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* r< 3122 UNITED STATES DEPARTMENT OF JUSTICE “oe as: s FEDERAL BUREAU OF INVESTIGATION in Reply, Please Refer Fle Ne. WASHINGTON 33, D.C. 7 Director W-2uli-S — Federal Bureau of Investigation United States Department of Justice Washington, D. C. Dear Sir: For inclusion in the fund to be paid to the designated beneficiary of any Special Agent,of the FBI who has previously contributed to this fund and who dies from any cause except self-destruction while employed as a Special Agent. I am forwarding herewith (by CHECK ~ MCNEY ORDER) the sum of $10, payable to the Assistant Director, Administrative Division, FBI, to be included in said fund. Payment will be made for death by self-destruction after the Agent has been a member of the fund for a continuous period of two years. It ie understood and agreed that the sum tendered herewith ja e voluntary, gratuitous contribution te said fund whieh I understand is to be administered in the following manner. The liability of the fund shall not under any circumstances exceed the amount of monies in the fund at the time any liability shall occur. The Director of the FBI will appoint a committee which shall consider all matters per- taining to the acquisition, safe keeping and expending of said fund, which committee will recom- mend appropriate action to the Director in pertinent matters. The Aasistant Director of the Administrative Division of the FBI shall receive all contributions and account for same to the Director. Upon the death of any Special Agent who is a member of said fund the appointed com mittee will consider the case and submit a recommendation to the Director as to ita conclusions. Appropriate instructions will then be issued to the Assistant Director of the Administrative Division, directing him to pay to the designated beneficiary the sup of §10,000. The following person is designated as my beneficiary for FBI Agents’ Insurance Fund: . Rame a Relationship Date_- Address The following person is designated as my beneficiary under the Chas. S. Ross Fund providing €1500 death benefit to beneficiary of agents kiijeg in line ef duty, ae NAME _ Relationship Date _ Address | NOV 21 1952 , OG Noy 21 i967 Very truly JOUrAs ook a WEE Die name, tne mn aE AEE