QUALIFICATIONS SUPPLEMENT TO PERSONAL HISTORY STATEMENT - MILLS, MONTRELL EUGENE

• Document Type: FOIA
• Keywords: MILLS MONTRELL E
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0001308984
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 7
• Document Release Date: February 19, 2008
• Case Number: F-2005-00558
• Publication Date: January 17, 1968

 QUALIFICATIONS SUPPLEMENT TO PERSONAL HISTORY STATEMENT READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING. TYPE OR PRINT. AVOID USING LIGHT COLORED INKS. SECTION I                                                          j       BIOGRAPHIC AND POSITION DATA 1. EMP. SER. NO.         2. NAM   L sl vsl?MiddI.J                                                             3. SEX   4. DATE OF BIRTH          5. SCHEDULE/GRADE/STEP M     01/31/.24     GS '.'13'06 6^SD          7. POS                                                   B. OFFICE OF ASSIGNMENT                          9. LOCATION (Country, Cil SECURITY OFFICER                SEC SECTION II                                                           AGENCY OVERSEAS SERVICE AREA TYPE TOUR FROM TO NQIO ERSEAS SERVICE. SECTION III                                                                   EDUCATION DEGREE MAJOR FIELD COLLEGE YEAR BACH  - A, ;ENFORCEMEN    GENERAL Mf CH ST` UNIV S/F,1171.) (Whe                                                      FFI  M``L7SE ONLY (until filled in) SECTION III                                                              EDUCATION (Cont'd) HIGH SCHOOL LAST HIGH SCHOOL ATTENDED ADDRESS (City, State, Coentry) YEARS ATTENDED (From-lo) GRADUATE Q YES    0 NO COLLEGE OR UNIVERSITY STUDY NAME AND LOCATION O SUBJECT YEARS ATTENDED DEGREE YEAR NO. SEM / QTR. F COLLEGE OR UNIVERSITY MAJOR MINOR FROM - - TO - - RECEIVED RECEIVED HRS. (specifr) " 1. 2. 3. 4. 5.  IF A GRADUATE DEGREE HAS BEEN NOTED ABOVE WHICH REQUIRED SUBMISSION OF A WRITTEN THESIS, INDICATE THE TITLE OF THE THESIS AND BRIEFLY DESCRIBE ITS CONTENT. TRADE, COMMERCIAL AND SPECIALIZED SCHOOLS NAME AND ADDRESS OF SCHOOL STUDY OR SPECIALIZATION FROM TO NO. OF MONTHS 1. 2. 3. OTHER NON-AGENCY EDUCATION OR TRAINING NOT INDICATED ABOVE NAME AND ADDRESS OF SCHOOL STUDY OR SPECIALIZATION FROM TO NO. OF MONTHS 2. 3. 4. 5. AGENCY-SPONSORED EDUCATION Specify which, if any, of the education shown in Section III was Agency sponsored. NAME AND ADDRESS OF SCHOOL STUDY OR SPECIALIZATION FROM TO NO. OF MONTHS I 2. 3. 4. 5. SE  ET -2- SECTION IV                                              GEOGRAPHIC AREA KNOWLEDGE AND FOREIGN TRAVEL KNOWLEDGE ACQUIRED BY - - CHECK )X) NAME OF REGION OR COUNTRY TYPE OF SPECIALIZED KNOWLEDGE DATES OF TRAVEL OR RESIDENCE DATE & PLACE OF STUDY REST- DENCE TRAVEL STUDY WORK ASSIGN- MENT SECTION V                                                        TYPING AND STENOGRAPHIC SKILLS 1. TYPING (WPM) C.!> 2. SHORTHAND (WPM) 3. INDICATE SHORTHAND SYSTEM USED - - CHECK (X) APPROPRIATE ITEM: 0 GREGG           0 SPEEDWRITING        0 STENOTYPE       11 SPECIFY: 4. INDICATE OTHER BUSINESS MACHINES WITH WHICH YOU HAVE HAD OPERATING EXPERIENCE OR TRAINING (comptometer, mimeograph, cord punch, etc.) Id    t>   c     .....a 4 SECTION VI                                                               SPECIAL QUALIFICATIONS 1. LIST ALL HOBBIES AND SPORTS IN WHICH YOU ARE ACTIVE OR HAVE ACTIVELY PARTICIPATED. INDICATE YOUR PROFICIENCY IN EACH. Car { t 4  .-  ?OOc~ 2. EXCLUDING BUSINESS EQUIPMENT OR MACHINES WHICH YOU MAY HAVE LISTED IN ITEM 4,  SECTION V,  LIST ANY SPECIAL SKILLS YOU POSSESS RELATING TO OTHER EQUIPMENT AND MACHINES SUCH AS OPERATION OF RADIO TRANSMITTERS (indicate CW speed, sending & receiving) OFFSET PRESS, TURRET LATHE, EDP AND OTHER SCIENTIFIC & PROFESSIONAL DEVICES. 3. ARE YOU NOW OR HAVE YOU EVER BEEN A LICENSED OR CERTIFIED MEMBER OF ANY TRADE OR PROFESSION SUCH AS PILOT,  , IVES ELECTRICIAN, RADIO OPERATOR, TEACHER, LAWYER, CPA, MEDICAL TECHNICIAN, PSYCHOLOGIST, PHYSICIAN, ETC.?                  ^ NO 4. IF YOU HAVE ANSWERED 'YES' TO ITEM 3 ABOVE, INDICATE KIND OF LICENSE OR CERTIFICATION AND THE ISSUING STATE. MUNICIPALITY, ETC.'(Provide license registry number if known) 5. FIRST LICENSE/CERTIFICATE (year of issue) RID k cZ 6. LATEST LICENSE/CERTIFICATE (year of issue) 7. LIST ANY SIGNIFICANT PUBLISHED MATERIALS OF WHICH YOU ARE THE AUTHOR (do NOT submit copies unless requested). INDICATE THE TITLE, PUBLICATION DATE, AND TYPE OF WRITING (non-fiction or scientific articles, general interest subjects, novels, short stories, etc.) 8. INDICATE ANY DEVICES WHICH YOU HAVE INVENTED AND STATE WHETHER OR NOT THEY ARE PATENTED. /4O 4e 9. PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE. SECRET (Wh Filled In) SECTION VII                                                               MILITARY SERVICE CURRENT DRAFT STATUS ARE YOU REGISTERED FOR THE DRAFT?                       YES           NO 2. SELECTIVE SERVICE CLASSIFICATION 3. LOCAL SELECTIVE SERVICE BOARD NUMBER AND ADDRESS 4. IF DEFERRED, GIVE REASON MILITARY SERVICE RECORD (Active Duty Only) 1. MILITARY ORGANIZATION (Army, Navy, etc. - specify) 2. BRANCH OR CORPS 3. DATES OF SERVICE  (extended active duty) FROM - -                                  TO - - 4. STATUS (Regular, Reserve, etc. - specify; 5. RANK, GRADE OR RATE (at separation if past service) 6. SERIAL, SERVICE OR FILE NUMBER 7.                   F-1 HONORABLE DISCHARGE                ^  RETIREMENT FOR SERVICE                            F-1 UNDUE HARDSHIPS CHECK TYPE OF ^ SEPARATION        RELEASE TO INACTIVE DUTY              RETIREMENT FOR COMBAT DISABILITY                  ^ OTHER(Sps,664 ^ RETIREMENT FOR AGE                   ^ RETIREMENT FOR PHYSICAL DISABILITY 8. BRIEF DESCRIPTION OF MILITARY DUTIES (record the duties and skills which best describe your work or function in the military service). MILITARY RESERVE, NATIONAL GUARD STATUS CHECK RESERVE OR GUARD ORGANI-               ^ ARMY                    ^ MARINE CORPS                                             ^ NATIONAL GUARD ZATION TO WHICH YOU BELONG                                                                         ^ COAST GUARD ^ NAVY                    ^ AIR FORCE                                                ^ AIR NATIONAL GUARD 1. CURRENT RANK, GRADE OR RATE 2. DATE OF APPOINTMENT IN CURRENT RANK 3. EXPIRATION DATE OF CURRENT RESERVE OBLIGATION 4. CHECK CURRENT RESERVE CATEGORY             ^ READY RESERVE    ^ STANDBY (active)           STANDBY (inactive)             RETIRED 11 DISCHARGED 5. BRIEF DESCRIPTION OF MILITARY RESERVE DUTIES (record the duties and skills which best describe your work or function in the. military service). 6. IF YOU ARE CURRENTLY ASSIGNED TO A RESERVE OR NATIONAL GUARD TRAINING UNIT,  IDENTIFY THE UNIT AND ITS ADDRESS. MILITARY SCHOOLS COMPLETED (Active Duty, Reserve Status or as Civilian) NAME AND ADDRESS OF SCHOOL STUDY OR SPECIALIZATION DATE COMPLETED RESIDENT CORRESPONDENCE 1. AGENCY-SPONSORED RESIDENT CORRESPONDENCE 2. AGENCY-SPONSORED .yea      ? ti.Iw! ?.%s.       -. RESIDENT CORRESPONDENCE 3. AGENCY-SPONSORED RESIDENT CORRESPONDENCE 4 AGENCY-SPONSORED RESIDENT CORRESPONDENCE' AGENCY-SPONSORED S WS  Filled EnET In) SECTION VIII                                                 AGENCY EMPLOYMENT HISTORY 1. INCLUSIVE DATES (From_To-by month & year) 2. LOCATION (Country, City) 3. DIRECTORATE -OFFICE OR DIVISION, BRANCH t4Tv1.j(.fi!- L 4. TI   OF JOBL C R 5. GRADES HELL /~ 6. DESCRIPTION OF DUTIES ea se a 1. INCLUSIVE DATES From- To- by month B year) 2. LOCATION (Country, City) 3. DIRECTORATE-OFFICE OR DIVISION, BRANCH /NOV. IQs'), - rvl 1 5 F _ 4. TITLE OF JOB 5. GRADES HELD IN JOB S t~Le CIt LL            ww-- /.\ - 6. DESCRIPTIbN OF DUTIES S?eC4a1      SStc~rr+l..ea~~s 1. INCLUSIVE DATES (From-To-by month 6 year) 2. 3. DIRECTORATE-OFFICE OR DIVISION, BRANCH 4. TITLE OF JOB 5. GRADES HELD IN JOB J  /e s 'F .   11 H !  --   ~--- 6. DESCRIPTION OF DUTIES --~ T~ /es-toyc/eae..S Ste eta             049 sST'tH    1--.1 'k 01 S                                                                           RET - 5 - SECTION VIII                                           . AGENCY EMPLOYMENkHISTORY (Cont'd)' - 1. INCLUSIVE DATES (From-To-by month & year) 2. LOCATION (Country, City) 3. DIRECTORATE-OFFICE OR DIVISION, BRANCH 4. TITLE OF JOB                                                                                       "-         - 5. GRADES HELD IN JOB 6. DESCRIPTION OF DUTIES 1. INCLUSIVE DATES From- To- by month & year) 2. LOCATION (Country, City) 3. DIRECTORATE-OFFICE OR DIVISION, BRANCH 4. TITLE OF JOB 5. GRADES HELD IN JOB 6. DESCRIPTION OF DUTIES 1. INCLUSIVE DATES (From-To-by month & year) 2. LOCATION (Country, City) 3. DIRECTORATE-OFFICE OR DIVISION, BRANCH 4. TITLE OF JOB                                                                                    / 5. GRADES HELD IN JOB 6. DESCRIPTION OF DUTIES SE*ET (Whe Filled In) SE  ET (When  slIed In) SECTION IX MARITAL STATUS 1. PRESENT STATUS (Single, Morried, Widowed, Seporo ted, D;norned, Annulled, Remnrr;ed) SPECIFY:                       b,, 9 se 2. NAME OF SPOUSE                       (Last) (First)                                                                                                                              (Mid el (hoiden) 3. DATE OF BIRTH 4. PLACE OF BIRTH  (City, Stole, Country) 5. OCCUPATION 6. PRESENT EMPLOYER 7. CITIZENSHIP 8. FORMER CITIZENSHIP(S) COUNTRY(IES) 9. DATE U. S. CITIZENSHIP ACQUIRED SECTION X DEPENDENT CHILDREN AND DEPENDENTS OTHER THAN SPOUSE NAME RELATIONSHIP DATE AND PLACE OF BIRTH CITIZENSHIP PERMANENT ADDRESS 10 11144 4            s gQ SZ~ /) o.b4k r-~  ~? S0~ ~7J-~..,~r9                                                     SS rE -X12 ~S, sC+-s~ SECTION X1 PROFESSIONAL SOCIETIES AND OTHER ORGANIZATIONS NAME AND CHAPTER DATE OF MEMBERSHIP ADDRESS (Number, Steed, City, Stole, Country) FROM TO Z%-v,%-. All a DATE SIGNATURE OF EMPLOYEE