FormStandard Form 171 Personal Qualifications Statement, Customs Security Officer applicant (Marine Corps background)17 December 1970page 2 of 4
fbi_formLegibility: medium

Part 26, page 36

DB Cooper-7189

Document date 17 December 1970

Open in FBI Vault (Part 26, page 36 of the PDF)

FBI 164-81, Vault Part 26 p. 36 (DB Cooper-7189), Form, dated 17 Dec 1970 — cooper.theunsolved.net/parts/Cooper-Part-26/pages/36

Transcript

The scan is the source; the transcript is machine-generated from it.

PLEASE BE SURE TO READ ATTACHED INSTRUCTIONS BEFORE COMPLETING ITEM 18 18. EXPERIENCE (Start with your PRESENT[redacted] and work back) May inquiry be made of your present employer regarding your character, qualifications, and record of employment? YES [ ] NO [X]

Dates of employment (month, year) From _______ To PRESENT TIME Exact title of position: [blank] If Federal service, classification series and grade: [blank] Salary or earnings: Starting $ _______ per _______ Present $ _______ per _______ Avg. hrs. per week: [blank] Place of employment City: [blank] State: [blank] Number and kind of employees supervised: [blank] Kind of business or organization (manufacturing, accounting, insurance, etc.): [blank] Name and title of immediate supervisor: [blank] Name of employer (firm, organization, etc.) and address (including ZIP Code, if known): [blank] Area Code and phone No. if known: [blank] Reason for wanting to leave: [blank] Description of work: [blank] For agency use (skill codes, etc.): [blank]

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Dates of employment (month, year) From [redacted] Exact title of position: [redacted] If Federal service, classification series and grade: b6 Per BOC

Salary or earnings: Starting $75.00 per month Final $600.00 per month Avg. hrs. per week: NA Place of employment City: Santa Ana State: Calif. Number and kind of employees supervised: 50-80 Enlisted Kind of business or organization: U.S. Marine Corps Name and title of immediate supervisor: [redacted] b6 Per BOC Name of employer: U.S. Marine Corps, Washington DC b7C Per BOC Area Code and phone No. if known: [blank] Reason for leaving: Transferred to the Fleet Marine Corps Reserve Description of work: b6 Per BOC

personell

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Dates of employment (month, year) From _______ To _______ Exact title of position: [blank] If Federal service, classification series and grade: [blank] Salary or earnings: Starting $ [illegible] per [illegible] Final $ _______ per _______ Avg. hrs. per week: [blank] Place of employment City: [blank] State: [blank] Number and kind of employees supervised: [blank] Kind of business or organization (manufacturing, accounting, insurance, etc.): [blank] Name and title of immediate supervisor: [blank] Name of employer (firm, organization, etc.) and address (including ZIP Code, if known): [blank] Area Code and phone No. if known: [blank] Reason for leaving: [blank] Description of work: [blank]

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IF YOU NEED ADDITIONAL EXPERIENCE BLOCKS USE STANDARD FORM 171-A OR BLANK SHEETS SEE INSTRUCTION SHEET DB Cooper-7189