.NzA1Ng.MjU3ODk

From Transcribe Wiki
Revision as of 23:14, 11 February 2018 by Mshimes (Talk | contribs) (Protected ".NzA1Ng.MjU3ODk" ([Edit=Allow only administrators] (indefinite)))

(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to: navigation, search

Form 100 (N.R.) (December 1942) BUDGET BUREAU No. 11-R004-42 Approval expires June 30, 1943. BUDGET BUREAU No. 11.R084 APPROVAL EXPIRES JUNE 30, 1944 WAR MANPOWER COMMISSION NATIONAL ROSTER OF SCIENTIFIC AND SPECIALIZED PERSONNEL WASHINGTON, D.C. Where more space is need, attach additional sheets. (Print or Type) 1. Name {Miss Mrs. Mr. Dr., etc} Mr. James Lawrence Smith | (Title) (First) (Middle) (Last) Mailing address 2420 High Portsmouth Virginia | (Number) (Street) (City) (State) 2. Date of birth: January 17th 1883 | (Month) (Day) (Year) 3. Place of birth: Harnett County N.C. | (State or foreign country only) (If foreign born, give the name of the country, as of the date of your birth) 4. Citizenship (check one): 1 [X} Native-born citizen of the United States, including foreign-born of the United States citizen parentage. 2 [ ] Naturalized citizen: Cert. No. Date Court 3 [ ] First papers obtained: Date Number of Declaration of Intention Court Country of which you are a citizen 4 [ ] Final papers applied for but not yet obtained. 5 [ ] If first papers not yet obtained, specify foreign country of which you are a citizen [ ] Other (desribe on a separate sheet). 5. Marital status, dependants: (Do not fill in) 1 [ ] Single. [5] 2 [X] Married. Marital status [6] 3 [ ] Divorced. (Check one) [7] 4 [ ] Widowed or separated [8] [0] Dependants (number of persons completely dependant on you, other than husband or wife)

6. Race and sex (check one): Male Female 1 [X] White [ ] 6 } If "Other,"specify: SEX 2 [ ] Negro [ ] 7 1 [ ] Male 3 [ ] Yellow [ ] 8 6 [ ] Female 4 [ ] Other [ ] 9

7. Physical condition: Specify any physical defect, disease, or disability. If none, write "None." (Emphasize particularly defects which may in any way limit your working capacity.) None Height 5 10 1/2 Weight 148 | (Foot) (Inches) (Pounds)

8. Military service: (a) Are you now or have you ever been a member of (check one): [X} No military service Regular Armed Forces [ ] Army [ ] Navy [ ] Marine Corps [ ] Coast Guard Reserve [ ] Army [ ] National Guard [ ] Marine Corps [ ] Coast Guard [ ] Public Health Service (b) If you checked one of the above items, answer the following: Branch of service: Dates of service: From To Rank Are you now on active duty? Yes No (c) Have you ever served in the armed forces of any country other than the United States? NO | (Yes or No) Period of service: From To Name of country Service and Branch Highest rank held

9. Foreign languages (check proficiency): LANGUAGE Read Speak Auditory Comprehension Exc. Good Fair Exc. Good Fair Exc. Good Fair

10. Federal service: (a) Do you now hold a full-time position in the Federal Service? NO (Yes or no) If "Yes," indicate: Dept. Bureau (b) If not, have you ever held any position in the Federal service? NO (Yes or no) 16-16797-2