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2o-t.) , ( - : —_ UNITED STATES DEPARTMENT OF JUSTICE FEDERAL BUEEAU OF INVESTIGATION In Reply, Piease Refer to JUL 2 61962 - File No. Director Federal Bureay of Investigation United States Tepartment of Justice RE: & l P Edgar Hoover Wasrington, 2. Cc. (Type or print plainly) Lear Sir: Far ing.usion ain the fund to be paid to the designated beneficiary of any Special Agent of the FBI who has previousi; contributed *. this fund und who dies from any cause except selt-destruction while employed ae a Specia! Agent, lam ic:- warding heres «© (by Check - Money Order} the sum of $10, payable to the Assistant Director, Administrative Division, FE: to Be included if said fund. Payment will be made for death by seli-desiruction after the Agent has been a member of th- fund fur acw tinuous period of two years. [ft ts undereitood and agreed thal the sum tendered herewith is a voluntary, gratuitou: eortmbution :- gaid fund which | underatand ia to be administered in the following mannar, The Turectcr of the FB] will appoint a committee which shall consider all mattera pertaining to the a¢quisition, sat. keeping und expending of #aid fund, which committee will recommend apprtoptiaie action to the Ditector in pertinent matters Tre Agsistat: “irector of the Administrative Division of the FBE shall receive a]] contributions ond account for same to the Foare star, Ul; or the death of any Special Agent who i# a member of said fund the appointed cammittee will consider the ca: @nd@ submit dre ommendation to the Director as to its conclusions. Appropriate instructions will then be issued to the Assist. ant Lirector cf the Administrative Division, directing him to pay to the desiqnated beneficiary the sum of $10,000. The liabiiit; of the fund shal. not under any cifcums#tancesa exceed the amount of monies in the fund at the lime any Jiability eholi occur The tollicwlng pergon 18 designoted as my beneficiary for FSI Agents’ Insurance Fund: Name tptimary teneficsary) Relationship Estate Address None (contingent beneficiary, li desired) Relationship Addiess The following peraon is designated as my beneficiqry under the Chas, 5, Rose Fund providing $1500 death benefit to beneticiary of agents killed in the line of duty, other than travel secidents. Nar * .prnmary ceneficijary} Relationship Estate Ada «ss Date Name {continve’ | beneficiary, if desired) Relationship Address aa >} . Lo : . Very truly yours, ee Ee APSE ae pT erp ny nee MU orm emnssocprame yary