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( ( : 7 BUY 3%. .ted States Department of Jus, sine Federal Bureau of Juvestigation a2 Washington, DB. €. © BERTI ATIN TE SREY 4 Director Federal Bureau of Investigation United States Department of Justice Washington, D. C. Dear Sir: For inclugion 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 CHECK - MOWEY-ORBER) the sum of $10, payable to the Chief Clerk of the FBI, to be included in gaid fund. Payment will be made for death by self-destruction after the Agent has been a member of the fund for two years. It is understood and agreed that the eum tendered herewith is a voluntary, gratuitous contribution to said fund which I understand is to bu administered in the following manner. The Director of the FSI will appoint a committees which shall consider all matters pertaining to the acquisition, safe keeping and expending of said fund, which committee will recommend appropriate action to the Director in pertinent matters. The Chief Clerk of the FBI shall receive all contributions and account for same to the Director. Upon the death of any Special Agent who ia a mamber of said fund the appointed committees will consider the case and submit a recommendation to the Director as to ite conclusions. Ap- propriate inatructions will then be issued to the Chief Clerk, directing him to pay to the designated beneficiary the sum of $10,000. Ths following person is designated ap my beneficiary for FBI Agentea' Insurance Fund: Name - Ss Late Relationship Address Date _O-'O- S°O The following person is designated as my beneficiary under the Chae. 5. Rose Fund providing $1500 death benefit to beneficiary of agente killed in line of duty. Name bo ie aver Relationship Date “a7 10-7 7059 Address __ CHM! Ee One aa , Very truly yours, MAR Of iysG oO mo a ee ¢ =e Meese CAL, ~