Part 45, page 41
DB Cooper-4664Serials 16-177-034
Document date 14 June 1943
FBI 164-81, Vault Part 45 p. 41 (DB Cooper-4664), Form, dated 14 Jun 1943, serial 16-177-034 (as read from the transcript) — cooper.theunsolved.net/parts/Cooper-Part-45/pages/41
Transcript
The scan is the source; the transcript is machine-generated from it.
16-177-034
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ENLISTMENT RECORD ENLISTED RESERVE CORPS
Last name: LIST First name: JOHN Middle name: EMIL Army serial number: 16-17034 Race: WHITE (see Instr. 6)
Home address: [illegible]
*Enlisted at Detroit, Michigan on the 14 day of June 1943 by [illegible] oros, 2nd Lt. NMD Grade: Private b6 per NPRC b7C
for service in (see Instr. 2): ENLISTED
Deferred until September 17, 1943 For Underage (Month) No(Year) (Reason)
*Rejected (date): None Last enlisted service in the Army (see Instr. 5):
(Company, regiment, and arm or service) Date of discharge _________ Period of last enlistment _________ years.
*If applicant is enlisted, strike out the line "Rejected------"; if rejected, strike out line "Enlisted------" (See Instr[illegible]) The serial number will not be entered until call into active service. Care will be taken to make place and date of enlistment and name of enlisting officer the same as in oath.
DECLARATION OF APPLICANT (See Instruction 7) b6 per NPRC b7C
1. When and where were you born? [REDACTED - date, city, town, or village, state or country] What is your race? white (See Instr. 6)
2. Are you a citizen of the United States? ______ (If a naturalized citizen, show how, when, and where naturalized)
3. What grade or year did you complete in: Grammar school 8 High school 4 College or university 0 Educational specialty (if any) none
4. What is your civilian trade or occupation? student How long did you work at it? no Weekly wage? ______
5. What special military qualification or occupation have you? no (For example, cook, company clerk, radio operator, motor mechanic, airplane engine mechanic, supply sergeant)
6. Are you single, married, widower, or divorced? Single Is anyone dependent on you for support? no State number and relationship
7. Have you ever been convicted (a) of a felony? no (b) of any offense? no Have you ever been imprisoned under sentence of a civil court? no If so, where and when? Have you ever been discharged other than honorably from the United States military or naval service, the Marine Corps, Coast Guard, or National Guard in an active, inactive, or reserve status? no
8. Have you ever served in the United States military or naval service, the Marine Corps, Coast Guard, or National Guard in an active, inactive, or reserve status? no If so, state last service, date, nature, and cause of separation therefrom ______
9. Have you ever previously applied for enlistment and been rejected? no If so, give date, place, and cause of rejection ______
10. Do you know that if you are rejected because of any disqualifications known to you and concealed from the accepting officer, you will [illegible] furnished with return transportation to the place of acceptance? yes
11. Have you ever: Used cocaine, heroin, morphine, marihuana, or any habit-forming drug or narcotic; since childhood [illegible] while [illegible] had gonorrhea, sore on penis, convulsions or fits, or spells of unconsciousness; raised or spat up blood; had any [illegible] disease, or [illegible] that [illegible] required treatment at a hospital or asylum? no If answer to any part of the above is "yes," [illegible] refers ______
12. To the best of your knowledge and belief, are you now sound and well? yes If not, [illegible] details ______
13. Do you know that if you secure your enlistment by means of any false statement, willful mis[illegible] or [illegible] to your qualifica- tions for enlistment, you are liable to disciplinary action? yes
14. Do you agree to enlist in the Enlisted Reserve Corps of the Army of the United States, [illegible] to be disqualified, under regulations prescribed therefor? yes
Remarks: [illegible] ...the Bu[illegible]
I declare that I am not now a member of the Army, Navy, Marine Corps, National Guard, or Coast Guard in an active, inactive, reserve, or retired status; that the foregoing questions and my answers thereto have been read to me; that my answers have been correctly recorded and are true in all respects and that I fully understand the conditions under which I am enlisting.
Given at Detroit, Michigan this 14 day of June 19 43 N. Mantzoros, 2nd Lt. NMB signature: [signature] (To be witnessed by enlisting officer) (Grade and organization) (First name) (Middle Initial) (Last name)
W.D., A.G.O. Form No. 165 MAN FURNISHED WITH W.D.A.G.O. FORM 166, 1897 Inst 28 April 10, 1942 (1) DB Cooper-4664