APPOINTMENT AFFIDAVITS - KRAEMER, WILLIAM FINAL

• Document Type: FOIA
• Keywords: PERSONNEL FILES
• Keywords: KRAEMER WILLIAM FINAL
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0001361038
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: June 22, 2015
• Document Release Date: October 8, 2009
• Case Number: F-2006-01413
• Publication Date: November 26, 1951

STANDARD FORM 61 (REVISED AUGUST 1949)
PROMULGATED BY CIVIL SERVICE COMMISSION
FEDERAL PERSONNEL MANUAL
[bl[31
[bl[61
APPOINTMENT AFFIDAVITS
IMPORTANT. Before swearing to these appointment affidavits, you should read and understand the
attached information for appointee
(Department or agency) (Bureau or division) (Place of cmploymrnt)
I, ____~L~l,.1A_~____~,____]~_RAEME2__________________________________ do solemnly swear (or affirm) that-
A. OATH OF OFFICE
I will support and defend the Constitution of the United States against all enemies, foreign and
domestic; that I will bear true faith and allegiance to the same; that I take this obligation freely
without any mental reservation or purpose of evasion; that I will well and faithfully discharge the
duties of the office on which I am about to enter; SO HELP ME GOD.
B. AFFIDAVIT AS TO SUBVERSIVE ACTIVITY AND AFFILIATION
I am not a Communist or Fascist. I do not advocate nor am I a member of any organization
that advocates the overthrow of the Government of the United States by force or violence or other
unconstitutional means or seeking by force or violence to deny other persons their rights under the
Constitution of the United States. I do further swear (or affirm) I will not so advocate, nor will
I become a member of such organization during the period that I am an employee of the Federal
Government.
C. AFFIDAVIT AS TO STRIKING AGAINST THE FEDERAL GOVERNMENT
I am not engaged in any strike against the Government of the United States and that I will not
so engage while an employee of the Government of the United States; that I am not a member of
an organization of Government employees that asserts the right to strike against the Government
of the United States, and that I will not; while a Government employee, become a member of such
an organization.
D. AFFIDAVIT AS TO PURCHASE AND SALE OF OFFICE
I have not paid, or offered or promised to pay, any money or other thing of value to any person,
firm or corporation for he use of influence to procure my appointment.
E. AFFIDAVIT AS TO DECLARATION OF APPOINTEE
The answers given in the Declaration of .Appointee. on the reverse of this form are true .and
correct.
----~ ~?---- ~o_v_ e rrt~e_C ---~ Q S -~- -
(Date of entrantt oa duty)
I ll Y A A i.nA t
~
~='~-'___________, A. D. 19_*_~_.~
Subscril~d and sworn before me this _____~'~__~___ day of _6~_~'~`_"_`~~?~
~~r.ue)
e date of expiration of his ~mmission should
be shown. APPROVED FOR
RELEASE^DATE:
30-Sep-2009
 DECLARATION OF APPOINTEE
This form is to be completed before entrance on-duty. Answer all questions. Any false statement in this '
declaration will be grounds for cancellation of application or dismissal after appointment. Impersonation is a
criminal offense and will be prosecuted accordingly.
1. PRESENT ADD ESS (street and number, city end State)
11 ~a~~e-s~~SSe ~ ~` 3 ~RAIJI~FUP~T J`1 ~errnan
2 (A) DATE OF. BIRTH (B) PLACE OF BIRTH (city or Eown and State or country)
I
3. (A)IN CASE OF EMERGENCY PL,EASJJE NOTIFY (B) RELATIONSHIP
(~'~ c. Clan r ~~. K R A E M E (Z ~c~~e-r'
(C) STREET AND NUMBER, CITY AND STATE
~SyQ Via ),~, Sc`va _
k~a~as Verz~es ~rfia~es CQ,11
FR,~'=~.~.~~
THE PAST 24 MONTHS7 ~ YES ~ NO
If so, for each such rely tfva fill in the blanks below. If additional space fs necessary, complete under Item 70.
POST OFFICE ADDRESS
(I) POSITION (2) TEMPORARY-OR NOT
RELATION-
MAR-
SINGLE
NAME
..
if any)
(Give street number
(3) DEPARTMENT OR AGENCY IN- WHICH
SHIP
,
~ RIED
,
EMPLOYED
(Check one)
1.__________________________________________
3.
...
1.------------------------'-----___________
Z' --"'-"------------------------------'--
3.
1.__________________________________________
2 --------------'--------------------------
3.
INDICATE "YES" OR "NO" ANSWER BY PLACING "X?
10. SPACE FOR DETAILED ANSWERS TO OTHER QUES710NS
YES
NO
IN PROPER COLUMN
INEOM
WRITE IN LEFF COLUMN NUMBERS OF ITEMS 70 WHICH DETAILED ANSWERS APPLV
5. ARE YOUACITIZEN OF OR DO YOU OWE ALLEGIANCE TO THE UNITED STATEST__
x
6. ARE YOU AN OFFICIAL OR EMPLOYEE OF ANY STATE, TERRITORY, COUNTY, OR
- ~~~ _
MUNICIPALITYT_____________________________________________________________________
~/
.
If your answer is "Yos", give dotails in Item 10.
7. DO YOU RECEIVE ANY ANNUITY FROM THE UNITED STATES OR DISTRICT OF
COLUMBIA GOVERNM[NT UNDER ANY RETIREMENT ACT OR ANY PENSION OR
-""'~
_______________________________
-------~---- -------~---------~---------------------
OTHER COMPENSATION FOR MILITARY OR NAVAL SERVICET_____________________
~
~ -
_______
_
_
__
___
_
_
_
_
If your answer is "Yes", give in Item 70 reason for retirement,
~
______
_
__
_
_
_
_
_
___
____________
_________________________________________
_
that is, age, optional disability, or by reason of voluntary
______
__________________________________________________________________________________
oz involuntary separation after 5 years' service; amount of
retirement pay, and under what retirement act; and re Ling,
______
__________________________________________________________________________________
if retired from military or naval service.
_ _
B. SINCE YOU FILED APPLICATION RESULTING IN THIS APPOINTMENT HAVE YOU
~
_______ _________________ _____________-
__
_
_
_
_
-
BEEN DISCHARGED, OR FORCED TO RESIGN, FOR MISCONDUCT OR UNSATIS?.
------
______
_
__
__
_
______ _
__ ______
_
- ~~~~
FACTORY SERVICE FROM ANY POSITIONT_________________________________
/
X
If your nnswer is "Yes", give in Ifam 10 the name end address
ofemployer, data and reason in each cnse.
9. HAVE YOU BEEN ARRESTED (NOT INCLUDING TRAFFIC VIOLATIONS FOR
WHICH YOU WERE FINED 3250R LESS, OR FORFEITED COLLATERAL OF f250R
_____
____________________________________________________________________ -
______________
LESS) SINCE YOll FILED APPLICATION RESULTING IN THIS APPOINTMENTT r,
..
.
If your answer is "Yes", list all such cases under Item ]0.
n
'
Give in eacfi case: (1) The date; (Y) fbe nature of the offense
______
_____
or violation; (3) the nnma and location of flee court; (4) the
penalty imposed, if any, or other disposition of the case.
______
______________ __________________________________________________________
If nppoin fed, your fingerprin is will be taken.
The appointing officer before whom the foregoing certificate is made shalt
determine to his own satisfaction that this appointment would tie in conformance
with the Civil Service Act, applicable Civil Service Rules and Regulations and
acts of Congress pertaining to appointment,
This form should be checked for holding of office, pension, suitability in con-
nection with any record of recent discharge or arrest, and particulazly For the
following:
(I) Identity o! appeinfee.-It is the duty of the appointing officer to
guard against inpersonation andto determine beyond reasonable doubt that the
appointee is the same person whose appointment was authorized. The
appointee's signature and handwriting are to be compared with the application
aadJor other pertinent papers. If the appointee qualified~in.a wtittgn eaamir
nation, the signature on this form should be compared-with?the signature on
the declaration sheet, which was signed in the tasmination room. His physical
appearance .may be.checked againstthe medical certificate. The appointee
may also be questioned on his personal history for agreement with hie previous
statements.
(~ Age.-If definite age limits have been established for the position, it should
be determined that applicant is not outside the age range for appoiritment.
Until such determination is made, the appointment may not be consummated.
(3) Citizenship.-The appointing officer is responsible for observing the
citizenship provisions of (1) the Civil Service Rules and (2) appropriation acts,
Form 61 constitutes an affidavit for both purposes and is acceptable proof of
citizenship status in the absence of conflicting evidence. In doubtful cases the
appointment should not be'consummated until clearance has been aecured from
the certifying office of the Civil Service. Commission.
(4) Members of Family.-Section 9~of the Civil Service Act provides that
whenever there aze already two or more members of a family serving under
- probational of permanent ,appointment in the Competitive service, no other
member of each family is eligible for probational or permanent appointment in
the competitive service. The appointments of persons entitled to veteran
preference are not subject to this requirement. The members-o&family provision
does not apply to temporary appointments, Doubfful cases may be referred to
the appropriate office of the Civil Service Commission for decision,