Part 94, page 46
DB Cooper-41961Serials PD 164-41-877
Document date 1 November 1970
FBI 164-81, Vault Part 94 p. 46 (DB Cooper-41961), Form, dated 1 Nov 1970, serial PD 164-41-877 (as read from the transcript) — cooper.theunsolved.net/parts/Cooper-Part-94/pages/46
Transcript
The scan is the source; the transcript is machine-generated from it.
Standard Form 86 AUGUST, 1954 U.S. CIVIL SERVICE COMMISSION (F.P.M. CHAPTER 735) 85-106
SECURITY INVESTIGATION DATA FOR SENSITIVE POSITION
INSTRUCTIONS.— Prepare in triplicate, using a typewriter. Fill in all items. If the answer is "No" or "None," so state. If more space is needed for any item, continue under item 28.
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1. FULL NAME (LAST NAME) (FIRST NAME) (MIDDLE NAME) [redacted - b6 per BOC / b7C per BOC]
(Initials and abridgements of full name are not acceptable. If no middle name, show "(NMN)"; if initials only, show "(no given or middle name)"
OTHER NAMES USED. (Maiden name, names by former marriages, former names changed legally or otherwise, aliases, nicknames, etc. Specify which, and show dates used.)
2. DATE OF BIRTH b6 per BOC b7C per BOC
3. PLACE OF BIRTH b6 per BOC b7C per BOC
4. [X] MALE [ ] FEMALE
5. HEIGHT: 70" WEIGHT: 200 COLOR EYES: Bl COLOR HAIR: Br
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6. [ ] SINGLE [X] MARRIED [ ] WIDOW(ER) [6] DIVORCED
7. IF MARRIED, WIDOWED, OR DIVORCED, GIVE FULL NAME AND DATE AND PLACE OF BIRTH OF SPOUSE OR FORMER SPOUSE. INCLUDE WIFE'S MAIDEN NAME. GIVE DATE AND PLACE OF MARRIAGE OR DIVORCE. b6 per BOC b7C per BOC
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8. DATES AND PLACES OF RESIDENCE (If actual places of residence differ from the mailing addresses, furnish and identify both and go back to January 1, 1937. Continue under item 28 on other side if necessary.) Begin with present
FROM TO NUMBER AND STREET CITY STATE 11/01/70 Present 07/68 10/70 05/68 07/68 09/67 04/68 11/66 09/67 04/66 11/66 04/65 04/66 03/65 04/65 01/64 03/65 11/63 01/64 11/60 11/63 10/60 11/60
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9. [X] BY BIRTH [ ] NATURALIZED ALIEN REGISTRATION NO. DATE, PLACE, AND COURT
[X] U.S. CITIZEN CERT. NO. PETITION NO. [ ] DERIVED-PARENTS CERT. NO(S).
[ ] ALIEN REGISTRATION NO. NATIVE COUNTRY DATE AND PORT OF ENTRY
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10. EDUCATION. (All schools above elementary.) NAME OF SCHOOL ADDRESS FROM (Year) TO (Year) DEGREES [empty/redacted]
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164-41-877 SEARCHED _____ INDEXED _____ SERIALIZED _____ FILED _____
FBI—PORTLAND
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11. THIS SPACE FOR FBI USE (See also item 29.)
12. SOCIAL SECURITY NUMBER b6 per BOC b7C per BOC
13. MILITARY SERVICE (Past or present) SERIAL NO. BRANCH OF SERVICE (If none, give grade (Army, Navy, Air Force, etc.) FROM (Yr.) TO (Yr.) or [guess: classification]) Marine Corps 1951 1970
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DB Cooper-41961