RESIDENCE AND DEPENDENCY REPORT - WILLIAM KING HARVEY (W/ATTACHMENTS)
Document Type:
Collection:
Document Number (FOIA) /ESDN (CREST):
0001228558
Release Decision:
RIPPUB
Original Classification:
U
Document Page Count:
3
Document Creation Date:
June 22, 2015
Document Release Date:
October 22, 2009
Sequence Number:
Case Number:
F-2003-01256
Publication Date:
January 24, 1950
File:
Attachment | Size |
---|---|
DOC_0001228558.pdf | 175.72 KB |
Body:
RESID~rdCF AA1D~~~'ETJDEIdCY REPO~',,,~
For use by staff officers and empi ,gees only. Submit in duplicate on entering
Service and v~henever designated ace of residence or marital or dependency
stat~zs. chan~!es. IrrPORTki1T in termining travel expenses and transit salary
allowable in connection c~ith 1 ave at Government expense, return to residence
upon separation, and in determining transportation expenses allowable in
connection with shipment of remains of officer or employee or member of family.
I~Tame of officer or emplo;*ee
William Bing Harvey
Place of residence eit~e;n appointed to service
If appointed abroad, last place of r~:~sidenc~ in continental TJnited States
Plac~:: i:. co., ~~.:~_nental i7nited States designated permanent or leF al residence
,~ ~ ~ ~~,y
_ _ _ :_
_____. ~
i Place of i'~~aria~?e ~ Date
~~oo~~~~~a.~;rN/~~~~
~._,l Single
or marria,ze
' ?lace of. c.i~?c^c~~ decree `DE.te o~ divorce decree
-- - ~
L~1 Divcrced
Q ?4'ido~aed
---- - i
.___._
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Place spouse died ;Date .;~ot~^e died
1--_ __._ __._.. ~
P~iem~ers c` H'a;t;il.y
(As llefired in C.y l J~ . il,
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APPROVED FOR RELEASE^DATE: 08-18-2009
" " cR ,r",~a ~o,W Lei EMPLOYEE'S WITHHOLDING EXEMPTION CERTIFICATEr x"' Emp~oya:'g~ eh+e
D.b.Treu ~ ~ ~ cerki8cste In your
my.~.~ ~ e e:r~~ ~ - ~ ~ , - _ ~/ (Collection of Income crag at'Source on Wages) '~`-' s~ee> ~ -
--- -- -
Print home addreaso16.2-7-----~p ~~.----5~=- ~- ~ ----?---.w~,~ ~!V -~ --- ~ N+----'~--: -~"~---- ------ ~ _~ ~----_.
Fu.e Tats Focus WITH Youx EMPLOI'EIt. Otherwise, he is required bylawto withhold tax"from yourw.agea witl
' HOW TO CLAIM YOlift WITHHOLDING EXEMPTIONS " '` "ii ,. a".~
II. If you are Mnxxmn, one exemption is allowed for the husband and one"exemption for the wife.
V. Add the number of exemptions which you have claimed above and write the total
I cExTSFr that t e number of withholding exemptions claimed on this cificate~d~ snot exceed thenumber to,wlyich I am entitled.
Dated-------- ------------``-~---~ 19~~ ~s-is-aa~c~-z (Signature) .~~.~-------------------~--- ---- ------------------------~;.;z;_-
exemption, write the figure "1"; if both will be 65 or older,:and you claim both :of these:
exemptions, write the figure " 2" ... .. ,,
(b) If you or your wife are blind, and you claim this exemption, write the figure "1"; if both are
blind, and you claim both of these exemptions, write the figure " 2"
IV. If during the year you will provide more than one-half of the support of ,persons olosely related"'to ''
you, write the number of such dependents. (See instruction 3 on other side.) ~ .. .
(b) if you claim one of theseexemptions;write the figure "1"
(c) If you claim neither of these. exemptions; write "0" .
III. Additional exemptions for age and blindness:
'
FUNDS
~~
PERSONNEL ACT1
ME -
DATE.;:
NATURE'OF
EFFECTLVE-DATE
.
TO
FROM
:
TITLE
GRADE AND SALARY
OFFICE ~
DIVISION
BRANCH
OFFICIAL STATION
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----. APPP.OVAL
Ur. FICATIONS
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(CLASSIFICATION
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YES NO
F05T DIFFE AL AUTHORIZED IN ACCORDANCE VNITH AGENCY REGU
LATIONS
7F ri OF OFFICE AND NO STRIKE AFFIDAVIT EXECUTED ON
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OVERSEAS AGREEMENT SIGNED
I'~O'fi ~. C8
ENTERED ON DUTY
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FFICER
RcMARKS:
PleASS truster leave
Security aoucUrtyae>
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