ML19053A689
ML19053A689 | |
Person / Time | |
---|---|
Issue date: | 02/15/2019 |
From: | NRC/OCIO |
To: | |
References | |
FOIA, NRC-2018-000725 | |
Download: ML19053A689 (12) | |
Text
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- Menial John Patton Longview. Washington
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11\VIIIU f pnt,Jot,.1* mtJrrilzke. ml' t, C'i'4 oil<< Off" Y6U 1/Jan)' *o&*eqrttllt to Ulr ~ I I , of tl&fa !lUtSfkiWJll't. it 1111/I bl tu 1"""poua
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I Father Mother Charles frank Bazata.
Alma A1y1ettnger Bazata v 100 Dead 92 Pres. Home.Car11s1 *PA.USA USA USA USA f Wffe Marte p erre sencmuter ,__ 35 RT2,Bx97,.01ckerso , MO II E FRENCH Fath.-1 -Lav Noel Senequ1er- zet 65 Papeterie de la Go t Domenetzere, Fran e FRAN E FRENCH Mo .-in-Law Marte-Magde1efne Sap~ s.-c. Dead' .
. 'Brother Charles Frank Baz~ v* 68 . M1aa1, Florida USA USA S1ster Beatrice Brown {)J.~ ~ 67 Dead USA USA Ex Wf.fe 5101 Rfver Rd.
Diana _Ch.trl~fson~ata .
(b) (6)
Penelope .Grant, Bazata *.
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' Chevy *Chase. MD Sfctly USA Ex Wffe *
(Dates and laces for 111rrfages and divorces
? London, England (fult~t- knovn) tsted.on reverse si e)
Australt Brftfsh.
i l&. REJ,'E~C~.(Nomt 'thlW./'RfOII.'* Ni>t Ref#~'vtt tJr Employer,, Whl> I.re. Wfll A.c,q~tai Wit,\ 'ri>tJ), .
Reference list attached.
., CB8.'t1flCA2'ION I Aou, ~.OU .o/tM obow qumton., lt1rtrti ~ 1M lltf61'111r,t/qt,;fwt,l,Md " 071,!1111r ro* thu1.qli#llons II Nrrecl Md to/rlfl(M.to tA~ &!it of Ill.)' l<MJwlrdg1 (Ill(.( " ' ~ On4 *l Ptldtntontl lAal i'r fa of gttllf lmpOTVM~I '111 IM. e'>lll'"r(/.twA 6/ 111).' .t/glbl/l.ty to, lfflJriJy ~ - ot ~,.
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- , 'l'o ~s ~tLt.EDOU.'r ar*AotNCY 01u*11tM EM)'lOYINCI , , ,.
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But1dtn~1M.aoagement
. . . S~1a16st It US rluclear Re lator.y C011111fstfo11 ADDRESS Washington, o. c. 20555 WU,l, PBRSON ffAVJ: ACX:ESS TO: I
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115 It Marrfed Qfana. C,*Baza~- Newark, HJ 1942 or 1943<, * *. * 'IJ.L.*. *, .. * .. *!
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Divorced * * * '.
- 1fashtngton. D.c. 1945. 6t or 7 Married Penelope G.
- Bazata- .London, England 1/5/48..~ . .
Divorced
- Kens1ngton, London,.England (Applted.1/15/52 and
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Mlrrfed Marje P. Senequter-- Attbe$, f'rance 5/10/70 I 4- , ... **
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, ~TOMIC eNERGY COMMISSION
, WASAINGTON, D,C, J0$4$
- L SECURITY' QUESflONN B. U yov, on,wer ro A It "YH'!, 414 yov, dwlt19 the petfo4 of ,..,c1' r,,,~1,,h~ or ouoclotlon, h1N* tho 1pecltlc lnl*nt to fyrth,, I, YCJES ~
tt.e 01111 of *~h or9011borlon or q,ovp of p,r,011, to ov,,,htow or onrt11t" "th* GoveJDtMtlf of ,,.. U11lt*)f $tot* or fl'IY p01itlcol 11/Wlvl1I011 thett~f l>y fore,, vlol111C*, or V11lowf11t aeon,t * . * .* '.
6, If )'9111 <J111wer toOuHt/0111 ,. o, 5o, .ohv* 1, ':¥**", 11010 l>elow, vMer "'"' No, 11, or OIi o 1oporote th!** ro h ottoc~d *o ond tt1o4o o port of thl,
~ttlonnolr*, the 110111n of oll ,111ch oroo11l1otlo11* 4,,.1 dot.. of ,.,,1111>,11Mp, Gin cOMpl,M d,tolh of yOVt ~etlvlllu 1h..1l11*~"'°"' ""1
- 111plot1otlon you d11lr1 t19<<dl110 >'°"' t111ml>er1lilp or octlvltlu, ME ADDRESS l"ROM TO Of'f'IC "EL.O 7, *ORGANIZATION MeMSERSHIP (lnclll4* oll pre ..111 -.um~*rshlp oll po1t 111e111 era Ip 111ln9""t
- lost 10 y1or1 In oll oroo11botlont (txcopt o or v11lo,ia olld relloloc,a oroo11l1otlon1) nol cove,1d b Qu.. 110111 5, ond 6, obove,) '
$. Hov* yo11 ever be*11 orr**t*d, ct.oro*4, Of lioW l>y Fe<l,rot. Sto1e, ~ 0,1,,, low ,11force10er1t O',/lhQrltiH f<< 011y vlolatloa ol otay YES~
f*derol low, $tot, faw, c.0111117 or 11>unlclpol low, requlotlon, .Of ordllionce? *oo i1otf11clvtfe Oll)'thl"9 thot hom111d l>1f9t9 yo11r l6tl, bhtt.40)', Oo 1101 lnclll4* traffic vSolotlone lot wlll~I, o fin, .of $30.00 ~ Ins wo*. l111po,..t, All oth*r ~h0<9n 1a11a1 .t.*
lnClll4ech;v.t1 If th.r WefO 4lt1111H04, I . I f I I Cll'\' I tryov* anawlll' ls "Y**"* c:0111Plot1 all c<'l1tl** lfl ltt<&t, ~*low, 9, ARRE$T$ (Co~pleto A,B,C, ori4 0 for ,act. co11, IMle1d* oll otr11tr~ f1,,.,, oth,, th011'"'l110, lrof£1c vlolotloi,1 evtt1 If the chor;u w*ro dl1111fu1d,)
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.1N$YAl,ICTION$ 'YO APPC,ICANT UPON COMP&,ETiON OF ABOVE a Now rhot rhe for,r, 'JI tlt11td, ploc* It ht th* pro,oddreo*d "IVtlop* fe1rra;,h,<I, ilo" ocrou ,r.. envelope flc,p on the lltae provU,d, and offhc rhe .cfot* of 1lono111r1, O*nv,, thl.,*ol*d *11v1tope to yo11r t~lorer 'i1a111t,ll<1ttlr ~ 1t1oll dlr,ct to th, oddren*** *, '
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(l,e, copy lro111 side PLEi\$l .. 'Before Mokl119 011y etltrlH Oft thlt 1lclt1 (I) ~.111ov* ~d rever,, co,bo,1 p~f, (2) Rev.r** l'h* o,der of copl**
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- Douglas Oel.Jitt Bazata.
REFERENCE LIST j'-1. DavhLfegan(Ernerson (b) (6) )
,I (b) (6)
,/
J,. Prof. Alan Haemer '((b)(6) )
V (b) (6)
. v--<b)(6)
- £. Frederick & Harriet Wildman ((b) (6) ) Occupation* Wine Importer
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~4. Paul Cyr(Might work for FEA, Wash. D.C.)
- Business phone in ~Wash., D. c. area- 961-8637
.I Is. . (b)Robert (6)
VanRoUen ((b) (6)
)
~ 6. Col. William Pietsch ((b)(6) )
(b) (6) .
. J'. Hon. wn liam E. Colby (b) (6) .
("' / s. Col
- Lu~i en E.
- Cone! ein (:(b) (6) )
V' (b) (6)
- t t- . Business. phone with DEA, WDC- 382-8825 r1'
)
- Glen Wolfe ((b) (6) '>
. (b) (6)
L. Frederick Schwartz (Plaza
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(b) (6) 1* Or. Bernard Knox ( (b) (6)
J Director of.Hellenic Affairs (b) (6)
)
FbP.s.a*
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-~, Dougla~ DeWitt Bazata REFEIRENCE llST (Continued) * . ...
- 12. Hon * .Phi111p Chadbourn
- Chief of Propaganda and Protocal (b) (6)
~ ~1a. Dr. Albert Rohan (Austrian citizen) 0
'(,P/ c/o Austrian State Department *
/' Vienna, Austria *
- 14. Edwinston Robbins and/or his wife (Phone #(b} (6) )
(b}(6)
(Robbins also has a* residence somewhere in Pe~nsylvania- Phone. #Lawrence (b) (6) )
~i, 15. Baron Hans-Georg VonStudnitz
~,. (b)(6)
- Baroness Madelein VonMunm (b) (6) .
~ -or-
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- 17. Jeoffrey Ha11owes (b) (6)
ORGANIZATIONAL MEMBERSHIP (b) (6)
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- 1NSTRUCTIONS,-:.~OMP1.ST£ THIS FORM IN PRIVATE, ALf. SECTIONS MUST BE COMPLETED. FORJA WILt. NOT Be ACCEPTED*
t/NLESS ~Mfitfi'tEL'f. 'Atll1 i>ROPERf.Y EXECUTED. T~ oniwet$ or stafc1M11,s on this for,,. ore p1lvilc9cd inlortr.otlor, between ro" cw! the Govcrnmenr, Tf Pe OR PRINT ALL ANSWERS. Write. "'None when cppllco61e, Enter ht lie,..,. J 1 Qfl'/ ot!rJltiol'IOI ln(ormoll,on, which 1110)' liCNe O hor/n9 on Y0!.11 sccu,Ur elecvonc1t, t( more $pOC:C Is teqvJred, c;olfocl. Otldirlonol sneets ond lt1dlcol1t ffiit I rem l)l,ll))Otrs to wPllc1t th. onswe,s or,ply*
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th* 011111, c-1 uch ~90'tla011011 o0t 9rqvp of p,r10t1* to overtllrow o, ovtllurll th* Govtrftfll*nl of the U\ltod $101.. or Oft'/ $tot* o, ony oolltlcol 1~<11-.,1,1~ thereof \,y fore*, vl0Te11ct, c,, ynlowful Mt<Hls?
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