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In compliance with ttia regul^tl^r* of the Departmmt eat la arGmr to your record, please f i l l out attache* Personal History >beet and. return 4d«Eu9 DlTlslon of Appointments, Room 3f2, Trmmmry. , k i V '1, If , , STANDARD FORM NO. 6 (Approved by the President 3/28/24) Revised Dec. 5,1929 PERSONAL HISTORY STATEMENT (To be prepared by appointee in own handwriting) Department or Establishment Tj*fe 1. Name in full (Mr., Miss, or Mrs.) 2. Present address 3COQ Date .....Eoclas. H&£T.tnSXL (Surname) . (Given name) CA®Y.?l^M.*VenUef...W.f. (Number) 31%skk 4. Where born &$&& (Middle name) lashi>fta (Street) 3. Legal (voting) residence £tCrfid&Xd X>.:..Q.»... (City) (State) .label! (State and Congressional District) .Qgden—- (County) (City or town) I&g&Xl (State or foreign country) When born .W-9/-90L (City or town) (Month Day Year) 5. If foreign-born, state whether naturalized or alien Et 6. Indicate sex, marital condition, and race by check, thus: V If Mrs., state other names under which previously employed. SEX Male X RACE. (If other, state which) MARITAL CONDITION Fomale Single Married Divorced Widowed White 7. Number and ages of dependents domiciled with you Gkmmm m flft« SQ f^»t$ Colored 1*««»^»**» 1 # 14 JTtl 8. A complete record of your past service for the United States Government other than military or naval: BRANCH OF SERVICE PLACE OF EMPLOYMENT SALARY POSITION DATE APPOINTED Month Day Year DATE SEPARATED Month Day Year NOBE 9. Are any members of your family, who an ) domiciled with you, in the U. S. Government service? If so, state below: POSITION AND DEPARTMENT OR OFFICE IN WHICH EMPLOYED NAME RELATIONSHIP Position Department or office Position Department or office Position Department or office MMM M l 10. Do you now hold any State or municipal office? (Title) If so, state below: (Location) (Date appointment expires) 11. Are you the wife of a disabled veteran or widow or orphan of a person who was in the military or naval service? (Wife, widow, or orphan) (Name of veteran) (Organization and last year of service) 12. Military and naval record. If any, check (V) to indicate branch and other information, and give dates of enlistment and discharge: None Army Navy Marine Corps Coast Guard War veteran Veterans' Bureau beneficiary Pensioner Enlisted Discharged Enlisted Discharged - Rank. Rank Rank Rank Organization - - Organization Organization __ Organization . [OVER] Do you receive annuity under Act? DigitizedeforCivil FRASERService Retirement th< . . 13. State any special qualifications not involved in your present position (for instance, lawyer, physician, civil engineer, knowledge of foreign languages, etc.) Business Executive 14. Statement of principal employment other than with the United States Government: NAME AND ADDRESS OF EMPLOYER POSITION AND CHARACTER OF WORK Ajaalgaisated Sugar Company Viee-President, Treasurer* Dlr# .ififi3LM.JG?estmenl.Goapaay. Sago Milk Products Goapany President* Director President* Director Stoddard Lumber Company President^ Director Utah Construction Coapaay President* Director LENGTH OF SERVICE 15. Education. Indicate by circling the number of years: Common school 1 2 3 4 5 6 High school 7 8 1 2 3 4 1 2 College 3 jr 4 (Name of college, degrees, and dates conferred) Utah Btatt Agricultural College 16. In case of emergency, notify Wife 3010 Cleveland Ave M 8.W., Washington, D, C# Relationship Post office address I certify that the foregoing answers are correct to the best of my knowledge and belief. u. 9 aormnui (Name as usually written and which will be used as official signature)
@FedFRASER