Supplemental Information Sheet — Sheridan Louis Peterson
Document date 27 April 1962
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Id: Cooper-Part-101:155-155
Subject: Cooper Files: Cooper-Part-101:155-155 Document: Supplemental Information Sheet — Sheridan Louis Peterson Id: Cooper-Part-101:155-155 Page: https://cooper.theunsolved.net/documents/Cooper-Part-101%3A155-155 What is wrong (title, date, type, which pages belong together, copies)? What does the scan show?
A person reads every report. Corrections are made by hand, to the data — titles, dates, names, which pages belong together — never to the scans, and they can take a while to appear.
FBI 164-81, Vault Part 101 p. 155 (DB Cooper-45617), Form, dated 27 Apr 1962 — cooper.theunsolved.net/documents/Cooper-Part-101%3A155-155
SUPPLEMENTAL INFORMATION SHEET
The following information is necessary to supplement your application. All questions must be answered fully. Write "None" where applicable.
Name: Peterson, Sheridan, Louis LAST FIRST MIDDLE Social Security No. [guess: 565]-30-858[guess: 4]
Place of Birth: Santa Rosa, California CITY STATE OR COUNTRY
Wife's full maiden name or Husband's name: [blank]
Father's full name: Chauncey Weaver Peterson Windsor, Calif deceased BIRTHPLACE PRESENT ADDRESS
Mother's full name including maiden name: Mrs Edith [guess: Koffee] (Peterson) Crane Lincoln, Calif Santa Rosa, Calif BIRTHPLACE PRESENT ADDRESS
List names and addresses of relatives and dependents living outside the United States or its Possessions: none
List all organizations, other than labor unions, to which you have ever belonged. (PAST AND PRESENT): Washington Education Association, National Education Association, Montana Education Association, VF[guess: W] [illegible]
Have you ever changed your name or gone by any other name? Yes ___ No X
NOTE: Females must answer "Yes" if married, and list all married names ever used.
If "Yes" indicate names used and dates of changes: [blank]
Authority for the change: [blank]
Date: 4/27/62 Signature: [handwritten signature, partially legible]
DB COOPER 45617
Serials: DB COOPER 45617