PERIODIC SUPPLEMENT - CARANCI, JOHN C.

• Document Type: FOIA
• Keywords: CARANCI JOHN C
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0001496512
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 6
• Document Creation Date: June 22, 2015
• Document Release Date: December 31, 2008
• Case Number: F-2007-00327
• Publication Date: May 17, 1957

SECTION I X GENERAL
SECTION III MARITAL STATUS
AP
PROVED FOR RELEASE
12
-Nov-2008
(b131
PERIODIC SUPPLEMENT
THIS DATE
PERSONAL HISTORY STATEMENT
/~""
INSTRUCTIONS
This form provides the means whereby your official personnel records will be kept current. Even though it duplicates
information you have furnished previously, it will be necessary for you to complete Sections _I through VI in their
entirety. You need complete Sections VII through XIII only if there has been a change since you entered on duty with
the organization or if you believe the item requires more complete coverage than you have previously reported.
1. FULL NAME (Last-First-M1 e)
2. CURRENT ADDRESS (No., reet, City, Zone, State)
3. PERMANENT ADDRESS (No., Street, City, Zone, State)
V,-,e L'! mod'.
4. HOME TELEPHONE NUMBER
5. STATE, TERRITORY, POSSESSION OR COUNTRY IN WHICH YOU NOW CLAIM RESIDENCE
SECTION II PERSON TO BE NOTIFIED IN CASE OF EMERGENCY
Lest-Fist?Middle PREFERABLY RESIDING IN U.S. 2? RELATIONSHIP
4. BUSINESS ADDRESS o . , ree t y, one, a e, ou M M IF APPLICABLE
5? HOME TELEPHONE NUMBER 6? BUSINESS TELEPHONE NUMBER 7. BUSINESS TELEPHONE EXTENSION
IN CAbh OF tMtKU~N~T. V1 HER CLOSE RELATIVES pouse, Mother, a er MAY ALSO BE NOTIFIED. IF SUCH NOTIFICATION
IS NOT DESIRABLE BECAUSE OF HEALTH OR OTHER REASONS, PLEASE SO STATE.
I. CHECK (X) ONE: SINGLE MARRIED WIDOWED SEPARATE DIVORCED ANNULLED
2. FURNISH DATE, PLACE AND REASON FOR ALL SEPARATIONS, DIVORCES OR ANNULMENTS
WIFE OR HUSBAND: If you have been married more than once, including annulments, use a separate sheet for former wife
or husband giving data below for all previous marriages. If marriage is contemplated, provide same data for fiance.
3. NAME (First) (.Middle) (Maiden) (Last)
4. DATE OF MARRIAGE
5. PLACE OF MARRIAGE (City, State, Country)
6. HIS (or her) ADDRESS BEFORE MARRIAGE (No., Street, City, State, Country,;sP';?
7. LIVING
8. DATE OF DEATH
9. CAUSE OF DEATH - -+""
YES NO
- ~(?~
10. CURRENT ADDRESS (Give last address, if deceased)
y
11. DATE OF BIRTH
12. PLACE OF BIRTH (City, State, Country) ..`~
13. IF BORN OUTSIDE U.S.-DATE OF ENTRY
14. PLACE OF ENTRY
15. CITIZENSHIP (Country)
16. DATE ACQUIRED
17. WHERE ACQUIRED (City, State, Country)
18. OCCUPATION
19. PRESENT EMPLOYER (Also give former employer, or if spouse is deceased or
unemployed, last two employers)
20. EMPLOYER'S OR BUSINESS ADDRESS (No., Street, City, State, Country)
SECTION III CONTINUED TO PAGE 2
F
5 444b USE PREVIOUS EDITIONS. E
4)
FORM NO
DEC
6
 oKT
(When flied In
SECTION III CONTINUED FROM PAGE 1
21. DATES OF MILITARY SERVICE (From- and To- ) BY MONTH AND YEAR
22
. BRANCH OF SERVICE
23- COUNTRY
WITH WHICH MILITARY SERVICE AFFILIATED
24. DETAILS OF OTHER GOVERMENT SERVICE, U.S. OR FOREIGN
SECTION IV RELATIVES BY BLOOD, MARRIAGE OR ADOPTION LIVING ABROAD
OR WHO ARE NOT U.S. CITIZENS
1. FULL NAME Last-First-Middle
4. I DES
5. CITIZENSH oun ry 6. FREQU
2. RELATIONSHIP 3.
7. DATE OF LAST CONTACT
AGE
2
1. first-Middle)
4.
5. CIT 6 CONTACT
J2. RELATIONSHIP
7. DATE OF LAST CONTACT
3.
AGE
first-Middle)
4. AUUHL%ib OR UN TRY IN WH CH LATIVE RESIDES
H__ REQ UENCY O CONTACT
2. RELAT IONNSH IP
7? DATE OF LAST CONTACT
3.
AGE
t-First-Middle)
2. RELATIONSHIP
3?
AGE
4
4. ADDRESS OR COUNTRY IN WHICH RELATIVE RESIDES
5. CITIZENSHIP (Country)
6. FREQUENCY OF CONTACT
7. DATE OF LAST CONTACT
5.
SPECIAL REMARKS. IF ANY, CONCERNING THESE RELATIVES
SECTION V FINANCIAL STATUS
1.
ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY? e x YES
NO
2.
IF YOUR ANSWER IS "NO" TO THE ABOVE, STATE SOURCES OF OTHER INCOME
3. BANKING INSTITUTIONS WITH WHICH YOU
HAVE ACCOUNTS
NAME OF INSTITUTION
ADDRESS (City, State, Country)
r G
/'
SECTION V CONTINUED TO PAGE
3
 SEAT
(When filled In)
SECTLON V CONTINUED FROM PAGE 2
4.
HAVE YOU.,EVER BEEN IN. OR PETITIONED FOR, BANKRUPTCY? YES NO
5.
IF YOUR ANSWER IS "YES" TO THE ABOVE QUESTION. GIVE PARTICULARS, INCLUDING COURT AND DATE(S)
6.
00 YOU RECEIVE AN ANNUITY FROM THE UNITED STATES OR DISTRICT OF COLUMBIA GOVERNMENT UNDER ANY RETIREMENT ACT,
PENSION, OR COMPENSATION FOR MILITARY OR NAVAL SERVICE? O YES ly INO
ICI
7.
IF YOUR ANSWER IS "YES" TO THE ABOVE QUESTION. GIVE COMPLETE DETAILS
8?
DO YOU HAVE ANY FINANCIAL INTEREST IN, OR OFFICIAL CONNECTION WITH, NON-U.S. CORPORATIONS OR BUSINESSES OR IN OR
WITH U.S. CORPORATIONS OR BUSINESSES HAVING SUBSTANTIAL FOREIGN INTERESTS? IF ^ IF YOU HAVE
I I Y E S F I N O
ANSWERED "YES". GIVE COMPLETE DETAILS ON A SEPARATE SHEET AND ATTACH IN A SEALED ENVELOPE.
SECTION VI CITIZENSHIP
I.
PRESENT CITIZENSHIP (Country)
A
1
/
_
2? CITIZENSHIP ACQUIRED BY ? CHECK (X) ONE:
? BIRTH MARRIAGE OTHER (Specify):
3.
HAVE YOU TAKEN ST
P
E
S TO CHANGE YOUR
PRESENT CITIZENSHIP? a YES ( No
4. GIVE PARTICULARS
..~___ -._......_
5.
IF. YOU HAVE APPLIED FOR U.S. CITIZENSHIP, INDICATE PRESENT STATUS OF YOUR APPLICATION (First papers, etc.)
SECTION VII EDUCATION
I. CHECK (X) HIGHEST LEVEL OF EDUCATION ATTAINED,
LESS THAN HIGH SCHOOL GRADUATE
OVER TWO YEARS OF COLLEGE NO DEGREE
HIGH SCHOOL GRADUATE
BACHELOR'S DEGREE
TRADE, BUSINESS, OR COMMERCIAL SCHOOL GRADUATE
GRADUATE STUDY LEADING TO HIGHER DEGREE
TWO YEARS COLLEGE OR LESS
MASTER'S DEGREE DOCTOR'S DEGREE
2. COLLEGE OR UNIVERSITY STUDY
NAME AND LOCATION OF COL
G
SUBJECT
DATES ATTENDED
DEGREE
DATE
SEM/QTR.
LE
E OR UNIVERSITY
MAJOR
MINOR
FROM
TO
RECD
REC'0
HOURS
SPECIFY
3. TRADE. COMMERCIAL AND SPECIALIZED SCHOOLS
DATES ATTENDED
TOTAL
NAME OF SCHOOL
STUDY OR SPECIALIZATION
FROM
TO
MONTHS
4.
MILITARY TRAINING (Full time duty in specialized schools such as Ordnance, Intelligence, Communications, etc.)
NAME OF SCHOOL
ST
DY
DATES ATTENDED
TOTAL
U
OR SPECIALIZATION
FROM
TO
MONTHS
5.
OTHER EDUCATIONAL TRAINING NOT INDICATED ABOVE
 SECTION VIII FOREIGN LANGUAGE ABILITIES
LANGUAGE
COMPETENCE IN ORDER LISTED
HOW AC
QUIRED
EQUIVALENT
FLUENT
ADEQUATE
ADEQUATE
(List below each language in
TO
BUT
FOR
FOR
LIMITED
CONTACT
ACADEMIC
which you possess any degree
NATIVE
OBVIOUSLY
RESEARCH
TRAVEL
KNO WLEDG
NATIVE
PROLONGS
(WITH
STUDY
of competence. Indicate your
FLUENCY
FOREIGN
TO
O
TRY
RESIDENCE
PARENTS
(ALL
proficiency to read, write or
R R D
-^
--
S
UN
ETC. )
LEVELS)
speak by placing a check (X) in
,IM
-..X+
.S
r;
I
the appropriate boxes)
R
W S
W S
5 R
?W
W
S
2. IF YOU HAVE CHECKED "ACADEMIC STUDY" UNDER "HOW ACQUIRED". INDICATE LENGTH AND INTENSIVENESS OF STUDY
3? DESCRIBE YOUR ABILITY TO DO SPECIALIZED LANGUAGE WORK INVOLVING VOCABULARIES AND TERMINOLOGY ON THE SCIENTIFIC,
ENGINEERING, TELECOMMUNICATIONS, MILITARY OR ANY OTHER SPECIALIZED FIELD
SECTION IX GEOGRAPHIC AREA KNOWLEDGE
1. LIST BELOW ANY FOREIGN REGIONS OR COUNTRIES OF WHICH YOU HAVE KNOWLEDGE GAINED AS A RESULT OF RESIDENCE, TRAVEL,
STUDY OR WORK ASSIGNMENT. UNDER COLUMN "TYPE OF SPECIALIZED KNOWLEDGE". INDICATE TYPE OF KNOWLEDGE SUCH AS
RRA N C A TS HARBORS. UTILITIES. RAILROADS, INDUSTRIES, POLITICAL PARTIES ETC.
DATES OF
KNOWLEDGE ACQUIRED BY
NAME OF REGION OR COUNTRY
TYPE OF SPECIALIZED KNOWLEDGE
RESIDENCE.
WORK
TRAVEL, ETC.
RES1~
TRAVEL
STUDY
ASSIGN-
DEN CE
MENT
2. INDICATE THE PURPOSE OF VISIT, RESIDENCE OR TRAVEL FOR EACH OF THE REGIONS OR COUNTRIES LISTED ABOVE
SECTION X TYPING AND STENOGRAPHIC SKILLS
I. TYPING (W.P.M.)
2. SHORTHAND(W.P.M.)
3. SHORTHAND SYSTEM USED ? CHECK (X) APPROPRIATE ITEM
GREGG SPEEDWRITING STENOTYP OTHER (Specify):
4. INDICATE OTHER BUSINESS MACHINES WITH WHICH YOU HAVE HAD OPERATING EXPERIENCE OR TRAINING (Comptometer, Mimeo-
graph, Card Punch, etc.)
SECTION XI SPECIAL QUALIFICATIONS
I. LIST ALL HOBBIES AND SPORTS IN WHICH YOU ARE ACTIVE OR HAVE ACTIVELY PARTICIPATED. INDICATE YOUR PROFICIENCY
IN EACH
2. INDICATE ANY SPECIAL QUALIFICATIONS. RESULTING FROM EXPERIENCE OR TRAINING, WHICH MIGHT FIT YOU FOR A PARTICULAR
POSITION OR TYPE OF WORK
3. EXCLUDING EQUIPMENT NOTED IN SECTION X. LIST ANY SPECIAL SKILLS YOU POSSESS RELATING TO OTHER EQUIPMENT OR MA-
CHINES SUCH AS OPERATION OF SHORTWAVE RADIO, MULTILITH, TURRET LATHE, SCIENTIFIC AND PROFESSIONAL DEVICES, ETC.
{{4? IF YOU ARE A LICENSED OR CERTIFIED MEMBER OF ANY TRADE OR PROFESSION (Pilot, Electrician, Radio Operator, Teacher,
Lawyer, CPA, Medical Technician, etc.), INDICATE THE KIND OF LICENSE OR CERTIFICATE, NAME OF ISSUING STATE, AND
REGISTRY NUMBER, IF KNOWN.
5, FIRST LICENSE OR CERTIFICATE (Year of issue)
6. LATEST LICENSE OR CERTIFICATE (year of issue)
SE T
(When4lilled In)
 l e
;yhen iid'In)
(
J SECTION XI CONTINUED FROM PAGE 4
7. LIST ANV SIGNIFICANT PUBLISHED MATERIALS OF WHICH YOU ARE THE AUTHOR (Do not submit copies unless requested).
INDICATE TITLE, PUBLICATION DATE. AND TYPE OF WRITING (Non-fiction, scientific articles, general interest sub-
jects, novels, short stories, etc.)
8. INDICATE ANY DEVICES WHICH YOU HAVE INVENTED AND STATE WHETHER OR NOT THEY ARE PATENTED
9. LIST ANY PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE
10. LIST ANY PROFESSIONAL, ACADEMIC OR HONORARY ASSOCIATIONS OR SOCIETIES IN WHICH YOU ARE NOW OR WERE FORMERLY A
MEMBER. LIST ACADEMIC HONORS YOU HAVE RECEIVED.
SECTION XII ORGANIZATION WORK EXPERIENCE - SINCE LAST COMPLETION OF A PERSONNEL QUALIFICATIONS QUESTIONNAIRE
I. INCLUSIVE DATES (From- and To-)
2. GRADE
3. OFFICE/DIVISION/BRANCH OF ASSIGNMENT
4. NO. OF EMPLOYEES UNDER YOUR DIRECT
SUPERVISION
5. OFFICIAL POSITION TITLE
6. DESCRIPTION OF DUTIES
1. INCLUSIVE DATES (From- and To-) 2. GRADE
3. OFFICE/DIVISION/BRANCH OF ASSIGNMENT
4. NO. OF EMPLOYEES UNDER YOUR DIRECT 5. OFFICIAL POSITION TITLE
SUPERVISION
2
6. DESCRIPTION OF DUTIES
I. INCLUSIVE DATES (From- and To-)
2. GRADE
3. OFFICE/DIVISION/BRANCH OF ASSIGNMENT
3
4. NO. OF EMPLOYEES UNDER YOUR DIRECT
SUPERVISION
S. OFFICIAL POSITION TITLE
6. DESCRIPTION OF DUTIES
I. INCLUSIVE DATES (From- and To-)
2. GRADE
3. OFFICE/DIVISION/BRANCH OF ASSIGNMENT
4
4. NO. OF EMPLOYEES UNDER YOUR DIRECT
SUPERVISION
5. OFFICIAL POSITION TITLE
6. DESCRIPTION OF DUTIES
I. INCLUSIVE DATES (From- and To-)
2. GRADE
3. OFFICE/DIVISION/BRANCH OF ASSIGNMENT
5
4. NO. OF EMPLOYEES UNDER YOUR DIRECT
SUPERVISION
5. OFFICIAL POSITION TITLE
6. DESCRIPTION OF DUTIES
(Use additional 'pages if required)
S SET
 SE '
(When mill ed In)
SECTION XIII
CHILDREN AN OTHER DEPENDENTS
I. NUMBER OF CHILDREN (Including stepchildren
and adopted children) WHO ARE UNMARRIED,
UNDER 21 YEARS OF AGE, AND ARE NOT SELF-
SUPPORTING.
2. NUMBER OF OTHER DEPENDENTS (Including spouse,
parents, stepparents, sister, etc.)
WHO DEPENI ON YOU FOR AT LEAST 50% OF
THEIR SUPPORT, OR, CHILDREN OVER 21 YEARS
OF AGE WHQ APP ~QT qP1 r. P
3. PROVIDE THE FOLLOWING
INFORMATION FOR ALL CHILDREN AND DEPENOENTS
SEX
NAME
RELATIONSHIP
YEAR OF BIRTH
N
F
CITIZENSHIP
ADDRESS
ADDITIONAL COMMENT AND/OR
CONTINUATION OF PRECEDING ITEMS
DATE COMPLETED
SIGNATURE OF EMPLOYEE