Part 116, page 284

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Record Request FD-425 (Rev. 11-3-71)

[X] Birth [X] Credit [X] Criminal [ ] Death [ ] INS [ ] Marriage * [ ] Motor Vehicle [ ] Other [ ] Driver's License

To #525 Buded CAROLYN Return to File number 164-81 [stamp: SU] 66[illegible] b6 b7c Name and aliases of subject, applicant, or employee, and spouse GILBERT A' HENKINS, JR. (i.e. not [guess: comparison] with Sr. or III

Addresses Residence 4[illegible] 9/05 NR 1[guess: 707] [guess: Gr. E. VUA] [guess: April] 1/73 - [guess: direct] - [guess: Owners] - [guess: Sacramento] Business [guess: 3848] [illegible] [guess: Wilton/Hart] RIFE - INSURANCE Co Suite 95 [guess: St. N17 3606] Former 2/57 - 2538 -102 N.E. Bellevue 8/56 - Rt. 1, Box 1540, [guess: Pinemondi] 2/64 [guess: Bonkers E/c Ins of] [guess: Redmond] 463 [guess: Jenkins] [guess: Sho. Agency - self] 5/56 Pacific [guess: Pricheleld] Co.

* Date and place of marriage ___________ (if applicable)

Race Sex Age Height Weight Hair Eyes W [X] Male 47 5'7" 165 Blue [ ] Female

Birth date Birthplace 6/21/25

Arrest Number Fingerprint classification Criminal specialty

Specific information desired ALL BACK GROUND E' PHOTOS TO PROCESS AS NOTED SUSPECT

Results of check SEPD 8/29/73 [guess: Oand attached] [guess: Sea. Murphy] Bus. 8/29/73 [guess: Bellevued] [guess: Arthur Hawkins] DOB 6/21/25, 165, 5'9" Add: 9105 N.E. 17, Bellevue

[guess: Other] [guess: Sigma] - 9/24/70 Lic. ORU683 164-81- Sub 662 K[illegible] DPS 8/29/73 NR [illegible stamp]

[guess: di. Guilt] Sur 5/30/73 [guess: for] Mrs. [guess: Lucy] [guess: Hawkins/Hopkins] [illegible stamp]

DB COOPER-53313 (Use reverse side, if necessary)