Part 39, page 105

Transcript

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

25378 SR 21274 FBI # [redacted] CII # [redacted]

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FD 2 2 1303 (Re[v]...) . NEVADA REVISED STATUTE 207/52 (Restricted Information)

Date ___[redacted]___10,___1965___

[redacted] (First Name) [redacted] ([guess: Common] Name) Aliases known names, nicknames, etc.) [redacted] Age [redacted] Date of Birth [redacted] Place of Birth [redacted] (month-day-year) (City and State) Sex [redacted] Race [redacted] Height [redacted] [guess: 5ft] [illegible] Weight _225_ Hair _B[guess: rn]_ Eyes _Brn_ (last 4 inches) Tattoos (Description & location on body) _None_ Amputations & Physical Deformities _None_

Social Security [redacted] Served in Armed Forces _Yes_ Branch _Army_ Present Residence [redacted] Length of time at Present Address _[illegible]_ Expected time at Present Residence _[guess: indef.]_ Expected length of time in County & State _Indef._ Previous Residence _[redacted]_, _[redacted]_ (ICty & C[guess: aSe]) Present Occupation [redacted] Previous Occupations &/ or Trades [redacted] Present Employer [redacted] Address [redacted] Nearest Relative [redacted] Relationship [redacted] Address [redacted] Committed as/or [redacted] Convicted of [redacted] on [redacted] (Note) Under the Name of [redacted] Booked at [redacted] (Type & location of jail) Paid a fine of $ _None_ and/or was confined for _None_ years _____ months _____ days In the _____ (Type & location of jail, prison, institution or hospital) I _________ placed on _________ until [redacted] was or was not probation or parole date of termination

Additional Arrests or Convictions: _None_

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Residence Changes ___[illegible]___ Date ___ ___ Date ___ ___ Date ___

FPC: [redacted]

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Interview [illegible] # of I, Name Use back of page for M.O. or Type

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Sex Reg -RPD X SEARCHED___INDEXED___ SERIALIZED [guess: /] FILED [guess: JAN] 2 1 1977 FBI — SEATTLE

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b6 b7C

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DB Cooper-15272