Employment application of Matthew (Mack) H. Easterbrook, 11/30/73

EMPLOYMENT APPLICATION Date: 11/30/73

MATTHEW (MACK) H. EASTERBROOK Full Name: Age: 37 Ph. No.: 238-0894 Address: P.O. Box 950 Date of Birth: 7/12/36 City & State: BEAVER TN OR6- Soc. Sec. No. 557-46-5529 Zip Single Married Widowed Separated Place of Birth: WISC [guess: WISCONSIN] If married, are you living with spouse? NO Spouse's name: Number of children ___ Their ages ___ Own or rent? RENT Do you live with your parents? N/O Telephone number given is in whose name? Your Father's name E.C. EASTERBROOK Address Sun City, Arizona Your Mother's name Vivian Alice Easterbrook Address // // Do you own a car? YES Year & make 1972 OLDS Drivers Lic. No. 1926306 Do you have a friend or relative working for this company? N/O Name ___ Do you drink any alcoholic beverages? N/O If so, how much per week? None Disregarding minor traffic law violations, have you ever been arrested? N/O If yes, when and where? ___ Offense charged? Disposition of charge?

PHYSICAL RECORD List any physical defects: None Were you ever injured? YES Give details: AUTO ACCIDENT NOT SERIOUS CUTS WHILE [guess: RETAIL] MEAT CUTTING Height: 5'5½ Weight: 155 Pants Size? 34 29 Shirt size? Sm (Med) L XL Person to notify in emergency ___ Relationship ___ b6 Address ___ PORTLAND Ph. No. ___ b7C

EMPLOYMENT RECORD Are you employed now? N/O How long off work? 2 days Last rate of pay? $2/[guess: hr] Rate per Hr. KIENOWS FOODS INC. From 1 1973 To 11/20 1975 10 Total Months Name of present or most recent employer SCIF MH. EASTFORK [guess: AGENCY] 11 From XX 19__ To 12 1972 25 Total Months SCIF MHG FCP Your next previous employer FREDRICH HERFURT RANCH From 2 1959 To __ 19[guess: 60] 12/ Total Months 11/59 year Your next previous employer CLOSE LE PLANT CO. From 1 1951 To 12 1958 9/ Total Months Your next previous employer Reason for leaving your last two jobs? [guess: See] [guess: for] [guess: statement] [illegible] [guess: caused] [guess: to] [guess: counsel] [guess: this/thy]

DB Cooper-42921 Over

1. Retail exact Cutting 2. [guess: Informing] outside [guess: jobs] [guess: Industrial] [illegible] & [guess: route] [illegible] 3. Hay Feed, Grain & Cattle Operation 4. Retail Sales - Store [guess: Mce.] [illegible] Sales - Outside [guess: Tech] Rep.

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[s]cribe the type of work you have been doing? [see annotations above]

[Na]me of supervisor at last two jobs? 1. __________ 2. Self [Te]lephone number of last two jobs 1. __________ 2. __________

EDUCATION [Hig]h School: ARCADIA HIGH SCHOOL From 19 51 to 19 55 Give name and location of school [Co]llege: LAVERNE COLLEGE From 19 55 to 19 58 UCLA, [guess: GOAL] POLY - MERRIT COLLEGE [Ot]her education or degree: In [guess: SUPPORT] of PRINT STORE, [guess: CATTLE RANCH] & [guess: MGMT] [guess: CUTTING] [Mi]litary experience? 8 YES Branch of Service? USN-R-R Type of discharge? Honorable

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REFERENCES.

__________ Allen Bradley Co. Phone No. What does he do? LA- [illegible] Los Angeles CAL Years acquainted? 29 City & State Superior Court Los Angeles Phone No. Name [illegible] Supporter Court What does he do? Los Angeles Years acquainted? 20 City & State __________ Life Ins. Phone No. What does he do? [illegible] Portland Years Acquainted? 1 City & State

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[Do] you feel you can pass a complete physical examination? Yes Date last examined 11/28/73

[I a]ffirm that the above answers are correct to the best of my knowledge. Any misrepresentation [of] information given is considered sufficient reason for discharge after employment.

[Dat]e 11/30/73 Signature [illegible signature]

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DO NOT WRITE BELOW THIS LINE

[Nea]tness __________ Character __________ [Per]sonality __________ Ability __________ [Ot]her comments: __________

[Da]te hired __________ Rate of Pay __________ Approved __________

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DB Cooper-42922

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b6 b7C