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Thurgood Marshall — Part 12
Page 48
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Complaint Form
FD-71 (Rey. 7-21-67) Name
NOTE: Hand print names legibly; handwriting satisfactory for remainder.
indices: ([] Negative [-] See below
Subject’s name and aliases Character of case
UNS) 6; 7 (oss VAL PAT O/F ZEA)
Lace tir Qe CAS Sphere bev ll
RCo b6
a el nn ie
pesd7 Oz VEEL eb Obrn Fag? By | Complaint received y
co,
Aersonal ytCreptonic Date oe. Time. F |
“tj
SESTb0!
Address of subject , address and gelephone number
51 date and Birthplace
_ | 7 -
(} Male
Age Weight Eyes Complexion
(Cj Female
Scars, marks or other date
Subject's
Description
Facts of complaint
_ oti till te postin Ch 724 |i
Za a a §20 cae Lee
fee! (llaaevedl)
l sere, prec ght oat aif, FE, a lta «AE
a Cptetd/
a ff own ip sean, Llp Tle rel pe a
hi, Yoo ties VODA
ZLfED Wei Pet i OE a7 if ve
b7C
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