STATUS OF YOUR APPLICATION (First Papers, Etc.)?

N. A.

  1. DATE OF ARRIVAL IN U.S. 16. PORT OF ENTRY 17. ON PASSPORT OF WHAT COUNTRY

JUNE6, 1961 MIAMI, FLA SWISS PROTECTIVE PASSPORT

  1. LAST U.S. VISA (No., Type, Place of Issue) 19. DATE VISA ISSUED

RESIDENT U.S. EMBASSY IN HAVANA, CUBA Nov. 1942 SECTION IV EDUCATION

  1. CHECK (X) HIGHEST LEVEL OF EDUCATION ATTAINED

LESS THAN HIGH SCHOOL GRADUATE OVER TWO YEARS OF COLLEGE NO DEGREE

HIGH SCHOOL GRADUATE BACHELOR'S DEGREE

TRADE, BUSINESS, OR COMMERCIAL SCHOOL GRADUATE GRADUATE STUDY LEADING TO HIGHER DEGREE

TWO YEARS COLLEGE OR LESS MASTER'S DEGREE DOCTOR'S DEGREE

  1. NAME OF ELEMENTARY SCHOOL 2. ELEMENTARY SCHOOL
  2. ADDRESS (City, State, Country)

COLEGIO DE LA SALLE HAVANA CUBA

  1. DATES ATTENDED (From-and-To) 4. GRADUATE

Sep. 1934 to Nov. 1942 X YES NO

  1. NAME OF HIGH SCHOOL 3. HIGH SCHOOL
  2. ADDRESS (City, State, Country)

ALCEE FORTIER HIGH SCHOOL NEW ORLEANS, LA.

  1. DATES ATTENDED (From-and-To) 4. GRADUATE

Nov. 1942 to June 1945 X YES NO

  1. NAME OF HIGH SCHOOL 2. ADDRESS (City, State, Country)

  2. DATES ATTENDED (From-and-To) 4. GRADUATE

YES NO

  1. COLLEGE OR UNIVERSITY STUDY

NAME AND LOCATION OF COLLEGE OR UNIVERSITY SUBJECT DATES ATTENDED DEGREE DATE SEM/QTR REC'D REC'D HOURS MAJOR MINOR FROM TO (Specify)

TULANE UNIVERSITY OF LOUISIANA Psychology Chemistry 1945 1948 B.S. Juve 1948 Sem has. Biology

TULANE UNIVERSITY OF LOUISIANA Spanish Portuguete 1949 1952 M.A. JUNE 1952 Sem hes.

TULANE UNIVERSITY OF LOUISIANA SPANISH French 1952 1954 NONE N.A. Sembas.

SECTION IV CONTINUED TO PAGE 3

14-00000 SECTION IV CONTINUED FROM PAGE 2

  1. IF A GRADUATE DEGREE HAS BEEN NOTED IN ITEM 4 WHICH REQUIRED SUBMISSION OF A WRITTEN THESIS, INDICATE THE TITLE OF THE THESIS AND BRIEFLY DESCRIBE ITS CONTENT. 5 ? EL EPITETO EN LAS OBRAS DE BERCEO (DO NOT REMEMBER EXACT TITLE). A DETAILED STUDY OF THE MANY USES OF THE EPITHET IN BERCEO'S WORKS, A 12TH CENTURY WPITER, INCLUDING A CROSS-REFERENCE LISTING OF ALL EPITHETS AS SHOWN IN HIS WRITINGS.

  2. TRADE, COMMERCIAL AND SPECIALIZED SCHOOLS NAME AND ADDRESS OF SCHOOL STUDY OR SPECIALIZATION FROM TO MONTHS

N.A.

  1. MILITARY TRAINING (FULL TIME DUTY IN SPECIALIZED SCHOOLS SUCH AS ORDNANCE, INTELLIGENCE, COMMUNICATIONS, ETC.) NAME AND ADDRESS OF SCHOOL STUDY OR SPECIALIZATION FROM TO MONTHS

N.A

  1. OTHER EDUCATIONAL TRAINING NOT INDICATED ABOVE.

N.A.

SECTION V FOREIGN LANGUAGE ABILITIES

  1. LANGUAGE COMPETENCE IN ORDER LISTED HOW ACQUIRED R-Read, W-Write, S-Speak

(List below each language in EQUIV- which you possess any degree ALENT FLUENT ADEQUATE ADEQUATE LIMITED PRO- CONTACT ACADEMIC of competence. Indicate your TO BUT FOR FOR KNOW- NATIVE OF LONGED STUDY (all proficiency to Read, Write or NATIVE OBVIOUSLY RESEARCH TRAVEL LEDGE COUNTRY RES- (with levels) Speak by placing a check (X) FOREIGN IDENCE parents, in the appropriate box(es). R W S R W S R W S R W S R W S etc.)

Spanish XX PORTUGUESE XX

FRENCH XX

ITALIAN XX

  1. IF YOU HAVE CHECKED "ACADEMIC STUDY" UNDER "HOW ACQUIRED", INDICATE LENGTH AND INTENSIVENESS OF STUDY.

FROM 1949 to 1954 STUDIED THE ROMANCE LANGUAGES AT THE GRADUATE LEVEL

  1. IF YOU HAVE INDICATED FLUENCY FOR A LANGUAGE HAVING SIGNIFICANT DIFFERENCES IN SPOKEN AND WRITTEN FORM, EX- PLAIN YOUR COMPETENCE THEREIN.

N.A.

  1. DESCRIBE YOUR ABILITY TO DO SPECIALIZED LANGUAGE WORK INVOLVING VOCABULARIES AND TERMINOLOGY IN THE SCIEN- TIFIC, ENGINEERING, TELECOMMUNICATIONS, MILITARY, AND OTHER SPECIALIZED FIELDS.

FAMILIAR WITH SCIENTIFIC AND ENGINEERING TERMINOLOGY IN SPANISH.

  1. IF YOU HAVE NOTED A PROFICIENCY IN LANGUAGE, WOULD YOU BE WILLING TO USE THIS ABILITY IN ANY POSITION FOR WHICH YOU MIGHT BE SELECTED? YES NO -3-

14-00000 -4- SECTION VI GEOGRAPHIC AREA KNOWLEDGE AND FOREIGN TRAVEL

  1. LIST BELOW ANY FOREIGN REGIONS OR COUNTRIES IN WHICH YOU HAVE TRAVELLED OR GAINED KNOWLEDGE AS A RESULT OF RESIDENCE, STUDY OR WORK ASSIGNMENT. INDICATE TYPE OF KNOWLEDGE SUCH AS TERRAIN, HARBORS, UTILITIES, RAIL- ROADS, INDUSTRIES, POLITICAL PARTIES, ETC.

NAME OF TYPE OF DATES OF DATES AND KNOWLEDGE ACQUIRED BY REGION OR COUNTRY SPECIALIZED KNOWLEDGE RESIDENCE PLACE OF STUDY RESI- WORK OR TRAVEL DENCE TRAVEL STUDY ASSIGN MENT CUBA HAVANA + VECINITY. POLITICAL N.A. ECONOMIC SOCIAL STRUCTURE. COMMERCE-IMPORTATIONS. 1954-1961

  1. INDICATE THE PURPOSE OF VISIT, RESIDENCE, OR TRAVEL IN EACH OF THE REGIONS OR COUNTRIES LISTED ABOVE.

To Work AS ASSISTANT DISTRICT MANAGER FOR Century Electric Co., IN change. of their HAVANA Office, IN HAVANA, Cuba. LATER REMAINED IN Cuba FROM MARCH 9960 to June 1961 AS 18. UNITED STATES PASSPORT NUMBER AND EXPIRATION DATE, IF ISSUED.

PASS. N№: 1095961 Expired: Sept. 2 1960 (NOT RENewed) SECTION VII TYPING AND STENOGRAPHIC SKILLS PRINcipal Agent for C.I.A...

  1. TYPING (wpm) 2. SHORTHAND (wpm) 3. SHORTHAND SYSTEM USED CHECK (X) APPROPRIATE ITEM

50 Ν.Α. GREGG SPEEDWRITING STENOTYPE OTHER (Specify):

  1. INDICATE OTHER BUSINESS MACHINES WITH WHICH YOU HAVE HAD OPERATING EXPERIENCE OR TRAINING (Comptometer, Mimeograph, Card Punch, Etc.). MIMEOGRAPH, ADDING MACHINE, CALCULATOR, DICTATING MACHINE

SECTION VIII SPECIAL QUALIFICATIONS

  1. LIST ALL HOBBIES AND SPORTS IN WHICH YOU ARE ACTIVE OR HAVE ACTIVELY PARTICIPATED. INDICATE YOUR PROFICIENCY IN EACH.

FISHING, HUNTING, SWIMMING (GOOD UNDERWATER RESISTANCE), PHOTOGRAPHY (BLACK & WHITE AND COLOR), MUSICAL(PLAY SEVERAL INSTRUMENTS BY EAR), FLYING, Bowling, Chess.

Average IN ALL OF THE ABOVE.

  1. INDICATE ANY SPECIAL QUALIFICATIONS RESULTING FROM EXPERIENCE OR TRAINING WHICH MIGHT FIT YOU FOR A PARTICULAR POSITION OR TYPE OF WORK.

TEACHING AND ADMINISTRATIVE EXPERIENCE SECURED AT THE UNIVERSITY LEVEL AND IN FOREIGN TRADE MANAGEMENT RESPECTIVELY. ALSO CAPACITY TO CARRY OUT IN DE PENDENT RESEARCH AT THE GRADUATE LEVEL.

  1. EXCLUDING BUSINESS EQUIPMENT OR MACHINES WHICH YOU MAY HAVE LISTED IN ITEM 2, SECTION VII, LIST ANY SPECIAL SKILLS YOU POSSESS RELATING TO OTHER EQUIPMENT AND MACHINES SUCH AS OPERATION OF SHORTWAVE RADIO (Indi- cate CW speed, sending and receiving), OFFSET PRESS, TURRET LATHE, SCIENTIFIC AND PROFESSIONAL DEVICES.

FAMILIAR WITH GENERAL SCIENTIFIC APPARATUS AS MAY BE PRESENT IN A MEDICAL RESEARCH LABORATORY. BECKMAN Spectophotometry.

(DID ONE YEAR RESEARCH AT TULANE MEDICAL SCHOOL))

: SECTION VIII CONTINUED TO PAGE 5

14-00000 SECTION VIII CONTINUED FROM PAGE 4

  1. ARE YOU NOW OR HAVE YOU EVER BEEN A LICENSED OR CERTIFIED MEMBER OF ANY TRADE OR PROFESSION, SUCH AS PILOT, ELECTRICIAN, RADIO OPERATOR, TEACHER, LAWYER, CPA, MEDICAL TECHNICIAN, ETC.? YES NO

  2. IF YOU HAVE ANSWERED "YES" TO ABOVE, INDICATE KIND OF LICENSE AND STATE ISSUING LICENSE (Provide License Registry Number, if known).

Student Pilot Certificate N№S-293957)

  1. FIRST LICENSE OR CERTIFICATE (Year of Issue) 22. LATEST LICENSE OR CERTIFICATE (Year of Issue)

2-18-54 N.A.

  1. LIST ANY SIGNIFICANT PUBLISHED MATERIALS OF WHICH YOU ARE THE AUTHOR (Do NOT submit copies unless requested). INDICATE THE TITLE, PUBLICATION DATE, AND TYPE OF WRITING (Non-Fiction or Scientific articles, General Interest subjects, Novels, Short Stories, Etc.).

Ν.Α.

  1. INDICATE ANY DEVICES WHICH YOU HAVE INVENTED AND STATE WHETHER OR NOT THEY ARE PATENTED.

N.A.

  1. LIST PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE.

IN COLLEGE AND AS A JUNIOR EXECUTIVE IN FOREIGN TRADE

  1. LIST ANY PROFESSIONAL, ACADEMIC OR HONORARY ASSOCIATIONS OR SOCIETIES IN WHICH YOU ARE NOW OR WERE FORMERLY A MEMBER. LIST ACADEMIC HONORS YOU HAVE RECEIVED.

Phi Sigma IOTA, National Honor Society of Romance Languages.

American Association of Teachers of Spanish and Portuguese.

Graduate Scholarships offered by the state of Louisiana and Tulane. UNIVERSI (UNDER WHICH I DID FIVE YEARS OF GRADUATE WORK)

HONORARY MENTIONS AND MEDALS.

SECTION IX EMPLOYMENT HISTORY

University. NOTE: (LIST LAST POSITION FIRST.) Indicate chronological history of employment for past 15 years. Account for all periods including casual employment and all periods of unemployment. Giveaddress and state what you did during periods of unemployment. List all civilian employment by a foreign Govemment, regardless of dates. In completing item 9, "De- scription of Duties" consider your experience carefully and provide meaningful, objective statements.

  1. INCLUSIVE DATES (From and To By Mo. and Yr.) 2. NAME OF EMPLOYING FIRM OR AGENCY

Meril1954 Oct. 1960 CENTURY ELECTRIC COMPANY

  1. ADDRESS (No., Street, City, State, Country) 4. NAME OF SUPERVISOR ARNESTO N. RODRIGUEZ, Dist. Mug Mu

1806 PINE ST., ST. Lours, Mo., USA. MR. Charles C. White, Expet MANAGER.

  1. KIND OF BUSINESS 7. SALARY OR EARNINGS 8. CLASS. GRADE (If Federal Service)

MANUFACTURER OF MOTORS, GENERATORS, 678. $1,000 PER MONTH (AO) 4. TITLE OF JOB

Assitant DISTRICT MANAGER

  1. DESCRIPTION OF DUTIES TO PROMOTE AND SERVICE THE SALE OF CENTURY MOTORS, GENERATORS AND RELATED EQUIPMENT IN THE TERRITORY OF CUBA, AND TO COOPERATE IN COLLECTIONS WHEN NECESARY. TO MANAGE THE HAVANA DISTRICT SALES OFFICE IN FULL RESPONSABILITY IN THE ABSENCE OF THE DISTRICT MIGR. TO LOOK AFTER THE INTEREST OF CENTURY ELEC.CO. IN CUBA

  2. REASONS FOR LEAVING

PRESENT CONDITIONS IN CUBA AND ACCEPTANCE / ASSIGNMENTS AS PRINCIPAL AGENT IN CUBA FOR C.I.A.

SECTION IX CONTINUED TO PAGE 6

14-00000 SECTION IX CONTINUED FROM PAGE 5

  1. INCLUSIVE DATES (From and To By Mo. and Yr.) 2. NAME OF EMPLOYING FIRM OR AGENCY

FEB. 1950 MARCH 1954 TULANE UNIVERSITY

  1. ADDRESS (No., Street, City, State, Country) 4.S.A.

ST. CHARLES ST., NEW ORLEANS LA., U.S.A.

  1. KIND OF BUSINESS 5. NAME OF SUPERVISOR

COLLEGE DR. John E. Englekiak, CHAIRMAN Sp. Depth.

  1. TITLE OF JOB 7. SALARY OR EARNINGS 8. CLASS. GRADE (If Federal Service)

Graduate Asst. $ goo PER MONTH (71)

  1. DESCRIPTION OF DUTIES

TEACHER OF BEGINNER AND INTERMEDIATED SPANISH.IN THE COLLEGE LEVEL. TO ASSIST WITH REGISTRATION AND DEPARTAMENTAL FUNCTIONS.

  1. REASONS FOR LEAVING

TO ACCEPT ABOVE POSITION

  1. INCLUSIVE DATES (From and To By Mo. and Yr.) 2. NAME OF EMPLOYING FIRM OR AGENCY

JANE 1950 JUNE 1949 BERLITZ SCHOOL OF LANGUAGEZ

  1. ADDRESS (No., Street, City, State, Country) 5. NAME OF SUPERVISOR

INTERNATIONAL TRADE MART, NEW ORLEANS, LA, 4.5.A. MR. HALL, DIRECTOR

  1. KIND OF BUSINESS 7. SALARY OR EARNINGS 8. CLASS. GRADE (If Federal Service)

LANGUAGE SCHOOL $ 3.00 PER UR.

  1. TITLE OF JOB

PROFESSOR

  1. DESCRIPTION OF DUTIES TO TEACH THE SPANISH LANGUAGE BY THE BERLITZ METHOD..

  2. REASONS FOR LEAVING

TO ACCEPT ABOVE POSITION AND PURSUET AN ADVANCED DEGREE

  1. INCLUSIVE DATES (From and To By Mo. and Yr.) 2. NAME OF EMPLOYING FIRM OR AGENCY

JAN. 1949 JUNE 1949 TULANE UNIVERSITY MEDICAL SCHOOL

  1. ADDRESS (No., Street, City, State, Country) 5. NAME OF SUPERVISOR

TULANE AVE, NEW ORLEANS, LA. 4.S.A. DR. Woo

  1. KIND OF BUSINESS 7. SALARY OR EARNINGS 8. CLASS. GRADE (If Federal Service)

MEDICAL SCHOOL $ 200.00 PER MONTH

  1. TITLE OF JOB

Medical Research TechnitIAN

  1. DESCRIPTION OF DUTIES

IN CHARGE OF SPECTROPHOTOMETRIC ANALYSIS IN THE CARDIO VASCULAR RESEARCH LABORATORY.

  1. REASONS FOR LEAVING

CONCLUSION OF RESEARCH

  1. INCLUSIVE DATES (From and To By Mo. and Yr.) 2. NAME OF EMPLOYING FIRM OR AGENCY

  2. ADDRESS (No., Street, City, State, Country)

5

  1. KIND OF BUSINESS 5. NAME OF SUPERVISOR

  2. TITLE OF JOB 7. SALARY OR EARNINGS 8. CLASS. GRADE (If Federal Service)

$ PER

SECTION IX CONTINUED TO PAGE 7

14-00000 SECTION IX CONTINUED FROM PAGE 6

6

  1. DESCRIPTION OF DUTIES

  2. REASONS FOR LEAVING

  3. INCLUSIVE DATES (From and To By Mo. and Yr.) 2. NAME OF EMPLOYING FIRM OR AGENCY

  4. ADDRESS (No., Street, City, State, Country)

  5. KIND OF BUSINESS 5. NAME OF SUPERVISOR

  6. TITLE OF JOB 7. SALARY OR EARNINGS 8. CLASS. GRADE (If Federal Service)

  7. DESCRIPTION OF DUTIES

  8. REASONS FOR LEAVING

  9. INCLUSIVE DATES (From and To By Mo. and Yr.) 2. NAME OF EMPLOYING FIRM OR AGENCY

  10. ADDRESS (No., Street, City, State, Country)

  11. KIND OF BUSINESS 5. NAME OF SUPERVISOR

  12. TITLE OF JOB 7. SALARY OR EARNINGS 8. CLASS. GRADE (If Federal Service)

  13. DESCRIPTION OF DUTIES

  14. REASONS FOR LEAVING

  15. IF PRIOR SERVICE WITH THE FEDERAL GOVERNMENT IS NOT ED ABOVE, INDICATE THE NUMBER OF YEARS CREDITABLE TOWARD U.S. CIVIL SERVICE RETIREMENT, IF KNOWN.

  16. HAVE YOU EVER BEEN DISCHARGED OR ASKED TO RESIGN FROM ANY POSITION. YES NO

HAVE YOU LEFT A POSITION UNDER CIRCUMSTANCES WHICH YOU DESIRE TO EXPLAIN? YES NO IF YOUR ANSWER TO EITHER OR BOTH QUESTIONS IS "YES", GIVE DETAILS

-7-

14-00000 SECTION X -8- MILITARY SERVICE

  1. CURRENT DRAFT STATUS

  2. ARE YOU REGISTERED FOR THE DRAFT UNDER THE UNIVERSAL MILITARY TRAINING AND SERVICE ACT OF 1948 (As amended) YES NO

  3. SELECTIVE SERVICE CLASSIFI- CATION 4-F

  4. SELECTIVE SERVICE NO. 16-45-28-53

  5. IF DEFERRED, GIVE REASON 5. LOCAL DRAFT BOARD NO. OR DESIGNATION AND ADDRESS

DIABETES MELLITUS №45, Orlean PARIsh, New Orleans, LA.

  1. MILITARY SERVICE RECORD

  2. CURRENT AND/OR PAST ORGANIZATIONAL MEMBERSHIP

CHECK (X) AS ARMY NAVY MARINE AIR COAST MERCHANT NATIONAL AIR NAT'L FOREIGN ORGAN. OR MIL. APPROPRIATE CORPS FORCE GUARD MARINE GUARD GUARD SERVICE (Specify):

HAVE SERVED

NOW SERVING

  1. BRANCH OR CORPS OF ABOVE CHECKED ORGANIZATION(S)

  2. DATE SEPARATED FROM EXTENDED ACTIVE DUTY (Past service) 4. TOTAL LENGTH OF EXTENDED ACTIVE DUTY IN U.S. ARMED FORCES (Past and current service)

  3. DÁTE ENTERED PAST SERVICE CURRENT SERVICE 6. TOTAL LENGTH OF ACTIVE DUTY IN FOREIGN MILITARY OR- ACTIVE DUTY GANIZATION

  4. RANK, GRADE OR PAST SERVICE CURRENT SERVICE 8. SERVICE, SERIAL OR FILE NUMBER (If now serving, provide cur- RATE rent number)

  5. PRIMARY MILITARY OCCUPATIONAL PAST SERVICE SPECIALTY (Mos or Designator AND TITLE CURRENT SERVICE

  6. SECONDARY MIL. OCCUPATIONAL PAST SERVICE CURRENT SERVICE SPECIALTY (Mos or Designator) AND TITLE

  7. BRIEF DESCRIPTION OF MILITARY DUTIES (Indicate whether applicable to past or current service)

HONORABLE DISCHARGE 12. CHECK (X) TYPE OF SEPARATION FROM ACTIVE DUTY RELEASE TO INACTIVE DUT Y RETIREMENT FOR SERVICE UNDUE HARDSHIPS RETIREMENT FOR AGE RETIREMENT FOR COMBAT DISABILITY OTHER: RETIREMENT FOR/PHYSICAL DISABILITY

  1. CHECK (X) COMPONENT IN WHICH YOU SERVED REGULAR RESERVE (Including the National and Air National Guard) OTHER (Including AUS)

  2. MILITARY RESERVE, NATIONAL GUARD AND ROTC STATUS

  3. DO YOU NOW HAVE YES 2. ARE YOU NOW A MEMBER OF THE YES 3. ARE YOU NOW A MEMBER OF YES RESERVE STATUST NAT'L. GRD. OR AIR NAT'L. THE ROTC? GRD.7 NO NO NO

  4. IF YOU HAVE ANSWERED "YES" TO ITEMS 1, 2 OR 3 ABOVE, CHECK COMPONENT MEMBERSHIP BELOW

ARMY MARINE CORPS NATIONAL GUARD COAST GUARD NAVY ROTC INDICATE ROTC CATEGORY NUM- BER NAVY AIR FORCE AIR NAT'L.GUARD ARMY ROT/C AIR FORCE ROTC

  1. CURRENT RANK, GRADE OR 6. DATE OF APPOINTMENT IN CURRENT 7. EXPIRATION DATE OF CURRENT RESERVE OBLIGA- RATE RANK TION

  2. CHECK (X) CURRENT RESERVE CATEGORY READY RESERVE STANDBY(Active) STANDBY (Inactive) RETIRED

  3. PRIMARY MILITARY OCCUPATIONAL SPECIALTY (Mos or Desig- 10. SECONDARY MILITARY OCCUPATIONAL SPECIALTY (Mos or Des- nator) AND TITLE Ignator) AND-TITLE

  4. BRIEF DESCRIPTION OF MILITARY RESERVE DUTIES

  5. ARE YOU CURRENTLY ASSIGNED OR ATTACHED TO A RESERVE, NAT'L. GUARD OR ROTC TRAIN- YES 13. IF YOU HAVE ANSWERED "YES" TO ITEM 12, GIVE UNIT OR AGENCY ING UNIT AND ADDRESS NO

  6. HAVE YOU A MILITARY MOBILIZATION ASSIGN- YES 15. IF YOU HAVE ANSWERED YES TO ITEM 14, GIVE UNIT OR AGENCY MENT? AND ADDRESS NO

  7. INDICATE TOTAL MILITARY SERVICE YEARS MONTHS 17. WHERE ARE YOUR SERVICE RECORDS KEΡΤΙ FOR LONGEVITY PURPOSES INCLUD- ING ACTIVE AND INACTIVE DUTY

14-00000 SECTION XI FINANCIAL STATUS

  1. ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY? YES NO

  2. IF YOUR ANSWER IS "NO" TO THE ABOVE, STATE SOURCES OF OTHER INCOME

N.A.

  1. BANKING INSTITUTIONS WITH WHICH YOU HAVE ACCOUNTS

NAME OF INSTITUTION ADDRESS (City, State, Country)

Whitney Nat. BANK of New Orleans New Orleans, LA., U.S.A.

The Airport BANK of Miami MIAMI, FLA., U.S.A.

The ROYAL BANK of CANADA HAVANA, CUBA.

  1. HAVE YOU EVER BEEN IN, OR PETITIONED FOR, BANKRUPTCY, YES NO

  2. IF YOUR ANSWER IS "YES" TO THE ABOVE, GIVE PARTICULARS, INCLUDING COURT AND DATE(S)

N.A.

  1. GIVE THREE CREDIT REFERENCES IN THE UNITED STATES

NAME ADDRESS (No., Street, City, State)

Whitney NAT. BANK of New Orleans New Orleans, LA. U.S.A.

DH.HOLMES Ltd. (Department Store) New Galeans, LA. U.S.A.

MAISON Blanche (Department Store) New Orleans, LA. U.S.A.

  1. DO YOU RECEIVE AN ANNUITY FROM THE UNITED STATES OR DISTRICT OF COLUMBIA GOVERNMENT UNDER ANY RETIREMENT ACT, PENSION, OR COMPENSATION FOR MILITARY OR NAVAL SERVICE? YES NO

  2. IF YOUR ANSWER IS "YES" TO THE ABOVE QUESTION, GIVE COMPLETE DETAILS

Ν.Α.

  1. DO YOU HAVE ANY FINANCIAL INTEREST IN, OR OFFICIAL CONNECTIONS WITH NON-U.S.-CORPORATIONS OR BUSINESSES; OR IN OR WITH U.S. CORPORATIONS OR BUSINESSES HAVING SUBSTANTIAL FOREIGN INTERESTST YES NO (If answer "YES", fumish details on separate sheet.) SECTION XII MARITAL STATUS

  2. PRESENT STATUS (Single, Married, Widowed, Separated, Divorced, or Annulled) SPECIFY: MARRIED

  3. STATE DATE, PLACE, AND REASON FOR ALL SEPARATIONS, DIVORCES OR ANNULMENTS

N.A. WIFE, HUSBAND If you have been married more than once including annulments use a separate sheet for former wife or OR FIANCE: husband giving data required below for all previous marriages. If marriage contemplated, fill in appropriate information for fiance.

  1. NAME (First) (Middle) (Maiden) (Last) PAULINE JUANITA Ross RODRIGUEZ

  2. STATE ANY OTHER NAMES EVER USED

PAULA (NICKNAME SINCE CHIL HOOD) INDICATE CIRCUMSTANCES (Including length of time) UNDER WHICH ANY OF THESE NAMES WERE USED. IF LEGAL CHANGE GIVE PARTICULARS (Where and by what authority). USE EXTRA SPACE PROVIDED ON PAGE 16 OF THIS FORM TO RECORD THIS INFORMATION.

  1. DATE OF MARRIAGE 6. PLACE OF MARRIAGE (City, State, Country) JUNE 10, 1948 New Orleans, LA., U.S.A.

  2. HIS (OR HER) ADDRESS BEFORE MARRIAGE (No., Street, City, State, Country)

300 OAKUM ST. EDENTON, N.C., U.S.A.

  1. LIVING 9. DATE OF DEATH 10. CAUSE OF DEATH

XYES NO N.A. N.A.

  1. CURRENT ADDRESS (Give last address, if deceased)

19361 S.W. 178 st. PERRINE 57, FLA. U.S.A.

  1. DATE OF BIRTH 13. PLACE OF BIRTH (City, State, Country) 14. CITIZENSHIP

JAN. 2, 1923 BOGALUSA, LA. U.S.A. 4. S.A.

SECTION XII CONTINUED TO PAGE 10

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14-00000 - 10- SECTION XII CONTINUED FROM PAGE 9 14. IF BORN OUTSIDE U.S. DATE OF ENTRY 15. PLACE OF ENTRY N.A. N.A. 16. FORMER CITIZENSHIP(S) [Country (ies) 17. DATE U.S. CITIZENSHIP 18. WHERE ACQUIRED (City, State, Country) N.A. ACQUIRED N.A. N.A. 19. OCCUPATION 20. PRESENT EMPLOYER (Also give former employer, or if spouse deceased or HOUSE WIFE unemployed give last two employers) 21. EMPLOYER'S OR BUSINESS ADDRESS (No., Street, City, State, Country) N.A. 22. DATES OF MILITARY SERVICE (From and to By Mo. and Yr.) Ν.Α. 23. BRANCH OF SERVICE 24. COUNTRY WITH WHICH MILITARY SERVICE AFFILIATED N.A. N.A. 25. DETAILS OF OTHER GOVERNMENT SERVICE, U.S. OR FOREIGN N.A. SECTION XIII CHILDREN AND OTHER DEPENDENTS

  1. PROVIDE THE FOLLOWING INFORMATION FOR ALL CHILDREN AND DEPENDENTS

NAME RELATIONSHIP DATE AND PLACE OF BIRTH CITIZENSHIP ADDRESS

EMILIO AMERICO RODRIGUEZ J.R.? SON SEPT. 18, 1951, New Orleans, LA 4.S.A. 9361 SW-178 ST. PERRINE $7, FLA.

JOSEPH ROSS RODRIGUEZ SON MARCH 1, 1953, New Orleans, LA. 4. S.A. 4361 SW. 1785 T. PERRINE 57, FLA

PATTI MICHELLE RODRIGUEZ DAUG THER OCT. 23, 1954, HAVANA, Cuba 4.S.A. 9361 SW. 178 ST. PERRINE 87, FLA.

PAUL MARSHALL RODRIGUEZ SON NOV. 1, 1957, HAVANA Cuba 4.S.A. 9361 SW. 178 ST. PERRINE 57, FLA.

  1. NUMBER OF CHILDREN Incbuding step children and adopted and adopted children) WHO ARE UNMARRIED, UNDER 21 YRS OF AGE, AND NOT SELF-SUPPORTING 3. NUMBER OF OTHER DEPENDENTS (Including spouse, parents, step-parents, sister, etc.) WHO DEPEND ON YOU FOR AT LEAST 50% OF THEIR SUPPORT, OR CHILDREN OVER 21 YRS. OF AGE WHO ARE NOT SELF-SUPPORTING.

SECTION XIV FATHER (Give same information, for Stepfather and/or Guardian on a separate sheet)

  1. FULL NAME (Last-First-Miتفن( 2. LIVING 3. DATE OF DEATH 4. CAUSE OF DEATH

RODRIGUEZ, ARNESTE NAPOLEON YES NO N.A. NA.

  1. STATE OTHER NAMES HE HAS USED

N.4. INDICATE CIRCUMSTANCES (Including length of time) UNDER WHICH HE HAS EVER USED THESE NAMES. IF LEGAL CHANGE, GIVE PARTICULARS (Where and by what authority). USE EXTRA SPACE PROVIDED ON PAGE 16 OF THIS FORM TO RECORD THIS INFORMATION.

  1. CURRENT ADDRESS Give inst address, if deceased (No., Street, City, State, Country)

The ORICANIAN Apt. wote! ST. CHARLES Ave., New Orleans, LA. H.S.A. 7. DATE OF BIRTH Augustos 1891 8. PLACE OF BIRTH (City, State, Country) 9. CITIZENSHIP

HAVANA, Cuba. Cuban

  1. IF BORN OUTSIDE U.S.-DATE OF ENTRY 11. PLACE OF ENTRY Νου. 1962 New Orleans, LA.

  2. FORMER CITIZENSHIP(S) Country (les)7 13. DATE U.S. CITIZENSHIP 14. WHERE ACQUIRED (City, State, Country) N.A ACQUIRED NA N.A.

  3. OCCUPATION 16. PRESENT EMPLOYER (Give last employer, if Father is deceased or unemployed)

RETIRED SELF EMPLOYED Century Elect. Co..

  1. EMPLOYER'S BUSINESS DRESS OR FATHER'S BUSINESS ADDRESS IF SELF-EMPLOYED

1806 PINE ST. ST. LOUIS, MO. 4.S.A.

  1. DATES OF MILITARY SERVIS (Prom-and-To) 19. BRANCH OF SERVICE 20, COUNTRY

N.K. N.A. N.A.

  1. DETAILS OF OTHER GOVERNMENT SERVICE, U.S. OR FOREIGN INTELLIGECE AGENT FOR 4.5. EMBASSY IN HAVANA, CUBA DURIRE WORLD WAR I, WORLD WAR II, AND RECENT CASTRO REVOLUTION

14-00000 SECTION XV MOTHER (Give same information for Stepmother on separate sheet)

  1. FULL NAME (Last-First-Middle) CASANOVA EMILIA

  2. STATE OTHER NAMES SHE HAS USED N.A.

  3. LIVING YES NO
  4. DATE OF DEATH July 6, 1861

  5. CAUSE OF DEATH ARTERIOSCLEROSIs INDICATE CIRCUMSTANCES (Including length of time) UNDER WHICH SHE HAS EVER USED THESE NAMES. IF LEGAL CHANGE, GIVE PARTICULARS (Where and by what authority). USE EXTRA SPACE PROVIDED ON PAGE 16 OF THIS FORM TO RECORD THIS INFORMATION.

  6. CURRENT ADDRESS GIVE LAST ADDRESS, IF DECEASED (No., Street, City, State, Country)

the pain Apr. Hotel, St. Charles Ave., New Cleans, LA U.S.A.

  1. DATE OF BIRTH 8. PLACE OF BIRTH (City, State, Country) 9. CITIZEN