NVDH personnel action form for Jack Coffelt, orderly O.R.
Document date 24 April 1972
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Id: Cooper-Part-86:038-038
Subject: Cooper Files: Cooper-Part-86:038-038 Document: NVDH personnel action form for Jack Coffelt, orderly O.R. Id: Cooper-Part-86:038-038 Page: https://cooper.theunsolved.net/documents/Cooper-Part-86%3A038-038 What is wrong (title, date, type, which pages belong together, copies)? What does the scan show?
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FBI 164-81, Vault Part 86 p. 38 (DB Cooper-37882), Form, dated 24 Apr 1972 — cooper.theunsolved.net/documents/Cooper-Part-86%3A038-038
B. C Tem. 3-3-72
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NORTHERN VIRGINIA DOCTORS HOSPITAL PERSONNEL ACTION
DATE: 4/24/72
NAME: Coffelt Jack last first initial
PRESENT STATUS Station O.R. POSITION Orderly DEPARTMENT O.R. Part time ✓ full time temporary permanent SHIFT: 9-5 [guess: 9:30 - 5:30 crossed out] 4-12 12-8
THE FOLLOWING PERSONNEL ACTIONS TO BE APPROVED:
EFFECTIVE: Current Pay Period or 4-24-72 Transfer to __________ position __________ department __________ Change status to: ____ Part time ____ full time Change station to ____ North ____ South Change shift to ____ 8-4 ____ 4-12 ____ 12-8 INCREASE rate of pay to $ __________ per day/month differential Grant Leave without Pay until: __________ Returning to duty. Resume on payroll as follows: Position Orderly Dept. O.R. $ 410.00 per day/month. Differential + O.T.
OTHER ACTION: (Specify) [blank box]
b6 b7C Approved __________ Disa[pproved] [REDACTED] Date __________ Administrator
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DB Cooper-37882