Declassified Per E.O. 13526 dtd 5 Jan 20
293 tmK. P. I . (MANlLAI2) X- 812
10-11 / 9.,-1? - to -I, I
/ (}cj~()
Declassified Per E.O. 13526 dtd 5 Jan 2010
REC.JSSIFICATIO~ SHEET '
-
. ~ L--'","~~
NEW CLASSIFICATION ___ ~f:..~__ ----------------~----~!:..~~ ~~ ,)( -'~/r
BE~LASSIFI~ATION SHEET QMC Fonn 857 (Revised 6-27-42)
Declassified Per E.O. 13526 dtd 5 Jan 2010
lebo , .
CARL R. H. MARK Cemetery Superin"C£iIUCl
P DISINTERMENT DIRECTIVE
//
SECTION A-NAME AND BURIAL LOCATION OF DECEASED "1'147 80687
NUMBER GRADE
PLOT GRAVE
P. I. 2
AND ADDRESS OF CONSIGNEE NAME AND ADDRESS OF NEXT OF KIN
lBIfBD 8!A.!IS m.I!Allt CIII'i'Klt! l ft. We azIlLBt, P. I.
X-812
BY PHtLCOM
02 DAY MONTH YEAR
ARM RACE RELIGION
CODE DIST. CTR.
DATE DISTINTERRED
18 Feb 1950 TAG ON ORGANIZATION RELIGION IDENTIFICATION VERIFIED BY
Shelter Half MEANS OF IDENTIFICATION
PAUL R NICHOLS Embalmer NAME AND nTLE
Skeletal
x-4855 Maus
REMAINS PREPARED AND PLACED IN CASKET
18 Feb 19 CASKET SEALED BY
CASKET BOXED AND MARKED
PAUL R NICHOLS
BAJ,MOND H TANGUAY Sgt Ie RA
SHIPPING ADDRESS VERIFIED BY
L. W. RICHARDSON RA I hereby certify that all the foregoing operations were conducted and accomplished under my immediate supervision
and that the report above is correct.
-0w.~ i?: vw•
REMARKS AND SPECIAL INSTRUCTIONS
RECORD OF CUSTODIAL TRANSFER
TO
AGRS MAUSOLEUM U S MILIT ARY CEMETE-:n. NAME OF CONVOYER
DATE SIGNATU~E OF RECEIVER
NAME OF CONVOYER
DATE SIGNATURE OF RECEIVER DATE
NAME OF CONVOYER
DATE SIGNATURE OF RECEIVER DATE
NAME OF CONVOYER
DATE SIGNATURE OF RECEIVER DATE
NAME OF CONVOYER
DATE SIGNATURE OF RECEIVER DATE
NAME OF CONVOYER
J.. SIGNATURE OF RECEIVER • r DATE
NAME OF CONVOYER
DATE SIGNATURE OF RECEIVER
('
\ C
~ Declassified Per E.O. 13526 dtd 5 Jan 2010
.... 'ARED BY PHILCOM . -.
~CIo1V1~2H'bb DI~IN tHMENT DIRECTltE I "
~ IS DY.1E 21(>~'Vlntsr m ISECEIAEIS IOV1E
\!d.I f~.~~!!ON A-
DIRECTIVE NUMBER DATE
KII-ID O~ COI-1AEAVIo1( Io1VW 01 rr.. ,("Ul:ll.. .~. ... a!I ... .. ",n ~ " .. _ IHHttAt-t8CAff9 ::r . ' ..... ~.
DAY MONTH YEAR
1** I""DI .... , •• "D I GRADE ARM I RACE IIIFIIr.lnN
• ...... 1 12HlbbEO - -~""'''.~" PLOT ROW I GRAVE ",., .. ",~, ,"" O~ ~I'U.UN"
. ?ICIo1V H' ".., r~
_lin..&. m _ L P .. !.t.!E ~IC".1nlS ~AJ:" a.Il. 'I'Jm. I !. .~. ---.... CODE I DIST._~
1011 J 0, r~"Ih\EA"L1CE SECTION B . CONSIGI ,._" • ,I:r' "" NAME AND ADDRESS OF CONSIGNEE ~AME AND ADDRESS OF NEXT OF KIN
tl!0W 10
. _!!IlIA.'" .... -..x e' 2. IbbEO" ~ ~ ~
~ .... ,r 11:". ,.I.. .-.. ,.a ,~"'''' .. .,. 'I r
?IC~1V1nISE 01: 2Hlbl.Et. ~£CTIDN t It.KM t.llt-." " ' IB'EN'ft1 NAME SERIAL NUMBER IGI ADE IDATE OF DEATH DATE DISTINTERRED
1<'1.10 O~ ~OI-lAEAV"'CE I-tYWE 101: COIo1.·,OAEIS -'~TION TAG ON nllr. '"V~ 10 ID"'It:.It'\N I ,,,,,,,,,"fICA TION VERifiED IY
n lII'u.a.INl;. 2' 2Hlbb£D
o MARKER NAME AN
SECTION 0-I PREPARATION OF REMAINS FOR SHIPMENT
"1UU'IIl' ." IDYlE 1-KJo1 01: COI'I"r. YHCE I'IYWE 01: COI'IAOAEII
OTHER MEANS OF IDENTIFICATION
l;ISOW .10
f 2HlbbED
MINOR ,Nr,I''' (Prepare Discrepancy Report Q He Form 1l~ ~4a for major d.; ~. ,n"i ... Q.)
2ICHV, m 2l-ilbbEIS DYlE 21CI-tV.1nISE 0" ISECEIO\EIS
Kli'1D 01: COI'IAEAYHCE I-tYWE 01: COIo1AOAEIS
REMAINS PREPARED AND PLACED IN CASKET
l~OW .10
DATE IY r (;"'DD~U CASKET SEALED BY t::>"nature)
21.:I-tYJ.nISE Of, 2HlbbEil DYJ.E 21CI'IV.lnISE 01: ISECElAEil
CASKET BOXED AND MARKED '" iIP"ING ADDRESS VERIFIED BY ;'"
KII'ID 01: COI-tAEA YIo1CE Io1YW!= 01: CO ..... AOAEIS
DATE IY
~.oW I h.erebY_.1:erfjfy that all the ~. .:. were LLO.". and . I!. under my'" .. II
and that the report above is correct. l' 2HlbbED
c'l,;ntJ.nISE 01: 2HlbbEJI DYiE 21CI'IV1nlSE 01: ISECEIAEIS
SIGNATURE OF AGRS 1~;)I"~'VII
...,....,..,. ."~INSTRUCTIONS Io1VWE 01: N"IIAAt'\ l""
~OW J.O F ~ ". r - ,. " , :,~,
'-' \. " ~,.,~
EC D O~ Cn210DIVr 11$ 2~EH
I QMC FORM 1194 REV1t FEB ..
.n
DY.lI:
P nm
IDYU
DYlE
DVlE
.: .
DV.1E
I
,
~
1'1
!
II
!.!
Ii
I ~
I ~
,
.
Ij Ii II
II
Declassified Per E.O. 13526 dtd 5 Jan 20
RECORD OF CUSTODIAL TRANSFER
1. SHIPPED FROM TO
NAME OF CONVOYER
2lC~YlnlSf 01: VCIS21H2bEClOIS
SIGNATURE OF SHIPPER DATE SlGNATUJIf OF RECEIVER DATE
c~ q auq accow
CY2KE!. 1l0X(i) \1110 W\lISII"EO
SIGNATURE OF SHIPPER DATE SIGNATURE OF RECEIVER DATE
3. SHIPPED FROM TO
EWVI~? blSEbVISEO Vl-lu br CEO 111 CV2KEl
ND OF CONVEYANCE NAME OF CON VOYER
DATE SIGNATURE OF RECEIVER DATE
4. SHIPPED FROM TO
IjlHE~ ,
ICIND OF CONVEYANCE NAME OF CONVOYER
DATE ~"~~~PP~E~R __________ ~ __ ~~~~r.D~A~TE~~C ~a. ... v~ 2ECI1011 0 bdEbYIlVlIOM OlllEWYIH2 lOIS 2HlbWEHl
HYWE Y lI.1fE
KIND OF CONVEYANCE H'1¥"E
SIGNATURE OF SHIPPER
FROM
OISCYI1IIV 110101
tiE Yl-10 \l001S1:22 01: COH2ICI1EE
SHIPP R
5. SHIPPED TO ISEnCIOH 10EHlI ICYllOH AEISII:IEO fA
NAMEIOF CONVOYER C YOE OVJ.E 01: OE"'lH O\lU DI21IH.1EISISED
DATE
YWE· VHD \lDOISE22 O~ I1EXl m KJI.1
2ECI10M B - COM21C ~O v ....
nw
D'MECIIAE l!10W ,,~ OV.1E
DATE SIGNATURE OF RECEIVER DATE
-Unk. p. I. anile) (X-4849 , !-2G06y 28cY/-1l tlu'u I-2S~, X-Z795, 279frA, Z79?
Tbru X-Z'/99, x 4101 and 1-4102) 26 J, ml 1950
Tdan 1f1cation of World W r II Doc sod
0 10
~
de to find nz of nld.nt1fiabll1 W d.
-4B49~ AGRS U8. l!12Jl1la, formerly X-816 II USAF Cam. :lfm.. 412 050. tf It " X-Q20 " n " n
" ~l# " " .. X-821 " " -tt-.. " ;It
x-4852. tt " " X-822 • n .. " .P
" X 85l: " " " X-B2; I' If If n " II
x-ha; .. " • " x-824 • It If " " ~
" X~55. " " " If X-812 • " " It •
" x-4656. " It " n 1-814 • If (1 " 7 " " X-615 .. " " tt
• 58. • " " x-C16 • " It " ~ • -2006. " tt X"2936, " p If • X-2007-A, If " " r. • -2937. n " .. " II
~a06. If " n " X-2930. " " " , .''-' .l1l--tt
~ • X-260C). " n n X-:/I . tt ft , X-2810. " n " .. O~ It If " ,
~ -2611, n " " tt X-2941. tt n It n • .. X-2012. n " " " X"'2942. " " " " • n X-219', If " x-2943. " " " n • 1--2'794 " n If " x-2944 .. It " " It ,.
" X-2'/95. " " " n X-2945 " n " " r. .. -Tl .. X-2796-A,. " " :'/ X~. " ft .
• " 1..-2797. " It " " X-29!.7. If n If ,. It X-2798. ft " tt " .l-~, n ft • n
• " X-2199. " " It " X-2949. tt n " • • X-4101. Uani1 if2.. P. I. n X-2796-B, AGRS Uaus. llan11a , • X-4102. " If n X-2607-B, It n •
2. Reo ndat10na for Unidentif b1lity haft been approv d by thi. Ottiuo. n quest your r.co~ be am nded aooordingly.
'llm '-LUARTERUASTER Gz...1lER..~,
~~Z REB A.. c. King. 1'YIS Lt. Colonel. 1.. ~. nute Meaorial Divis! n TEe J r.1Ddaor
AllUlAIL
Co .~ ••
Declassified Per E.O. 13526 dtd 5 Jan 2010
• • HEADQUARTLRS PHILCOi~! Zm~E
A~ :jERICAH GRAVES REGISTr-0~TI01~ SERVICE
SUBJECT: UnidenUfiable Remains
TO The Quarterme.ster Washington 25 ;1 D. C. Attn: Memorial Division
__ 12 __ . Dec +949 Date
The records pertaining to Unknown X - 812 , Plot 2-, Row -.3Q. , Grave 2481 ,USMC USAF Cem. mnila it2 have
been r evi ewed and it is tho opinion of this Office that insufficient
evidence is available to establish the identity of this deceased,
and that thos0 r emains should be classified as unidentifiable.
FOR THE CeMMANDING OFFICER:
Attch: Form 1044
. -~lAR
Captain, QMC Chief, Records Branch
IDENTIFICATION DATA REMAINS OF UNKNOWN 2. 01. TE
'L T"( C" X-4855 NA~E OF CEMETERY
uGR L1ausoleurn,
8. ESTIMATED WEIGHT
lTD .GIVE DESCRIPTION OF ANY OFFICIAL IDENTIFICAT ION
tor E
I).GIVE DESCRIPTION OF TATTOOS OR SCARS ON BOOY ANDIOR SUCH INFORMATION OBTAINED FROM OTHER SOURCES
1; T D
WAS BODY BURNED TO WHAT EXTENT
CJ YES Q9 NO WAS BODY MANGLED ? 10 WHAT EXTENT?
CJ YES [LJ NO DESCRIBE EVIDENCE OF HEALED FRACTURES AND BONE MALFORMATIONS
TOT E
17. LIST EVERY ITEM OF CLOTHING, EQUIPMENT AND PERSONAL EFFECTS FOUND, SHOWING THE TYPE, COLOR, SIZE, MARKINGS, SERV ICE, ETC. (11 laundry _rlr •• re JndJ.tinct such not.tion ahould be •• de .nd .".ei", .. n for".rded throu,h eh.nnel. lor ...... in.tion "hen I.elljti •• • re not .... JI.bl .. in th .. • re.)
TO:
"U NIL> E NT ~ f' sAB L E" "BY REASON OF LACK OF SUFFICIENT IfJENTIFYING DATA"
OMC FORM 10'IU REV 18 MAR '11 ....
PREVIOUS EDITIONS OF THIS FORM ARE OBSOLETE
29E-21-12-47 PAGE 1 OF 3
Declassified Per E.O. 13526 dtd 5 Jan 2010
, MISSI •• TEETH: ALL TEETH MISSING THROUGH EXTRACTION (NOT THOSE FRACTURED OR DISPLACED BY RECENT WOUNDS) SHOULD BE ·X· '0 OUT AND LABELED THUS:
CRc.lNEO TEETH: BLOCK IN SOLID AND CR()t/N OF TOOTH (LABEL GOLD, PORCELAIN, SILVER OR GOLD AND PORCELA IN). THUS:
BRIDGE WORK: BLOCK IN SOLID AND CROWN OF TOOTH (LABEL GOLD BRIDGE. GOLD AND PORCELAIN BRIDGE). THUS:
FILLINGS: DRAW FILLING ON TOOTH AS ACCURATELY AS POSSIBLE (BLOCK IN AND LABEL GOLD. SILVER. CEMENT). THUS;
CARIES (C ... UJee): OUTLINE LOCATION AND SIZE OF CAVITY. SHADE IN THUS:
.f Toofh Mlssil1g" :\-
eY~G9®
Bridge
e Gold F11linq ~Si/Yerfi'//;l1g
cr~~<8 ~Covity Oecoyed
6)~e3B
eJ~®@
[j
WQ~()
wi3QO Ow~l)
id. Vi •••
l5JQJcrJoe~ \) @OOO(39G3(t) @@lffi~(2)0~~ &&6~G2@JPfliJ Lo.n
DUTURES (PI.t .. ): DRAW DIAGRAM OF RELATIVE SIZE AND ING CLASPS ON NATURAL TEETH WITH THE WORD. ·CLASP,·
...& '.C.K : M xillt:. is fractured 0., media .... ':i"e .
RETAIN
p ur ':. TJCTTCIS Chief, Ide.,tificatio~ Sec
29[·21-12·47 PAGE 2 OF 3
20.
X-4655 MA CK OUT PARTS OF BODY NOT o
timate height - l~D
MASS BURl AL CUT!'I CATE (1' APPL1CABL~) (Whereln se~re,atlon In whole or part. 1. l_posslble)
I CERTIFY THAT THE GROUP REMAINS CONSIST OF PARTS OF ______ DECEDENTS BASED ON THE PRESENCE OF ONE OR MORE OF THE FOLLOWING ANATOMICAL PARTS: IUMIER
SI8MATURE OF MEDICAL OFFICER 21. REMARKS ANO ADDITIONAL INFORMATION
o .CI, ide~tificatio~ taes or perso~al effects ou~d with remai~s .
timated eight of remai~s - 71 bs .
Circumfere~ce of skull - 2lt i~ches .
" E SO 0 Le i 0, IJ FFIC}ENT ft'J£NTlFVI G 0
I CERTIFY THAT I HAVE PERSONALLY VIEWED THE REMAINS OF DECEASED AND THAT ALL RESULTING INFORMATION HAS BEEN RECORDED TO THE BEST OF MY KNOWLEDGE
TYPEO NAME, GRADE, ARM OR SERVICE, AND ORGANIZATION
1i.UL I . 'lCHOIS Chief Ide ...
ote FORM I Oll14 b 18 MAR ~1 29E-21-12-47
IDENTIFICATION DATA REMAINS OF UNKNOWN 2. DA TE OF REPORT
~-4g55 (For X-812 Ce • Mnnila #2) NAME OF CEMETERY
Dec J, 7 12 13
8. RACS (J:':) mr.r( • .
2.GIVE DESCRIPTION REMAINS
N 0 J E
1).GIVE DESCRIPTION OF TATTOOS OR SCARS ON BODY AND/OR SUCH INFORMATION OBTAINED FROM OTHER SOURCES
UTD
14. WAS BODY BURNED ? TO WHAT EX TENT?
D YES CD NO WAS BODY MANGLED? fO WHAT EXTENT?
D YES co NO 16. DESCRIBE EVIDENCE OF HEALED FRACTURES AND BONE MALFORMATIONS
NON E
11. LIST £VERY ITEM OF CLOTHING, EQUIPMENT AND PERSONAL EFFECTS FOUND, SHOWING THE TYPE, COLOR, SllE, MARKINGS, SERV ICE, ETC. (If I.u"drr _ria .r. ;"dlstJnet such not.tlo" ."ovld b. _d • • net .,..e •• on 'orw.rdod tltr<_,1t elt.n"e/. for ." •• i".t.o" .. lton f.ei ·IHi •• • r. IIot ••• il.blo 'n tlto .r •• )
QMC FORM 10'1\1 REV 18 MAR "1 ....
rOE
PREVIOUS EDITIONS OF THIS FORM ARE OBSOLETE 29E-21-12-47 PAGE 1 OF .3
MISSING TEETH: ALL TEETH MISSING THROUGH EXTRACTION (NOT THOSE FRACTURED OR DISPLACED BY RECENT WOUNDS) SHOULD BE ·X· '0 OUT AND LABELED THUS:
CRGlNEO TEETH: BLOCK IN SOLID AND CRClIIN OF TOOTH (LABEL GOLD, PORCELAIN, SILVER OR GOLD AND PORCELAIN). THUS:
BRIDGE WORK: BLOCK IN SOLID AND CROWN OF TOOTH (LABEL GOLD BRIDGE, GOLD AND PORCELAIN BRIDGE). THUS:
FILLINGS: DRAW FILLING ON TOOTH AS ACCURATELY AS POSSIBLE (BLOCK IN AND LABEL GOLD. SILVER, C EI4E NT) , THUS:
CAR IES (en If lee ): OUTL I NE LOCAT ION A NO SIZE OF CAVITY, SHADE IN THUS:
DEIITURES (PI.t .. ): DRAW DIAGRAM OF RELATIVE SIZE AND ING CLASPS ON NATURAL TEETH WITH THE WORD, ·CLASP,·
.f. Toofh Missil1fJ. ::\-
e~G9®
Bridge
e fJo/d hl/lnq ~Si/Yerfi'//iI11
e:r~~<8 ~CoYl'tY Decoyed
~e3B
,~ill~ is !r ctureJ o. 3GJi~n lin~. 12 is und velopod.
L(J~®@
Q00 wQ~D
tJi3QO
OQC30
id. Vi ....
UPPER
/ I Cpl. Joseph D. .1urphy
o.c FORM I Oij~ a 18 MAR ~1
29E.21-12·47 PAGE 2 OF 3
20·
Declassified Per E.O. 13526 dtd 5 Jan 2010
5 12 1I.ur . 'L.8 PARTS OF BODY NOT RED
Lst . Ht . - UTD MASS BURl Al CUTI FI CATE (IT APPLICABL
(Wherein s8,re,ation in whole or part. i. i_possible)
I CERTIFY THAT THE GROUP REMAINS CONSIST OF PARTS OF_---:::-::-:-:-=-=-::--_DECEDENTS BASED ON THE PRESENCE OF ONE OR MORE OF THE FOLLOWING ANATOMICAL PARTS: .UMBER
SIGNATURE OF MEDICAL OFFICER
21. REMARKS AND ADDITIONAL INFORMATION
These remains were one of the group disinterred from Grave 717, Row 0, Plot 7, at PO Camp Cabanatuan, Luzon, P. I .
No identi ication tags, personal ef~ects, hurial.bottle or other means of id~ntin4cution found wit rema~ns .
Circum e~enc~ a the skul 21, in0 es . stirnated{ei~ht of remains 7~ lbs .
I CERTIFY THAT I HAVE PERSONALLY VIEWED THE REMAINS OF DECEASED AND THAT ALL RESULTING INFORMATION HAS BEEN RECORDED TO THE BEST OF MY KNOWLEDGE
SIGNATURE TYPED NAME. GRADE. ARM OR SERVICE. AND ORGANI ZATION Ipl .... ::>, l.D F . 'O'lI {TY Emb . Sup
CIP L·b . Mani a, P. I . lsi Ed'lard F . t.oriarty
01«: FORM 10"" b 1B MAR ~1 .... 29E-21-12-47
FORM 1042 1 Apr. 1945)
(Supersedes GRS Form 1)
Imprint Identification Ta, II P05lible . DO NOT TYPE
PLACE OF DEATH
• .'0 •. Cam, Cabanatuan, P I
RESTRICTED
REPORT 'OF INTERMENT (AR 30-1810 and AR 30-1815)
ORGANIZATION
Civilian RACE RELIGION
CAUSE OF DEATH
EMERGENCY ADDRESSEE (N"""" ,el4liomAip, "lid udd,_)
DATE OF
SERIAL No.
BRANCH OF SERVICE
IF OTHER THAN U. S. DEAn. GIVE NAME OF COUNTRY
DATE OF DEATH
IDENTIFICATION TAGS FOUND ON BODY (1, t, or 110M)
None
IF NO TAGS FOUND ON BODY. DESCRIBE MEANS OF IDENTIFICATION (II .. "ideotlified, flU '" • ..,,"'" 8 "" ,,,,,,,, .. )
"corls in ~icete f'ourteen (U, ) bo 11,,5 rOlUl:1 in CO'll.mon ""''''c.ve, lirteen (13) of which were uniuentified : -
WERE SUBSTITUTE TAGS PROVIDED7(Y ... or .... )
Ye"" ,e Sec 3 r everse side)-UST PERSONAL EFFECTS FOUND ON BODY AND DISPOSITION OF SAME
None
NAME. NUMBER. COORDINATES. AND LOCATION OF CEMETERY
DATE OF BURIAL HOUR BURIED IN (Sh,ovd, bla"ket, or """'" olotMr) TYPE OF GRAVE MARKER
PLOT No. ROW No. GRAVE No.
12 Jnn 46 WAS THIS A REBURIAL?
(Y .. or no)
Yes
09')0 S l-J.e 1 ter H:J ro Cross IF A REBURIAL. INDICATE NAME. NUMBER. COORDINATES OF PREVIOUS CEMETERY. AND
;V. 01" nps I ... II r,;'lb~l"I~tu'" t; llet<"r.,r, TJuzon, .tT 45 .7-70.9 1/50 000
TYPE OF REUGIOUS CEREMONY
PERSON CONDUCTING BURIAL RITES IF IDENTIFICATION TAGS NOT USED. DESCRIBE IDENTIFICATION DATA AND CONTAINERS BURIED WITH BODY
IDENTIFICATION TAG BURIED WITH BODY (Y .. or no)
IDENTIFICATION TAG ATTACHED TO MARKER (Y .. or ..0)
Yes [~s
BODY BURIED ON DECEASED LEFT. NAME (Leul, !i,ll, middle ,,,Uial)
-131' (~I' HL"'''::;''''', John, mf!~' "'l" G-?71 Cab~ - _ t"an C .,oter J
BODY BURIED ON DECEASED RIGHT, NAME (Lan, !i,ll, middle ,,,Uial)
mTV' r - T '{ B13 (u co,., - " ~ ' ) '-' j .~ • - LUh .J.} ,....:;t'VI't;;l1C'e.h.
(;>Qrmerly UNKF ~i C-27j vabanatuan Cemet'3r SIGNATURE OF PERSON PREPARING REPORT
G':S.
RANK SERIAL No. ORGANIZATION GRAVE No.
C:,1 1Q ,040097 21 .:'UP. 248~ RANK SERIAL No. ORGANIZATION GRAVE No.
Sgt 61372$0 31st Inf 2482 SIGNATURE OF GRS OFFICER VERIFYING REPORT
Isltl L . ' . J,K}"'RE, 1st :'t ., ~dC .
DISTRIBUTION OF REPORT: Si,ned ori,inal for U. S. and alljed dead, ai,ned original and one copy for enemy dead, to the Quartermaater Oeneral through Headquarter. GRS Officer. Copie. for retention in theater aa prescribed by theater coaunander.
RESTRICTED
Declassified Per E.O. 135:20 dtd 5 Jan 201
RESTRICTED
INSTRUCTIONS: (a) Great care will be taken to record the most minute clues for the future identity of un ide ntified rp. .
mains. Fill in anatomical characteristics below, and any other clues under "Other," such as shoe size. social security number; position of body found in airplanes, vehicles, and tanks ; and serial numbe rs of ai rplanes, veh icles, and tanks .
(b) A fingerprint , or prints, are the most valuable of all clues. Imprint all fingers and thum bs in the J..------------I chart at left , or as many as possible. If no fin~erprintor prints can be secured, the condit ion of each a nd
every tooth will be indicated on the tooth chart In accordance with diagram below. Tooth cha rt will flot be accomplished if one or more fingerprints are secured.
HEIGHT WEIGHT COLOR OF EYES COLOR OF HAIR BIRTHMARKS. SCARS. OR TATTO~S
I-------------i WEAPON AND SERIAL No. LAUNDRY MARKS WHERE BODY WAS BURIED OR FOUND
;r: c ~r;; :!':!J OTHER IDENTIFICATION CLUES ~ ,., "
FILLINGS
CAVITIES
MISSI,NG TEETH
H
~SILVEA FILLING ~ GOLD mLlNG
~COAVITY I~ECAVED
~OTHMISSIKG
~
~!C£UIHCROWN ~lDCROW"
~OLDBRIDGt
,..)"-' ~ . ..
FURNISH SKETCH AND MAP REFERENCE AND COORDINATES FOR BU RI AL IN OTHER THAN ESTABLISHED CEM ETERY
Yor 1.:: , aAor"'e Sr. Ci vi] !lin S"'t Hanscom, Lawrence K. 6137280 Cpl .uark, John 278681 Cp1 Collins, Fredrick G. 6578~18 Cpl immon~, George G. 19019886 Pfc Gutierrez, Juan E. 2024.3125 Pfc Lobdell, Lloyd J.. 206L~5267 k
ich()l;3 A. 7009171 REMARKS: MD
Kelder, 36016623 HD r Kova.c"!, John 20500764-~:£ irschi, Harold S. 19038407
, ~g . Pvt Overby, :Zvuns E. 13035026 19 Bomb . ~ T is bodies wero b1.lr; e:i in this rtrave l:'Iut i j' 'J 1
f · t" ' hI 6 n lVl ua iden-~c& ~on lS 'O.,Sl. t"
RESTRICTED 29E·21-12-47
·~ -FORM 1042
1 Apr. 19(5) (Su~ GRS Form 1)
Imprint Iden tification Ta, II Possible. DO NOT TYPE
PLACE OF DEATH
~ Camp, Cabanqtuan, T,uzon, P . I .
RESTRICIED
REPORT OF INTERMENT CAR 30-1810 and AR 30-1815)
NAME (Loat. firat. middle i"itia!) UIJfN'J TN \-4<:355 (Formerly UNK " -812 ITS F CeM "ani la "2, T,uzon, P. I . )
GRADE ORGANIZATION
Unknown Unknom RACE RELIGION
TJnkno1'Tn Un.1(nOi'lll CAUSE OF DEATH
TJnknovrn EMERGENCY ADDRESSEE (Name, re/atiomAip. alld addr ... )
• TJnknovm
SERIAL NO.
Unknown BRANCH OF SERVICE
Unknown
IF OTHER THAN U. S. DEAD, GIVE NAME OF COUNTRY
DATE OF DEATH
Unknown
IDENTIFICATION TAGS FOUND ON BODY (1. !, or n/lM)
IF NO TAGS FOUND ON BODY, DESCRIBE MEANS OF IDENTIFICATION (If ""identiMd. fiU i" .,,'ion 8 em r._)
Fone See Remarks WERE SUBSTITlfTE TAGS PROVIDED7(Y .. or no)
Yes (2) LIST PERSONAL EfFECTS FOUND ON BODY AND DISPOSITION OF SAME
None
NAME, NUMBER, COORDINATES, AND LOCATION OF CEMETERY
DATE OF BURIAL
12 ug 4Q WAS THIS A REBURIAL?
(Y .. or no) ES10K~aJ
TYPE OF GRAVE MARKER
Capt . ,
Yes US F Cemet ery Manila / 2, Tuzon, p. I . TYPE OF RELIGIOUS
CEREMONY PERSON CONDUCTING BURIAL RITES
IDENTIFICATION TAG BURIED WITH BODY (Y .. or no)
fes
IDENTIFICATION TAG ATTACHED TO MARKER (Y .. or no)
Yes BODY BURIED ON DECEASED LEFT, NAME (Laal, firat, mW!. i"itial)
10Y, I.eon BODY BURIED ON DECEASED RIGHT, NAME (Loat, firat, mW!. i"ilial)
SIGNATURE OF PERSON PREPARING REPORT
IF IDENTIFICATION TAGS NOT USED, DESCRIBE IDENTIFICATION DATA AND CONTAINERS BURIED WITH BODY
RANK SERIAL No. ORGANIZATION GRAVE No.
,0 ""-" CkY I
Pfe 34153$07 186 Inf 1957 RANK SERIAL No. ORGANIZATION GRAVE No.
Co "I" enl
Pfe 37130217 127t~ Inf 1953 SIGNATURE OF GRS OFfiCER VERIFYING REPORT
18 It I ~rr; •
DISTRIBUTION OF REPORT: Si,ned ori,inal (or U. S. and allied dead, li,ned ori,ina! and on. copy (or .nemy dead, t.O the Quartermaater General throu,h Headquarter. GRS Officer. Copi •• (or retention in theater a. preactlbed by the_ter commander.
RESTRICTED
Declassified Per E.O. 13526 dtd 5 Jan 2010
t.l ... '""'"" _________ -.;:::;..~~....., J
INSTRUCTIONS: (a) Great care will be taken to record the most minute clues for the future identity of unidentified re
mains. Fill in' an'atomical characteristics below. and any other clues under "Other." such as shoe size. social security number; position of body found in airplanes. vehicles. and tanks; and serial numbers of air-planes. vehicles. and tanks . .
(b) A fingerprint. or prints. are the most valuable of all clues. Imprint all finaers and thumbs in the 1------------1 chart at left . or as many as possible. If no fin~erprint or prints can be secured. the condition of each and
every tooth will be indicated on the tooth chart In accordance with diaaram below. Tooth chart will not be accomplished if one or more fingerprints are secured .
HEIGHT WEIGHT COLOR OF EYES COLOR OF HAl R BIRTHMARKS. SCARS. OR TATTOOS
1------------1 WEAPON AND SERIAL No. LAUNDRY MARKS WHERE BODY WAS BURIED OR FOUND
3: <;
~f;; :!'~ OTHER IDENTIFICATION CLUES ~ !;!
FI LLI NGS
CAVITIES
MISS I NG TEETH
CROWNED TEETH
BRIDGE WORK
if SILVER Flllt"G GOLD FILLING
\
~COAVITY I~£CAV£D
~OTH MISSING
~
~!CEUIHCROWN ~LDCROWN
a Ol:> BRIDGE ,.,)v ,
•
8
DIAGRAM REPRESENTS THE MOUTH WIDE OPEN
FURNISH SKETCH AND MAP REFERENCE AND COORDINATES FOR BURIAL Itl.OTHER THAN ESTABLISHED CEMETERY
~.LC).KS: aIlK '{-1()-55 1}1<:: .Euso1eum, anila, -'.1 ., fo"'ml'lrI.r :11'1. X-812 US F Cern Manila ,'2, Luzon, P . r., could be anyone 0 the f'o11o'ilin", listed buri l.3 'ill the Cabanatuan roster :
YC'U..., '.reor ~e Sr. Civilian
REMARKS:
pI lU .K, John. 278681 CDI coLLI S, Fredrick G 6578818 Cpl SI r 0 IS, 1 QJ19°"6 prc If) T)EIJ ?06L E 7 Pvt Pvt :..J 1, Fvt .. OV C f, John Pvt Klq~CHI, Harold S Pvt OVER Y, Evans
30016623 20500764 1 Qa3~/,.a7 13035026 19 Bomb
Me Form 1044 , 1044- and 1044-:3 accomplished .
RESTRICTED 29E·21-12·47
Declassified Per E.O. 13ST6 dtd 5 Jan 2010
,
'Ito C 1025 . . )/1.-( K£.:!t 1 ~Ir 1 £.U . WD QMCFORM Ui42 REPORT OF INTERMENT
DATE OF REPQRT (Rev. 1 ~r. 1945)
7 Feb 46 (Superaedes RS Form 1) (AR 30-1810 and AR 30-1815)
Imprint Identification Ta, If P o .. ible. Section l.-IDENTIFICATION. DO N O T T Y PE
NAME (L<ul, firsl, middle initial) SERIAL No.
UNKNO,iN X-S12 (YORK, George Sr) (Formerly UNKNO,JN C-272 Cabana tuan Cemetery GRADE ORGANIZATION BRANCH OF SERVICE
0 Civil~an I'
RACE RELIGION IF OTHER THAN U. S. DEAD. GIVE NAME OF COUNTRY
-. PLACE OF DEATH CAUSE OF DEATH DATE OF DEATH
POi; Camp Cabanatuan, Luzon, P I
EMERGENCY ADDRESSEE (Name, rel4tionahip, and addr ... )
- - -
IDENTIFICATION TAGS FOUND ON BODY IF NO TAGS FOUND ON BODY. DESCRIBE MEANS OF IDENTIFICATION (If unidenlijiMl, fiU in section $ on reller ... ) (1, ~, or none) Records indicate Fourteen (14) bodies found in common
None grave , thirteen (13) ,Of whicfL.were unidentified_:;' I
~ : - . ".t _ WERE SUBSTITUTE TAGS PROVIDE07(Y .. or no) u'
Yes (2) -(See Sec 3 side)-reverse
LIST PERSONAL EFFECTS FOUND ON BODY AND DISPOSITION OF SAME
~7V1 None
Section ') DII DOA "" ' map .,,;,
NAME. NU MBER. COORDINATES. AND LOCATION OF CEMETERY
USAF Cem",tery Manila #2, Luzon, P I
DATE OF BURIAL HOUR BURIED IN (Shrt1lUi, blanUl, or na ..... of oIMr) TYPE OF GRAVE PLOT No. ROW No. GRAVE No. MARKER
l2 Jan 46 0900 Shelter Half Cros s 2 201 24S1
WAS THIS A REBURIAL? IF A REBURIAL. INDICATE NAME. NU MBER. COORDINATES OF PREVIOUS CEMETERY. AND LOCATION OF GRAVE (Y .. or no) POd Camps I & II Cabanatuan Cemetery, Luzon, PI Yes PLOT No. ROW No. GRAVE No.
45.7-70. 9 1/50,000 7 0 717 TYPE OF RELIGIOUS PERSON CONDUCTING BURIAL RITES IF IDENTIFICATION TAGS NOT USED, DESCRIBE IDENTIFICATION DATA AND
CEREMONY CONTAINERS BURIED WITH BODY
.. . , . IDENTIFICATION TAG BURIED WITH IDENTIFICATION TA~ ATTACHED TO .,
BODY (Y .. or no) MARKER (Y .. or no
Yes Yes . ,. ' . .. , '. . .,
BODY BURIED ON DECEASED LEFT. NAME (L<ut, fi rat, middle i"~ RANK SERIAL No. ORGANIZATION GRAVE NO.
It "" UNKNO,iN X.:..sll (RICHAHDSON, John , )
Cp1 19049097 21 PUR 24S0 l'1. lUI:: ·l.v TTNKN()"l\T C':'271 Cabanatuan Ce,'""'''' "' ... ,,) BODY BURIED ON DECEASED RIGHT. NAME (Laat, firat, middle .initial) RANK SERIAL No. ORGANIZATION GRAVE No. . .
Ie'" UNKNOdN X-B13 ( HANSCOM, Lawrence . K)
Ilt ·1.v INK N )\JT\T C-27'1 r.::th::tnJ:ltuan Cpm""+~rv) Sgt 61372S0 31st Inf 24S2
"GNATU"O~;'; SIG~:ATUREO! G?:~~ ---- '/:::¥ ____ J' •
;. ' . lAKttl',_T, bjogl. . , GRS . . E. L bmORE-L 1st Lt . , Q,11C . DISTRIBUTION OF REPORT: S iAned ori,in al for U. S . and allied d ead , si,ned ori, inaland one copy for en emy dead, to t h e Q uar t er master General t hrou,h Hea cJqua~te,rs GRS Officer . Copies for retention i n t h eater as prescribed by t h ea t er commander .
~i I RESTRICTED 16-43997- 1
.
" . h "
INSTRUCTIONS: (a) Great car e will be taken to record the most minute clues for the future identity of unidentifiild re
mains. Fill in anatomical characteristics below, and any other clues under "Other," such as shoe size , social security number; pos ition of body found in airplanes, veh icles, and tanks; and serial numbers of airplanes, vehicles , and tanks.
(b) A fingerprint , or prints, are the most valuable of all clues. Imprint all fingers and thumbs in th e chart at left, or as many as possible. If no fingerprint or prints can be secured, the condition of eac;h and every tooth will be indicated on th'e tooth chart in accordance with diagram below. Tooth chart will not be accomplished if on e or more fingerprints a re secured.
HEIGHT WEIGHT COLOR OF EYES COLOR OF HAl R BIRTHMARKS, SCARS, OR TATTOOS
1------------1 WEAPON AND SERIAL No. LAUNDRY MARKS WHERE BODY WAS BURIED OR FOUND
" ,
/ : .. .. Z J " ~::!
..,(i) -J: a'i-i !a
3: C "::0 J;;iii
~:!j G>
!a
~ li::! ..,(i)
~:!j !a
, "
' I:
,(' ( ~::! . .. ". ..,(i) . .. z:!j G>
'" ::0
OTHER IDENTIFICATION CLUES
S
CAVITIES
MISSING TEETH
" : ... • • r ~\
"if51l\f(R filLING. r GOLO FlLllNG
• • I ~
~Ct.vITY I~ECAVlC
C»)'1OOTH MISSING
~
. ~!CELAIN CROWN ~LDCROWH
raOLD BRIDGE ,.,)v
. • . t
, '\
8
DIAGRAM
16
FURNISH SKErCH AND MAP REFERENCE AND COORDINATES FOR BURIAL IN OTHER THAN ESTABLISHED CEMETERY
York, C~orge Sr . Civilian /fXrJ, Sgt Hanscom, l.a.-renee K. 6137280 31 Inf
Cpl Ruark, John ', f . 278681 USMC Cpl Collins, Rredrick ~. 6578818 QMC Cpl Simmons, George G. 190198 6 60 C ~C
1 0<' tv' Pfc Gutierrez , Juan E. 20843125 200 CAC Pfc Lobdell, Ll.oyd J. 20645267 192 Tank
I r ,J Pfc N-' c hell:) ij.,pYQY ~ . 7009171 REMARKS: Pvt ,laid, Charles F . 19049058 1ID
Pvt Kelder , Arthur H. 36016623 MD Pvt Kovach, John 20500764 Pvt Kirschi , Harold S . 190384(17 Pvt Overby, .llivans E. 13035026 19 Bomb
This bodies were buried in this ve but individual :tdentif~
• RESTRICTED GOVERNMENT PRINTING O,'ICE
J1