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( ( UNITED STATES DEPARTMENT OF JUSTICE FEDERAL BUREAU OF INVESTIGATION fa Reply, dlease Refer to ~ File No, Foe cde to’ puted Corewe fy pataer pate tl tates (oe ot mers of dus time wi ' it T abe Noam et tect be paid to the desighated bener cary ofoany Special Agent ct the F°RI who hes Previgk: i. - aot? fiogor dow Jie Mf TRY Cadboe em cept ceatedentruction while employed us a Special Acpent, Coan pore eoibdbe 8 pewedt: (by Check + Money Order} the sum af £2, payable tf S.A.I.F., te be an duded in gard fund. Payeent well k : : petty cdtede. th hc outter tue Arent has beer qaomember of the fund fata continuqus pened uf two years, Tt. ‘ boctn. eooeoa thatthe sun “endered herewath de a vedundary, Qidtuilout contribution ta said fund which | understand ro Laer, Tokar th f° Wang manned. Tre fee tet of the Fast will appoint a committee which shaj] consider aj] matters pertaining to the aequisition, sate keep doe an tung ef Said fund, whick commattee will recommend @ppropnate action te the Director in pertinent matter... Due AsSastan shot po ot the Administrative Division of the FBI shall receive aj] contributions and account for same to the wtarct me he ogerth Gt any Specia] Agent whe ia @ member of said tund the appointed committee wit] consider the case and feo wnat on vendats.h t. the Director ge ta tts conclusions, Appropriate inatructions will then be ipeued ta ihe Assist ant roche poob tt fodmanigstortive dtivision, directing him to pay to the designated beneficiary the sum of $20,006. The liability Gt ee tus tore tl nat upder any circumspiagnces @exceed the amount of monies in the fund at the time any liability shall occur. EXECUTE IN DUPLICATE AND SUBMIT BOTH COPIES TO THE BUREAU WW icral “Hureau Name (please “type or print} Office of Assignment (or SOG Division} J. Edgar Hoover Director's Office the following person is desighuted as my beneficiary for Special Agente Ineurance Fund: Nane (primary bene lie Jury; Use given firat name if female) Relationship Clyde A. Tolson A idrens Name (cu. ungent be nefciary, if desired; use given first name if female) Relationship Address Do youd: .re te de a guute the above-listed beneficiaries as the beneficiary and contingent beneficiary respectively of the “has. S Rees Furs as well? 07 Yeu C_} No If not, the entire following portion must be executed. The follow os. cerson is designated as my beneficiary under the Chae. 8. Ross Fund providing $1500 death benefit to ueneficiary of agents killed in the line of duty, other than travel accidents. same (primary beneficiary; use given firal name if female) Clyde A. Tolson Relationship Address Na w (continge wnt ter ficiary, if desired, use given firet name if female) | Relationship ve ee ee ee Address —_— Very truly yours, ——_——e ee . ector Nad on i