DOJ-OGR-00029681.tif

i Recor Request FD-125 (Rev. 4-1-93) Date b O oe oo7 O Birth © Credit Ay Criminal O Death CO INS CG Marriage* “ Motor Vehicle “Ol Other Buded b6 -2,-3 b7c -2,-3 b3 -1 File Number ZEW. Return to O06 2. Name and aliases ofsubject, applicant, or employee, and spouse Addres: Residence Business Former - * Date and place of marriage Gfapplicable} Race Sex Age Eyes Birthplace est NuMBer Fingerprint classification Criminal specialty Social Security Number ' | Divers License Number CO DLPhsto OO Other Specific information desired N CEC. Results of check b7E -1 CT A 03956-8419: DOJ-OGR-00029681