Record of Emergency Data (DA AGO Form 41) - 1st Lt John Emil List
Document date 1 February 1951
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Id: Cooper-Part-45:026-027
Subject: Cooper Files: Cooper-Part-45:026-027 Document: Record of Emergency Data (DA AGO Form 41) - 1st Lt John Emil List Id: Cooper-Part-45:026-027 Page: https://cooper.theunsolved.net/documents/Cooper-Part-45%3A026-027 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 45 pp. 26–27 (DB Cooper-4649–4650), Form, dated 1 Feb 1951 — cooper.theunsolved.net/documents/Cooper-Part-45%3A026-027
b6 per NPRC b7C
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1. DESIGNATOR'S LAST NAME—FIRST NAME—MIDDLE: List, John Emil 2. PRESENT SERVICE: 0-978253 3. FORMER S[ERVICE] NOS. (If any): 17177034 4. [GRADE]: 1st Lt 5. DATE OF BIRTH: [redacted] 6. [X] CHANGE / [ ] INITIAL DESTINATION 7. DESIGNATOR'S PERMANENT HOME ADDRESS (Number, street, city, county and State): [redacted] 8. FIRST NAME—MIDDLE NAME—LAST NAME OF PERSON TO BE NOTIFIED IN CASE OF EMERGENCY (If person with permanent address is [illegible]) RELATIONSHIP (If friend, so state): Wife
Helen Patricia List ADDRESS (Number, street, city, county, and State): [redacted]
THE PERSONS NAMED IN ITEMS 9, 11, AND 12, BELOW, MAY ALSO BE NOTIFIED OF THE EMERGENCY. IF SUCH NOTIFICATION IS NOT DESIRABLE DUE TO HEALTH OR FOR OTHER PERTINENT REASONS, SO STATE:
9. SPOUSE (First name, middle name, last name) (If none, or if deceased or divorced, so state): Helen Patricia List ADDRESS (Number, street, city, county, and State): [redacted]
10. CHILDREN (First name—Middle name—Last name): Brenda Joyce Taylor (Step-daughter) ADDRESS (Number, street, city, and State): [redacted] MARRIED OR SINGLE: Single SEX: Fem AGE: 8
11. NAME OF FATHER (Or male guardian) (First name—Middle name—Last name): Deceased ADDRESS (Number, street, city, and State): [redacted] b6 per NPRC b7C
12. NAME OF MOTHER (Or female guardian) (First name—Middle name—Last name): Alma Marie List ADDRESS (Number, street, city, and State): [redacted]
Information included on this form does not designate or change beneficiaries of life insurance; direct communication to the Veterans Administration or insurance company is necessary for that purpose.
DA AGO FORM 41, 1 FEB 51. Replaces DD Form 93, 1 Jul 50, which is obsolete, except for National Guard not on active duty. RECORD OF EMERGENCY DATA FOR THE UNITED STATES ARMY
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CAUTION: SPECIAL HANDLING REQUIRED This material copied from records of National Personnel Records Center, St. Louis, Missouri. Personnel Records Center, St. Louis. Do not recopy to be used for reference only. Do not [disseminate] in its original form outside or disseminate in its original form outside the Bureau.
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DB Cooper-4649
b6 per NPRC b7C
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IN THE EVENT THAT I AM NOT SURVIVED BY A SPOUSE OR ELIGIBLE CHILD, OR IF THEIR DECEASE OR DISQUALIFICATION OCCURS BEFORE PAYMENT OF SIX (6) MONTHS GRATUITY, I THEN DESIRE THAT PAYMENT BE MADE TO THE DEPENDENT RELATIVE SHOWN BELOW: 13. FIRST NAME—MIDDLE NAME—LAST NAME ADDRESS (Number, street, city, and State) RELATIONSHIP
Alan Mario List Mother
IN THE EVENT OF DEATH OR DISQUALIFICATION OF THE ABOVE-NAMED DEPENDENT RELATIVE, I THEN DESIGNATE THE ALTERNATE DEPENDENT RELATIVE SHOWN BELOW (Other than spouse or child): 14. FIRST NAME—MIDDLE NAME—LAST NAME ADDRESS (Number, street, city, and State) RELATIONSHIP
William G. List Half-Brother
15. VOLUNTARY ENTRIES I REQUEST THE FOLLOWING COMMERCIAL LIFE INSURANCE COMPANIES BE OFFICIALLY NOTIFIED IN CASE OF MY DEATH IN ACTIVE SERVICE (The "Policy Number" should be entered if possible, since this information will assist in expediting action by the insurance company should a claim become payable):
FULL NAME OF COMPANY ADDRESS OF HOME OFFICE POLICY NO.
[redacted] [redacted]
IN THE EVENT THAT I AM LISTED AS MISSING, OR BY OTHER MILITARY CIRCUMSTANCE AM UNABLE TO TRANSMIT FUNDS TO MY DEPENDENTS, IT IS MY DESIRE THAT— 16. FIRST NAME—MIDDLE NAME—LAST NAME RELATIONSHIP
Helen Patricia List Wife
ADDRESS (Number, street, city, and State) RECEIVE EACH MONTH 100 % OF MY PAY. MILITARY ADDRESS SIGNATURE OF DESIGNATOR DATE SIGNED
9206th TSU TC - SFPE, Ft [guess: Mason], Calif. [signature: John C. List] 7 Jan, 52
U.S. GOVERNMENT PRINTING OFFICE : 1951 O—929241
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b6 per NPRC b7C
[largely illegible/redacted content]
DB Cooper-4650