FEDERAL BUREAU OF INVESTIGATION DELETED PAGE INFORMATION SHEET 1340440-0 Total Deleted Page(s) 2 18 Page 76 Duplicate; Page 77 Duplicate; Page 78 Duplicate; Page 94 Duplicate; Page 95 Duplicate; Page 98 b6; b7C; Page 99 Referral/Direct; Page 102 b3; b6; b7C; b7E; Page 103 b3; b6; b7C; b7E; Page 109 b6; b7C; Page 111 Referral/Direct; Page 112 Referral/Direct; Page 114 Duplicate; Page 115 Duplicate; Page 252 Duplicate; Page 254 Duplicate; Page 257 Duplicate; Page 259 Duplicate; Deleted Page(s) No Duplication Fee For this Page FD-340 (Rev. 4.11.03) File Number 533) Kg Field Office Acquiring Evidence Serial of Originating Document Date Received 359/ 1 ??/cmv From ofConuibutor/Interviewee) (Address) (City and State) By To Be Returned Yes No Receipt Given Yes Grand Jury Material - Disseminate Only Pursuant to Rule 6 Federal Rules of Criminal Procedure Yes No Federal Taxpayer Information (FTI) Yes No Title: Mix) muss) LN Reference: (Communication Enclosing Material) ?t Description: [Fl/Original notes re interview of be b7C? b6 b6 b7C d9; Wk My?! a?m 1L 0? .ng 1., . :13" CE .- ?m 9 7:94. i Maw-x 19/1411 (W . THE WHITFJ HOUSE . WASHINGTONDate May 12, 2009 b7C To: Federal Bureau of Investigation Attn: )NationaI?Name Check Program Unit (ICRC Winchester, VA) (X) SIGBIU (Room NV . From: The White House - 5 ?q . . . cement - tare? Subject 3 m1] name acquellne Ann Berrlen UDED: age" Other names used (including birth, prior married, and nicknames) nickname Jackie POD 9 32 ?do! Social Security Number 577-932-5623 Date of birth] 3 ?28 4] 95] Place of birth jg; QM ng?l-n-n . no Permanent address (also current residence, if different) Current employer(s) NAACP Legal Defense and Educational Fund, Inc. e? 5//z (Subjea?s' Sig/nature) . (Date) CONSENT: I hereby authorize the FBI tzide the information Speci?ed below to the White House. Request of FBI (Use of this 1 to request information deveIOped by the FBI or contained in FBI files requires the subject's consent. Exceptions will only permitted as authorized by the Attorney General/Deputy Attorney General.) Name check (NCU) Copy of previous report (NCU) xpanded name check (SIGBIU) Full ?eld investigation (SIGBIU) )Level 1' (U??evelZ )Leve13 )Level4 )S-year reinvestigation (SIGBIU) )Leve12 )Level 3 )Limited update investigation (SIGBIU) )Other (Specify)' I ?0 The applicant ?is being considered for: )Presidential appointment osition requiring Senate con?rmatibn White House staff position Access: Detailee/other government employee Contractor Intern Volunteer Presidential recognition ()-Other (specify) . . - egg. (90613?, Attachments: Supplement )Fingerprint Card )Other Remarks/ Special instructions: I certify, subject to 18 U.S.C. 1001, that the above is sought for of?cial purposes only and I understand that obtaining this information under false pretenses or any unauthor,? Wt" the Privacy Act, 5 U.S.C. 55221. Requested by: (Signature) This request has been reviewed and approved by the White?ouse ?mime? REQUEST REVIEWED AND db FOR RESPONSEPW [001 gnaw/not 445%? i ITIAL AT . .b6 ENTIA ,3 :0 l; Exams ?bvc b6 b7C i? Investigation Request #5708674Compact COpy Page 1 of 14 . Applicant SSN: 577-92-5628 Form: Questionnaire for National Security Positions (SF86 Format) Request 5708674 )1 Sections 1-7: Your Identifying Information (1) Full name Last: Berrien First: Jacqueline Middle: Ann Suf?x: (2) Date of birth Month/Day/Y ear: 11128l1 961 - . (3) Place of birth City: Washington, DC County: None State: DC Country: - (5) Have you used any other names? Yes . Other names used Vs sex I. Name Last: Berl?ien First: Jackie Middle: (NMN) Suf?x: . Dates used From (Month/Year): To (MonthIYear): Present (6) Mother's maiden name Last: Smith First: Anna Middle: Belle (7) Height (feet): 5 (inches): 5 Weight 245 Hair color Dark Brown color Dark Brown Sex Female Additional comments: I have been referred to by the nickname "Jackie" frequently by my family members and intermittently outside of my family. Section 8: Your Contact Information Home e-mail address jaberrien@gmail.com and jberrien@post.harvard.edu Work e-mail address 'ber - i - Home telephon Time: Evening - Work telephone 212-965-2277 and 212-300-7416 Time: Both Mobile telephone 347-743-7921 Time: Both Section 9: Citizenship Current citizenship status lam a U.S. citizen or national by birth in the U.S. or U.S. territory/commonwealth. U.S. Passport Passport number 113322530 Date issued Month/Day/Y ear: 07/31/2006 Expired? No Alien Registration Number Alien registration number Not Applicable - Item 9A: Documentation of U.S. Citizens Born Abroad [State Department Form (F S) 240, DS 1350, PS 545, etc.] Date form was completed Month/Day/Year: I I Document number Place of issuance City: State: Country: Item 9B: Citizenship Certi?cate Court Location City: State: Certi?cate number Date issued Month/Day/Y ear: I I Item 9C: Naturalization Certi?cate Court Location City: State: Certi?cate number Date issued Month/Day/Y ear: I I Item 9D: Immigration Status . "Location City: State: Date of entry Month/Day/Y ear: I I a, Type of document (1?94, etc.) Document number Country(ies) of citizenship (No Entry Provided) Section 10: Citizenship Information Do you now hold or have you EVER held multiplelcitizenships? No Item 10A Country(ies) of citizenship (No Entry Provided) Item 10B 1 Time periods 8 Item 10C Is your non-U.S. citizenship based on your birth in a foreign country or the citizenship of your parents?k Explanation Item 10D Have you renounced or attempted to renounce your foreign citizenship(s)? Explanation Section 11: Where You Have Lived 5/21/2009 I b6 b7C b?7E it Investigation Request #57 08674Compact Copy Page 2 of 14 1. Dates of activity From (Month/Year): 11/2005 To (Month/Year): Present Status Own Explanation Street address/AP dress Street City! I Statel I Country: Zip Code: Point of Con act Name of person who knows you at this addressl Relationship Neighbor Explanation Since November 2005 I have lived one block away we first became acquainted during the 19905. Current street address/APO address/FPO addr=ss (if curren ly app icabl Streeti ICity: State Country: Zi Code Telephonel Iiwork) Alternate contactl Imobile) ome) 2. Dates of activity From (Month/Year): 10/1992 (Estimated) To (Month/Year): 11/2005 Status Rent Explanation a Street address/APO address/FPO address Street: 280 St. James Place City: Brooklyn State: NY Country: Zip Code: K1238 Point of Contact . Name of person who knows you at this address: b6 b6 b7C Relationship lain) b?7C Explanation attended the same law school as I did and we lived on the same block in Brooklyn, New York "or approximatel?ears. Current street address/APO a PO address if currently ap Iicable) - Street: City: State Country:- Zip CodeEl Telephonel A ternate contact Section 12: Where You Went To School Schools Attended 1. Dates of activity From (Month/Year): 09/1983 To (Month/Year): 06/1986 School type College/UhiversitylMilitary College Name of school HariIard Law School Street address of school Street: 1563 Massachusetts Avenue City: Cambridge State: MA Country: Zip Code: 02138 Degree/diploma received? Yes Degree/diploma 1. Degree/diploma: Professional degree MD, DVM, JD) Other degree/diploma Date awarded Month/Year: 06/1986 Person Who Knows You Name Current address . Street: City: State: Country: Zip Code: Telephone 2. Dates of activity From (Month/Year): 09/1979 To (Month/Year): 05/1983 School?type College/UniversitylMiIitary College Name of school Oberlin College Street address of school Street: Cox Administration Building, 70 N. Professor Street City: Oberlin State: OH Country: Zip Code: 44074 . 7. Degree/diploma received? Yes Degree/diploma 1. Degree/diploma: Bachelor's Other degree/diploma Date awarded Month/Year: 05/1983 I Person Who Knows You Name Current address Street: City: State: Country: Zip Code: Telephone Section 13: Employment Activities Section 13A: Employment/Unemployment Information 1. Dates of employment From (Month/Year): 09/2004 To (Month/Year): Present Type of employment Other (explain) Explanation Non-pro?t organization/public interest law firm 5/21/2009 NE if Investigation Request #5708674Compact Copy . Page 3 of 14 Work hours Full-time Positiontitle Associate Director-Counsel Name of employer NAACP Legal Defense and Educational Fund, Inc. Address of employer Street: 99 Hudson Street, Suite 1600 City. New York State. NY Country: Zip Code. 10013 Telephone 212-965-2200 Physical Location Your actual work address_(if different from employer address) Street: City: State: Country: Zip Code: Telephone Superviso Name I Title .. Work addr Stree I CityI I State:I I Country: Zip CodeI:I Telephone rm ,1 Additional periods of activity with this employer . 1. Dates of employment From (Month/Year): 09/1 Tn (Month/Yea?' 1 112001 Position title'Assistant Counsel Supervisor I Explanation/reason for leaving Ac?cepted an offer of employment from the Ford Foundation Dates of employment From (Month/Year): 11/2001 To (Month/Year): 08/2004 Type of employment Other (explain) Explanation Grantmaking foundation Work hours Full-time Position title Program Of?cer Name of employer The Ford Foundation Address of employer Street: 320 E. 43rd Street City: New York State: NY Country: Zip Code: 10017 Telephone 212-573-5000 7 Physical Location Your actual work address (if different from employer address) Street: City: State: Country: Zip Code: Telephone Supervisor NameI I TitleI I Work resso supervrsor Street: The Foundation Center, 79 Fifth Avenue City: New York State: NY Country: Zip Code: 10003 TelephoneI Additional perto act1v1ty th this employer Not Applicable (No Entry Provided) . Explanation/reason for leaving To accept position as Associate Director-Counsel with the NAACP Legal Defense and Educational Fund. Inc. Additional comments: I Iduring my tenure with_ the Ford Foundation. He currently serves as land his contact Information is listed above. Dates of- employment From (Month/Year): 07/1995 (Estimated) To (Month/Year): 06/2000 Type of employment Other (explain) Explanation Higher education (law school) Work hours Part-time Position title Adjunct Professor of Law Name of employer New York LawSchool Address of employer . Street: 57 Worth Street City: New York State: NY Country: Zip Code: 10013 Telephone 212-431-21 00 Physical Location Your actual work address (if different from employer address) Street: City: State: Country: Zip Code: Telephone - Supervisor . Nanrlel:l :Fitlel I Work address of superv1sor Street: New York Law School Office of Human Resources, 57 WOrth Street City: New York State. NY Coun Zi Code. 10013 Telephone?l Additional perlo act1v1ty with this employer Not Applicable (No Entry Provided) Explanation/reason for leaving Due to the demands of my full-time employment I have not pursued adjunct teaching opportunities? In recent years. However, my understanding' Is that I remain eligible to teach at New York Law School as an Adjunct Professor. - Dates of employment From (Month/Y ear) 05/1 992 To (Month/Year): 08/1994\ 5/21/2009 b7C b7E Investigation Request #5708674Compact Copy Page 4 of 14 Type of employment Other (explain) Explanation Non-profit organization/public interest law firm Work hours Full-time Position title Staff Attorney Name of employer Lawyers' Committee for Civil Rights Under Law Address of employer Street: 1401 New York Avenue N.W., Suite 400 City: Washington State: DC Country: Zip Code: 20005 Telephone 202-662-8600 Physical Location . Your actual work address (if different from employer address) Street: City: State: Country: Zip Code: Telephone . Supervisor Nam . b6 b'i'C I City: : State: : Telephone ex I \g Additional periods of activity with this employer Not Applicable (N 0 Entry Provided) Explanation/reason for leaving To accept employment with the NAACP Legal Defense and Educational Fund, Inc. 9 my tenure with the Lawyers' Committee] I supervised my work. She hassince mailed to Massachusetts and serves asl I Her current contact information is listed above. Section 13B: Former Federal Service, Excluding Military Service, Not Indicated Previously Former Federal Services 1. Dates of Federal Service From (Mont Position title Judicial Clerk Agency Iu.s. District b5 Court for the Northern District of llabama 137?: Location City: Birmingham State: AL Country: Zip Code: 35203 2. Dates of Federal Service From (Month/Year): 05/1982 (Estimated) To (Month/Year): 0711982 (Estimated) Position title Clerk-Typist Agency Small Business Administration - Location City: Washington, D.C. State: DC Country: Zip Code: 20416 Additional comments: Please note that the agency was in a different location in Washington, DC (14th and Streets N.W.) during my tenure. 3. Dates of Federal Service From (Month/Year): 05/1980 (Estimated) To (Month/Year): 08/1980 (Estimated) Position title Congressional Intern Agency U.S. House of Representatives Committee on the District of Columbia ?Location City: Washington State: DC Country: Zip Code: 20515 4. Dates of Federal Service From (Month/Year): 07/1979 (Estimated) To (Month/Year): 09I1979 (Estimated) Position title Clerk-Typist Agency Federal Highway Administration Location City: Washington, D.C. State: DC Country: Zip Code: 20590 Additional comments: Please note that the agency was in a different location in Washington, DC (Federal Center Soirthwest) during my tenure. 5. Dates of Federal Service From (Month/Year): 05I1979 (Estimated) To (Month/Year): 0711979 (Estimated) Position title Clerk-Typist Agency Bureau of Alcohol, Tobacco and Firearms Location City; Washington, D.C. State: DC Country: Zip Code:.20226 Additional comments: Please note that the agency was in a different location in Washington, DC (12th Street and Avenue N.W.) during my tenure. . Section 13C: Employment Record 1. Has any of the following happened to you in the last 7 years? . Fired from a job Quit a job after being told you would be ?red Left a job by mutual agreement? following charges or allegations of misconduct Left a job by mutual agreement following notice of unsatisfactory performance Left a job for other reasons under unfavorable circumstances 6. Laid off from job by employer No . (No Entry Provided) 2. Have you received a written warning, been of?cially reprimanded, suspended, or disciplined for misconduct in the workplace? No 3. Have you received a written warning, been of?cially reprimanded, suspended, or disciplined for violating a security rule or policy? No (No Entry Provided) ., weave b7E 5/21/2009 Investigation Request #5708674Compact Copy Page 5 of 14 Section 14: Selective Service Record a. Are you a male born after December 31, 1959? No b. Have you registered with the Selective Service System Registration number Explanation Section 15: Military History a. Have you EVER served in the US. military or the US. Merchant Marine? No b. Have you EVER served in a foreign country?s military, security forces, merchant marine, militia, or other defense forces? No Military Service (No Entry Provided) .1 - c. Have you EVER received a discharge that was not honorable? . . d. In the last 7 years (if an SSBI go back 10 years), have you been subject to court martial or other disciplinary proceedings under the Uniform Code of Military Justice? (Include non-judicial, Captain's mast, etc.) at? . Military Charges (No Entry Provided) "x Section 16: People Who Know You Well 1. Dates known. From Mo 986 To (Month/Year): Present . b6 Reference name 1; 1 Relationship to you (Check all that apply) Work associate Explanation 1370 Home orw .. .-- I City: Country: Zip Code: Timp' n2" Aifnmafn fan can nna Additional comments: 2. Dates known Fr - '995 (Estimated) Present .: b6 - Reference namel 4 Relationship Friend Work associate Explanation 1370 Home orw 31w sad: Country; zip Code 7 Telepm : Time: Day Alternate telephone 3. Dates known From (Month/Year): 05/1981 (Estimated) ~To (Month/Year): Present Reference name 135 Relationship to. you (Check all that apply) Friend Schoolmate Explanation and I met b7C during the Harry S.'Truman Scholarship awards program in 1981 and were both members of he Harvard Law School Class of 1986. Home or work address Streetzl I 1ty: Statezl I Country: Zip Codez . ep one ime: Day Alternate te ephone . . Section 17: Marital Status Marital Status Married (include Common Law) Current Spouse . - b6 I Full name Last Isl?I biliddlei ISuf?x: Date of birth Mi?WYIear b7C Place of birth City Country: Social Security Nu Other names us .ntry Provided) Current address Stree?i CitrJaLLl' Country: Zip Code: Telephone Date married Mont r-l Place married City Statei I Country: Date of separation Month/Day/Year: I 1.. Location of separation record City: State: Country: Zip Code: Country(ies) of citizenship i 1. Country United States of America b7E 5/21/2009 .0) Investigation Request #5708674Compact Copy .: Page 6 of 14 0 Type of documentExplanation Document number Former Spouse(s) Not Applicable (No Entry Provided) Cohabitant Not Applicable (No Entry Provided) Section 18: Relatives 1. Relationship type: Mother Full name Last: Berrien First: Anna Middle: Smith Suf?x: Deceased Yes Date of birth Month/Day/Year: 02/1711930 Place of birth City: Stanford State: KY Country: Current address Street: City: State: Country: Zip Code: Country(ies) of citizenship 45 1. Country United States of America Type of document Explanation . Document number Relationship type: Father Full name Last: Berrien First: Clifford Middle: (NMN) Suf?x: Deceased Yes Date of birth Month/Day/Y ear: 02/21/1923 Place of birth City: Springfield State: 0H Countryi- Current address Street: City: State: Country: Zip Code: Country(ies) of citizenship 1. Country United States of America Type of document Explanation Document number Relationship e: i Full name Last: I MiddieEI Suffix: Deceased No Date of birth Monti! a lYea Place of birth City: I Statezl Country: Current address Street? City: State: : Cpuntry: .Zip Code: Country(ies 0 Citizens 1p 1. Country United States of America Type of document Explanation Document number Relationship typf-J 7 Full name- Last: rst: Middle: 'Suf?x: Deceased Yes Date of birth Month/Day/Y ear Place of birth City: Arlington State: MA Country: Current address Street: City: State: Country: Zip Code: Country(ies) of citizenship 1. Country United States of America Type of document Explanation Document number Relationship type: Full name Lasti [PHMiddleE Suf?x: Deceased Yes State: Date of birth ont ay ear: Place of birth City: Jacksonv Current address Street: City: State: Country: Zip Code: Country(ies) of citizenship - 1. Country United States of America Country: 5/21/2009 b6 b7C b6 b7C b6 b7C 57E Investigation Request #5708674Cornpact Copy . Page 7 of 14 Type of document Explanation Document number Section 19: Foreign Contacts Do you have or have you had close and/or continuing contact with foreign nationals within the last 7 years with whom you, your spouse, or your cohabitant are bound by affection, in?uence, and/or obligation? Include associates, as well as relatives, not already listed in Section 18. (A foreign national is de?ned as any person who is not a citizen or national of the U.S.). No Foreign Contacts (No Entry Provided) Section 20: Foreign Activities Item 20A: Foreign Financial Interests 1. Do you have or have you EVER had any foreign ?nancial businesses, foreign bank accounts, or other foreign ?nancial interests of which you have direct control or direct ownership? No r5 Direct Foreign Financial Interests (No Entry Provided) 2. Do you have or have youhad any foreign ?nancial interests that someone controls on your behalf? No Indirect Foreign Financial Interests (N 0 Entry Provided) 3. Do you own or have you owned real estate in a foreign country? Foreign Real Estate Holdings (No Entry Provided) 4. Do you receive or have you received any educational, medical, retirement, social welfare, or other such benefits from a foreign country? No Foreign Bene?ts (No Entry Provided) Section 20B: Foreign Business, Professional Activities, and Foreign Government Contacts 1. In the last 7 years, have you provided advice or support to anyone associated with a foreign business or other foreign organization that you have .not previously listed as a former employer regarding any of the following: management, strategy, or technology? No Was activity on of?cial U.S. Government business? Advice/Support Activities (No Entry Provided) . 2. In the last 7 years, have you attended any international conferences, trade shows, seminars, or- other meetings outsrde of the Yes Was activity on of?cial U.S. Government business? No Meetings, 1. Dates of event From (Month/Year): 04/2007 To (Month/Year): 0412007 Location of event City: Abuja Country: Nigeria Foreign country(ies) involved 1. Country United States of America s? 2. Country Guinea 3. Country The Gambia 4. Country Kenya 5. Country Angola 6. Country United Kingdom . 7. Country Cote d'lvoire 8. Country, Sierra Leone 9. Country Botswana 10. Country Nigeria 11. Country Canada 12. Country Niger 13. Country Liberia 14. Country South Africa 15. Country Cameroon "16. 'Country Indonesia 17. Country The Netherlands Sponsoring organization(s) The National Democratic Institute Purpose of event Member of National Democratic lnstitute?s International Observer Delegation to Nigeria's April 2007 Elections; attended pre-eiection training session, post-election meeting of the Delegation and press? conference. 5/21/2009 b7E Investigation Request #5708674Compact Copy Page 8 of 14 2. Dates of event From (Month/Year): 01/2005 (Estimated) To (Month/Year): 01/2005 (Estimated) Location of event City: Oranjestad Country: Aruba Foreign country(ies) involved 1. Country Aruba Sponsoring organizationCs) National Bar Association Purpose of event Mid-winter meeting of the National Bar Association's Judicial Council Additional comments: I was invited to make a presentation during a panel entitled "Celebrating the 40th Anniversary of the Voting Rights Act: How It Changed the Face of the Judiciary" 3. Dates of event From (Month/Year): 1012003 To (Month/Year): 1 0/2003 Location of event City: Hanoi Country: Vietnam Foreign countty(ies) involved . 1. Country Vietnam Country India Country indonesia . Country South Africa Country Chile . . Country Brazil Country Mexico Country Kenya 9. Country China . Sponsoring organization(s) The Ford Foundation Purpose of event Meeting of the worldwide gran?t?making professionals of the Ford Foundation's Governance and Civil Society Unit Additional comments: The countries listed above were the overseas Ford Foundation offices represented in - this meeting. The staff members representing those of?ces may have been citizens of countries other than the places in which they were stationed. 4. Dates of event From (Month/Year): 10/2003 To (Month/Year): 10/2003 Location of event City: Jakarta Country: Indonesia Foreign country(ies) involved Country Indonesia Sponsoring organization(s) The Ford Foundation Purpose of event "Peer exchange" meetings with Ford Foundation program officers and grant recipients, based in Indonesia - 5. Dates of event From (Month/Year): 03/2003 To (Month/Year): 03/2003 Location of event City: Sao Paulo, Rio de Janiero and Bahia Country: Brazil Foreign country(ies) involved 1. Country Brazil Sponsoring organization(s) The Ford Foundation Purpose of event "Peer exchange" meetings with Ford Foundation Brazilian office staff and grant recipients 6. Dates of event From (Month/Year): 0312003 To (Month/Year): 03/2003 Location of event City: Santiago Country: Chile Foreign country(ies) involved 1. Country Chile 2. Country Mexico 3. Country Brazil 4. Country Indonesia 5. Country South Africa - 6. Country India 7. Country China 8. Country Kenya Sponsoring organization(s) The Ford Foundation Purpose of event Meeting of Foundation's ,Governance and Civil Society program of?cers 7. Dates of event From (Month/Year): 10/2002 ?To (Month/Year): 1012002 5/21/2009 b'i'E Investigation Request #5708674Compact Copy . Page 9 of 14 Location of event City: .New Delhi and Kerala Country: India Foreign country(ies) involved 1. Country India Sponsoring organization(s) The Ford Foundation . . Purpose of event "Peer exhange" meetings with India-based Foundation staff and grant recipients; meeting on gender and governance hosted by Ford Foundation grant recipient 8. Dates of event From (Month/Year): 02/2002 (Estimated) To (Month/Year): 02/2002 (Estimated) Location of event City: Rio de Janeiro Country: Brazil - Foreign country(ies) involved 1. Country Brazil . Country China Country Kenya Country Mexico . Country. Chile 7 Country Egypt Country South Africa 3 .. Sponsoring organization(s) The-Ford Foundation Purpose of event Worldwide meeting of Foundation's Human Rights program officers 9. Dates ofevent From (Month/Year): 08/2001 To (Month/Year): 09/2001 Location of event City: Durban_ Country: South?Africa Foreign country(ies) involved 1. Country South Africa SponsoringIorganization(s) The United Nations Purpose of event United States non-governmental organization observer for the World Conference against Racism, Racial Discrimination, Xenophobia and Related Intolerance 10. Dates of event From (Month/Year): 05/2001 (Estimated) To (Month/Year): 05/2001 (Estimated) Location bf event City: Toronto Country: Canada Foreign country(ies) involved 1. Country Canada Sponsoring organization(s) The African Canadian Legal Clinic . Purpose of event Invited speaker for preparatory conference for Canadian non-governmental organization delegates to theIWorld Conference Against Racism, Racial Discrimination, Xenophobia and Related Intolerance 11. Dates of event From (Month/Year); 04/2004 To (Month/Year): 04/2004 Location of event City: Toronto Country: Canada Foreign country(ies) involved Country Canada Sponsoring organization(s) The Councilbn?Foundations Purpose of event Annual Meeting of the Council on Foundations 12. Dates of event From (Month/Year): 08/1999 To (Month/Year): 08/1999 Location of event City: Johannesburg Country: South Africa Foreign country(ies) involved 1. Country South 'Africa Sponsoring organization(s) The Black Lawyers' Association of South Africa Purpose of event Invited speaker for Black Lawyers'-Association's Constitutional Litigation training program 13. Dates of event From (Month/Year): 05/2! 995 To (Month/Year): 05/1995 Location of event City: Medellin Country: Colombia Foreign country(ies) involved 1. Country Colombia 7 Sponsoring organization(s) Partido Liberal Colombiano (Liberal Party of Colombia) Purpose of event Invited speaker.(via U.S.I.A.) for "Derechas .Sociales Ciudadania en El Seminario Taller Cuidadania Mujer" . Additional comments: The invitation to attend this event was originally issued to the NAACP Legal Defense 5/21/2009 b7E Investigation Request #5708674Compact Copy Page 10 of 14 I and Educational?Fund's President and Director-Counsel, Elaine R. Jones, but Ms. Jones had another commitment which precluded her participation in the conference. 3. In the last 7 years, have you or any of your immediate family members been asked to provide advice or serve as a consultant, even informally, by any foreign government of?cial or agency? No Was activity on of?cial U.S. Government business? Requests/Consultations (No Entry Provided) . 4. In the last 7 years, have you or any of your immediate family members had any contact with a foreign government, its (embassies, consulates, ?agencies, or-military services), or its representatives, whether inside or outside the No Was activity on of?cial U.S. Government business? Government Contacts (N 0 Entry Provided) . 5. In the last 7 years, have you sponsored any foreign citizen to come to the U.S. as a student, for work, or for permanent resrdence? No Was activity on of?cial U.S. Government business? Sponsored Visits (No Entry Provided) 6. Have you EVER held or do you now hold a passport'that was issued by a foreign government? No Was activity on of?cial U.S. Government business? I Foreign Passports (N 0 Entry Provided) Section 20C: Foreign Countries You Have Visrted Have you traveled outside the U.S. in thelast 7 years? Respond for foreign countries you have visited in the last 7 years. Do not list travel under of?cial U.S. Government business, but you must include any personal trips made in conjunction with the of?cral U.S. Government travel. Yes Foreign Travels 1. Dates of activity From (Month/Year): 0412007 To (Month/Year): 04/2007 Purpose(s) of visit Volunteer activities, Countries-visited 1. Country Nigeria Number of days 7 2. Dates of activity From (Month/Year): 08/2006 To (Month/Year): 08/2006 Purpose(s) of visit Other Countries visited 1. Country Senegal Number of days 1 - Additional comments: I was en route from South Africa to the United States (New York), and when I changed planes in Senegal my passport was stamped. I did not leave the airport in Senegal. 3. Dates of activity From (Month/Year): 08/2006 To (Month/Year): 08/2006 Purpose(s) of visit _Volunteer activities Tourism - Countries visited 1. Country South Africa Number of days 9 4. Dates ofactivity 01/2005 To (Month/Year): 01/2005 Purpose(s) ofvisit Business/Professional conference Tourism Countries visited 1. Country Aruba Number of days 5 5. Dates of activity From (Month/Year): 04/2004 To (Month/Year): 04/2004 Purpose(s) of visit Business/Professional conference Countries visited - 1. Country Canada Number of days 5 h\ I 6. Dates of activity From (Month/Year): 03/2004 To (Month/Year): 03/2004 Purpose(s) of visit Tourism Countries visited 1. Country Bahamas Number of days 4 . 7. Dates of activity From (Month/Year): 10/2003 To (Month/Year): 1012003 5/21/2009 b7E '13. 10. 11. 12. 14. 15. 16. Investigation Request #5708674Compact Copy I . Page 11 of 14 Purpose(s) of visit Business/Professional conference Countries visited 1. Country Indonesia Number of days 4 Dates of activity From (Month/Year): 10/2003 To (Month/Year): 10/2003 Purpose(s) of visit Business/Professional conference Countries visited 1. Country Vietnam Number of days 8 Dates of activity From (Month/Year): 03/2003 To (Month/Year): 03/2003 Purpose(s) of visit Business/grofessional conference Tourism Countries visited . 1. Country Brazil Number of days '7 Dates of activity From (Month/Year): 03/2003 To (Month/Year): 03/2003 Purpose(s) of visit.fBusiness/Professional conference Countries visited 1. Country Ghile Number of days 7 Dates of activity From (Month/Year): 10/2002 To (Month/Year): 1012002 Business/Professional conference Tourism Countries visited 1. Country India Number of days 10 Dates of act1v1ty From (Month/Year): 01/2002 (Estimated) To (Month/Year): 02/2002 (Estimated) Purpose(s) of v1s1t Business/Professional conference Countries visited Country Brazil Number of days 4 1 Dates of activity From (Month/Y ear) 08/2001 To (Month/Year): 09/2001 Purpose(s) of v151t Business/Professional conference Countries visited 1. Country South Africa Number of days 7 Dates of activity From (Month/Year): 0512001 (Estimated) To (Month/Year): 05/2001 (Estimated) Purpose(s) ofvisit Business/Professional conference Countries visited 1. Country Canada Number of days 2 Dates of activity From (Month/Year): 08/1999 (Estimated) To (Month/Year): 08/1999 (Estimated) Purpose(s) of Business/Professional conference Tourism Countries visited 1. Country South Africa Number of days 1 0 Dates of activity From (Month/Year): 115/1995 To (Month/Year): 0511995 (Estimated) Purpose(s) of visit Business/Professional conference Countries visited 1. Country Colombia Number of days 7 5/21/2009 . b7E Investigation Request #5708674Compact Copy . Page 12 of 14 A Section 21: Mental and Emotional Health In the last 7 years, have you consulted with a health care-professional regarding an emotional or mental health condition or were you hospitalized for such a condition? Answer "No" if the counseling was for any of the following reasons and was not court-ordered: strictly marital, family, grief not related to violence by you; or strictly related to adjustments from service in a military combat environment. . No (N 0 Entry Provided) - Section 22: Police Record a. Have you been issued a summons, citation, or ticket to appear in court in a criminal proceeding against you; are you on trial or awaiting. a trial on criminal charges; or are you currently awaiting sentencing for a criminal offense? b. Have you been arrested by any police of?cer, sheriff, marshal, or any other type of law enforcement of?cer? No c. Have you EVER been charged\with an Jelony offense? (Include those under Uniform Code of Military Justice.) No d. Have you EVER been charged with Egrearms or explosives offense? No B. Have you EVER been charged with any offense(s) related to alcohol or drugs? No (N 0 Entry Provided) Section 23: Illegal Use of Drugs or Drug Activity - a. In the last 7 years, have you illegally used any controlled substance, for example, cocaine, crack cocaine, THC (marijuana, hashish, etc.), narcotics (opium, morphine, codeine, heroin, etc.), stimulants (amphetamines, speed, methamphetamine, Ecstacy, ketamine, etc.), depressants (barbiturates, methaqualone, tranquilizers, etc.), hallucinogenics (LSD, PCP, etc.), steroids, inhalants (toluene, amyl nitrate, etc.) or prescription drugs (including painkillers)? Use of a controlled substance includes injecting, snorting, inhaling, swallowing, experimenting with or otherwise consuming any controlled substance. No b. Have you EVER illegally used a controlled substance while possessing a security clearance; while employed as alaw enforcement of?cer, prosecutor, or courtroom of?cial; or while in a position directly and immediately affecting the public safety? No c. In the last 7 years, have you been invoitied in the illegal possession, purchase, manufacture, traf?cking, production, transfer, shipping, receiving, handling, or sale of any controlled substance (see question a above) including prescription drugs? No d. In the last 7 years, have you received counseling or treatment or have you been ordered, advised, or asked to seek counseling or treatment as a result of your use of drugs? If you answered "Yes," provide date(s) of treatment and name(s) and address(es) of provider(s). You will be asked to sign an additional release if information is needed conceming any treatment. No (No Entry Provided) Section 24: Use of Alcohol I a. In the last 7 years, has your use of alcohol had a negative impact on your work performance, your professional or personal relationships, your ?nances, or resulted in intervention by law enforcement/public safety personnel? Explanation . b. In the last 7 years, have you been ordered, advised, or asked to seek counseling or treatment as a result of your use of alcohol? No c. In the last 7 years, have you received qoun?eling or treatment as a result of your use of alcohol? No Treatments (No Entry Provided) Section 25: Investigations and Clearance Record a. Has the U.S. Government or a foreign government EVER investigated your background and/or granted you a security clearance? If use the codes that follow toprovide the requested information below. If "Yes,? but you can't recall the investigating agency and/or the security clearance received, check "Unknown." If your response is or you don't know or can't recall if you were investigated and cleared, check the "No" box. No Entry Provided) b. To your knowledge, have you EVER had a clearance or access authorization denied, suspended, or revoked; or been debarred from government employment? If "Yes," give the action(s), date(s) of action(s), agency(ies), and circumstances. Note: An administrative downgrade or termination of a security clearance is not a revocation. No (No Entry Provided) . Section 26: Financial Record a. Have you ?led a petition under any chapter of the bankruptcy code? If "Yes," indicate Chapter 7, 11, or 13. No b. Have you had any possessions or property voluntarily pr involuntarily repossessed or foreclosed? No c. I;Iave you failed to pay Federal, state, or other taxes, or to ?le a tax return, when required by law or ordinance? No d. Have you had a lien placed against your property for failing to pay taxes or other debts? No e. Have you had a judgment entered against you? No f. Have you defaulted on any type at loan? No g. Have you had bills or'debts turned over to a collection agency? Yes h. Have you had any account or credit card suspended, charged off, or cancelled for failing to pay as agreed? Yes i. Have you been evicted for non?payment of ?nancial obligations? No j. Have you been delinquent on court?imposed alimony or child support payments? No k. Have you had your wages, bene?ts, or assets garnished or attached for any reason? No I. Have you been counseled, warned, or disciplined for violating terms of agreement for a travel or credit card provided by your employer? No . . . 5/21/2009 b'7E Investigation Request #5708674Compact COpy Page 13 of 14 I. m. Have you been over 180 days delinquent on any debt(s)? No 11. Are you currently over 90 days delinquent on any debt(s)? No 0. Have you EVER experienced ?nancial problems due to gambling? No p. Are you currently delinquent on any Federal debt? No 1. Check corresponding question 9) Had bills or debts turned over to a collection agency? Date satis?ed Month/Year: 10/2004 (Estimated) Amount of property value involved 5250.00 (est.) Loan/account number 54241 80553021640 Bankruptcy type: (7) Name of agency/organization/individual to whom debt is/was owed CitiCard Name action/debt is recorded under Jacqueline A. Berrien Status of action or debt Listed as "charge off" on credit report; I was advised by the card issuer in May, 2009 that the account history shows a "zero balance" as of October, 2004. I believe that the account was turned over to a' collection agency, but] do not recall the name of the collection agency. I have used information from an Equifax credit report dated 12/27/07 to estimate the outstanding balance on the account when it was closed. Name of company, court or agency handling case CitiCard Address of company, ?qurt or agency handling case Street: P.O. Box 6077 City: Sioux Falls State: SD Country: -Zip Code: 57117 Additional comments: -I have been unable to obtain the name of the collection agency through CitiCard Customer Service. 2. Check corresponding question h) Had an account or credit card suspended, charged off, or cancelled for failing to pay as agreed? . Date satis?ed Month/Year: 10/2004 (Estimated) - Amount of property value involved 900.00 (est) Loan/account number 0013363107 Bankruptcy type: Name of agency/organigation/individual to whom debt is/was owed Lord Taylor Name action/debt is recorded under Jacqueline A. Berrien .Status of action or debt The account was closed by the card issuer, but I believe that the outstanding balance was paid in full. - Name of company, court or agency handling case GEMBIL Address of company, court or agency handling case Street: P.O. Box 981400 City: El Paso State: TX Country: Zip Code: 79998 Additional cements: I called the customer service number for Lord Taylor charge customers and was informed that ?no match was found" for this account number. The representative stated that GE Money Bank has assumed responsibility for Lord Taylor charge accounts, and may not have records concerning accounts closed more than two years ago. 3. Check corresponding question h) Had an account or credit card suspended, charged off, or cancelled for failing to pay as agreed? Date satis?ed Month/Year: 01/1998 (Estimated) Amount of property value involved 3200.00 (est) Loan/account number 461657004069 Bankruptcy type: Name of agency/organization/individual to whom debt isl-was owed CitiCard Name action/debt is recorded under Jacqueline A. Berrien Status of action 'or debt 'My credit report indicates that this account was "paid satisfactorily" but "closed by [the] .Credit grantor." I contacted CitiCard customer service for more information because I do not recall the circumstances?surrounding the closing of this account. [was advised that the account number does not appear in theirurecords. i believe that have paid this account in full and have estimated the date the account was closed and the amount at issue based upon an Equifax credit report dated 12/27/2007. Name of company, court or agency handling case CitiCard - Address of company, court or agency handling case . Street: P.0. Box 6077 City: Sioux Falls} State: SD Country: Zip Code: 57117-6077 4. Check corresponding question h) Had an account or credit card suspended, charged 'off, or cancelled for failing to pay as agreed?- Date satis?ed Not Applicable Month/Year: I Amount of?property value involved 2,341.04 Loan/account number 5424180129887136 Bankruptcy type: Name of agency/organization/individua1 to whom debt is/was owed CitiCard Name action/debtis recorded under Jacqueline A. Berrien Statusof action or debt A CitiCard customer service representative stated that the account was closed in 2003. As of May 10, 2009 the total outstanding balance on the account was $2,341.04 and payments were current Name of company, court or agency handling case CitiCards Address of company, court or agency handling case Street: P.O. Box 6077 City: Sioux Falls State: SD Country: Zip Code: 57117-6077 5. Check corresponding question h) Had an account or credit card suspended, charged off, or cancelled for failing to pay as agreed? . 5/21/2009 b?7E Investigation Request #5708674Compact Copy Page 14 of 14 Date satis?ed Not Applicable Month/Year: I Amount of property value involved 1,547.43 Loan/account number 526021 0080883100 Bankruptcy type: Name of agency/organization/individual to whom debt is/was owed JP Morgan Chase Name action/debt is recorded under Jacqueline Berrien Status of action or debt A customer service representative for the card issuer stated that the account was closed in 2006. As of May 10, 2009 the account was current, with a total outstanding balance of 1,547.43. Name of company, court or agency handling case Chase Cards Address of company, court or agency handling case Street: P.0. Box 15298 City: Wilmington State: DE Country: Zip Code: 19850-5298 1 ?5 Section 27: Use of Information Technology Systems a. In the 1ast'7 years, have you illegally or without proper authorization entered into any information technology system? No b. In the last 7 illegally or without authorization modi?ed, destroyed, manipulated, or denied others access to information \3 residing on an infonnatidn'technology system? No 0. In the last 7 years, have?you introduced, removed, or used hardware, software, or media in connection with any information technology system without authorizatidn, when speci?cally prohibited by rules, procedures, guidelines, or regulations? No (No Entry Provided) Section 28: Involvement in Non-Criminal Court Actions In the last 7 years (if an SSBI go back 10 years), have you been a party to any public? record civil court action(s) not listed elsewhere on this form? No (No Entry Previded) Section 29: Association Record a. Have you EVER been an of?cer or a member of, or made a contribution to, an organization dedicated to terrorism, and which engaged in illegal activities to that end, either with an awareness of the organization's dedication .to that end or with the speci?c intent to further such illegal activities? No b. Have you EVER been an of?cer or a member of, or made a contribution to, an organization dedicated to the use of violence or force to overthrow the US. Government, and which engaged in illegal activities to that end, either with an awareness of the organization's dedication to that end or with the speci?c intent to further such illegal activities? No 6. Have you EVER been an of?cer or a member of, or made a contribution to, an organization that unlawfully advocates or practices the commission of acts of force or violence to discourage others from exercising their rights under the US. Constitution or any state of the US. with the speci?c intent to further such unlawful activities? No (1. Have you EVER advocated any acts of terrorism or activities designed to overthrow the US. Government by force with the speci?c intent to incite others to unlawful action in furtherance of such aims? No e. Have you EVER knowingly engaged in any activities designed to overthrow the US. Govemment by force? No f. Have you EVER knowingly engaged in any acts of terrorism? Neither your truthful response nor information derived from your response to this question?ill be used as evidence against you in any subsequent criminal proceeding. No g. gave you EVER participated in militias (not including of?cial state government militias) or paramilitary groups? No xp anation - Additional Comments Additional Comments I . i . Expected Attachments .p Expected Attachments (N 0 Entry Provided) I . 5/21/2009 WE Jacqueline A. Berrien 577-92?5628 Continuation of Response to Question 20B (2): Addendum to SF-86 Page 1 of 3 Dates?of Event Location Event Sponsor Purpose of Event 4/2007-4/2007 Abuja, Nigeria - National International Democratic Institute Observer Delegation Training and Post Election Meeting 7\ and Press Conference l/200551/2005 Oranjestad, Aruba National Bar Invited Speaker for Association (NB A) NBA Judicial Council Mid?Winter Meeting 4/2004-2/2004 Toronto, Canada The Council on Annual Meeting of . Foundations COP Hanoi, Vietnam The Ford Worldwide-Meeting Foundation of Foundation Grant Makers 10/2003-10/2003 Jakarta, Indonesia The Ford ?Peer Exchange" Foundation Meeting with Foundation Program. Of?cers and Grant . Recipients 3/2003?3/2003 San Paulo, Bahia, The Ford ?Peer Exchange? and Rio de Janeiro, Foundation. Meeting with Brazil Foundation Program Officers and Grant Recipients . 312003-3300?? Santiago, Chile i ,?The Ford Worldwide Meeting 3 Foundation of ounciation Grant i - Makers 10/2002-10/2002 New Delhi and The Ford ?Peer Exchange? Kerala, India Foundation Meeting with Foundation Program Of?cers and .Grant Recipients 2/2002-2/2002 . Rio de Janeiro, The Ford Worldwide Meeting (estimated) Brazil Foundation of Foundation Grant Makers 8/2001-9/2001 Durban, South The United Nations World Conference Africa Against Racism, Racial Discrimination, Jacqueline A. Berrien Addendum to 577?92?5628 Page 2 of 3 Xenophobia and Related Intolerance 5/2001-5/2001 Toronto, Canada African Canadian WCAR Prep Con. Legal Clinic For Canadian NGOs 8/1999-8/1999 Johannesburg, Black Lawyers? Invited Speaker for South Africa Association. of Constitutional South Africa Litigation Training Program Medellin, Columbia Particle Liberal Invited Speaker (via Columbiano U.S.I.A.) for (Liberal Party of Sociales Columbia) Ciudadania en El Seminario Taller Cuidadania Mujer Jacqueline A. Berrien 577-92?5628 Continuation of Response to Questibn 20C: Addendum to Page 3 of 3 Code r. to MOJY r. of Days Country 1 #8 10/2003-10/2003 8 Vietnam 1 #9 10/2003-10/2003 4 Indonesia 1 #10 7 Brazil 1 #1 1 3/2003?3/2003 7 Chile 1 #12 10/2002?10/2002 10 India 1 #13 2/2002-2/2002 4 Brazil 1 #14 8/2001?9/2001 7 South Africa l. #15 5/2001-5/2001 2 Canada 1 #16 . 8/1999-8/1999 10 South Africa 1 #17 511995-5/1995 7 Columbia THE WHITE HOUSE Washington PRIVACY ACT PROTECTED INFORMATION (When completed) Disclosure and Authorization Pertaining to Consumer Reports Pursuant to the Fair Credit Reporting Act This?is a release for the Federal Bureau= of Investigation and/or the Of?ce of Counsel to President Barack Obama, acting on the President?s behalf, to obtain one or more consumer credit reports about you in a connection with consideration of your appointment to a position with the Executive Branch, or in the course of your employment with the Federal Government. One or more reports about you may be?? obtained for employment purposes, including evaluating your ?tness for employment, promotion, reassignment, retention, or access to classi?ed information. I, Jacqueline Ann Berrien (print or type full name), hereby authorize the Federal Bureau of Investigation and/or the Of?ce of Counsel to President Barack Obama, acting on the President?s behalf, to obtain such reports from any consumer/credit reporting agency for employment purposes. Mav 12, 2009 Date 577?92?5628 Social Security Number - Electronic Questionnaires for Investigations Processing Page 1 0f 1 Investigation Request #5708674 for Applicant SSN 577~92?5628 Signature Forms Electronic Questionnaires for Investigations Processing Investigation Request #5708674 SIGNATURE FORMS The signature(s) in this document refer to information on forms submitted in the Investigation Request #5708674. The signature on the statement below is as valid as directly signing the same .r statement on a printed Investigation Request #5708674 Of?cial Archival Copy. This signed statement and an image of each page from the Investigation. Request #5708674 Of?cial Archival Copy will be considered of?cial record. Sign and submit all forms in this document to the of?ce that initiated your Investigation Request. Data Hash Code: . Of?cial Archival Copy PDF Hash Code: Datefl?ime Certi?ed in the System: 2009-05-18 20:08:45.745 - Applicant's Social Security Number: 577-92-5628 Questionnaire for National SecurityPositions (SF86 Format) OMB No. 3206?0005 Certification My statements on this form. and on any attachments to it, are true, complete, and correct to the best of my knowledge and belief and are made in good faith. I have carefully read the foregoing instructions to complete this form. I understand that a knowing and willful false statement on this form can be punished by ?ne or imprisonment or both (18 U.S.C. 1001). I understand that intentionally withholding. misrepresenting, or falsifying information may have a negative effect on my security clearance, employment prospects, Orjob status, up to and including denial or revocation of my security clearance, or my removal and debarment from Federal service. . . . . Signatur Date . 575/0? UM Version 2 PRIVACY ACT INFORMATION . Investigation Request #5708674 . Document Type CER . . S?i?ida?dff?r??ogss'1 FOR Sir"; flipiziigboos ise . - US. Of?ce of Personnel Management NATIONAL POSITIONS . NSN 7540-00 634-4036 5 CFR- Parts 731 732. and 736 86-111 UNITED STATES OF AMERICA AUTHORIZATION FOR RELEASE OF INFORMATION . Carefuliy read this authorization to release information about you, then sign and date it in ink. Authorize any investigator, special agent, or other duly accredited representative of the authorized?Federal agency conducting my background investigation, to obtain any information relating to my activities from individuals, schools, ,a residential management agents, employers, criminal justice agencies, credit bureaus, consumer reportingagencies, collection agencies, retail business establishments, or other sources of information. This information may include, but is not limited to, my academic, residential, achievement, performance, attendance, disciplinary, employment history, criminal history record information, and ?nancial and credit information. I authorize the Federal agency conducting my investigation to disclose the record of my background investigation to the requesting agency for the purpose of making a determination of suitability or eligibility for a national security position. I Authorize the Social Security Administration (SSA) to verify my Social Security Number (to match my name, Social Security Number, and date of birth with information in SSA records and provide the results of the match) to the Of?ce of Personnel Management (0PM) or other Federal agency requesting or conducting my investigation for the purposes outlined above. I authorize SSA to provide explanatory information to 0PM, or to the other Federal agency requesting or conducting my investigation, in the event of a discrepancy. I Understand that, fer ?nancial or lending institutions, medical institutions, hospitals, health care professionals, and other sources of information, separate speci?c releases may be needed, and I may be contacted for such releases at a later date. I Authorize any investigator, special agent, or other duly accredited representative of the OPM, the Federat Bureau of investigation, the Department of Defense, the Department of State, anduany other authorized Federal agency, to request criminal record information about me from criminal justice agencies for the purpose of determining my eligibility for assignment to, or retention in, a national security position, in accordance with 5 U.S.C. 9101. understand that I may request a copy of such records as may be available to me under the law. ?1 Authorize custodians of records and other sources of information pertaining to me to release such information upon request of the investigator, special agent, or other duly accredited representative of any Federal agency authorized above regardless of any previous agreement to the contrary. I Understand that the information released by records custodians and sources of information is for of?cial use by the Federal Government only for the purposes provided in this Standard Form 86, and that it may be disclosed by the Government only as authorized by law. . . Photocopies of this authorization that shew my signature are valid. This authorization is valid for ?ve (5) years from the date signed or upon the termination of my af?liation with the Federal Government, whichever is sooner. Signature (Sig r'nink) Full name (Type or print Iegibly) Date signed Jacqueline Ann Berrien 0 35 0 Other na 5 usgd Date of birth . Social Security Number Jacki Berrien il/zs/rr?l EW-Ciz-a'ezr W?hl Apt.# Slate Home teleghoge gumber Version 2 - Investigation Request #5708674 Document Type REL b6 b7C Standard Form 86-1 4 Form approved: Revised July 2003 QUESTIONNAIRE FOR - OMB No. 3206 0005 U.S. Office of Personnel Management NSN 7540-00 634-4036 5 CFR Parts 731, 732, and 736 NATIONAL SECURITY POSITIONS 86-111 UNITED STATES OF AMERICA AUTHORIZATION FOR RELEASE OF INFORMATION . Carefully read this authorization to release information about you, then sign and date it in ink. Authorize any investigator, special agent, or other duly a0credited representative of the authorized Federal agency conducting my background investigation, to obtain any information relating to my activities from individuals, schools, residential management agents, employers, criminal justice agencies, credit bureaus, consumer reporting agencies, collection agencies, retail business establishments, or other sources of information. This information may include, but is not limited to, my academic, residential; achievement, performance, attendance, disciplinary, employment histo criminal history record information, and ?nancial and credit information. I authorize the Federal agency conducting my investigation to disclose the record of my background investigation to the requesting agency for the purpose of making a determinatioQof suitability or eligibility for a national security position. Authorize the Social Security Administration (SSA) to verify my Social Security Number (to match my name, Social Security Number, and date of birth with information in SSA records and provide the results of the match) to the Of?ce of Personnel Management (OPM) or other Federal agency requesting or conducting my investigation for the' purposes outlined above. I authorize SSA to provide explanatory information to 0PM, or to the other Federal agency requesting or conducting my investigation, in the event of a discrepancy. Understand that, for ?nancial or lending institutions, medical institutions, hospitals, health care professionals, and other sources of information, separate speci?c releases may be needed, and I may be contacted for such releases at a later date. Authorize any investigator, special agent, or other duty accredited representative of the OPM, the Federal Bureau of investigation, the Department of Defense, the Department of State, and any other authorized Federal agency, to request criminal record information about me from criminal justice agencies for the purpose of determining my eligibility for assignment to, or retention in, a national security position, in accordance with 5 U.S.C. 9101. I understand that i may request a copy of such records as may be available to me under the law. I Authorize custodians of redords and other sources of information pertaining, to me to release such information upon request of the investigator, special agent, .or other duly accredited representative of any Federal agency authorized above regardless of any previous agreement to the contrary. .9 Understand that the information released by records custodians and sources of information is for of?cial use by the Federal Government only for the purposes provided in this Standard Form 86, and that it may be disclosed by the Government only as authorized by law. ,how my signature are valid. This authorization is valid for ?ve g5) years from the date signed or upon the termination 'of my af?liation with the Federal Government, whichever is sooner. Photocopies of this authorization that i Signa re (Sign in k) I Full name (Type or print Iegibly) Date signed - - Jacqueline Ann Berrien 05/12/2009 ft er Wines used Date of birth - Social Security Number 11/28/1961 577?92?5628 ICurrent street address Apt. City (Country) State ZIP Code 5 'Fer 1:36 I I 3- 921 Enter your Social Security Number before going to the next page 577?92-5628 Revised 9/2/2008 Supplement to Standard Form 86 Attach additional pages as necessary. (SF-86) 13. a) Please list names of all corporations, firms, partnerships or other business enterprises, and all nonprofit organizations, and other institutions with which you are now, or during the past five years only, have been affiliated as an officer, owner, director, trustee, partner, advisor, attorney or consultant. Name/Address/Telephone of Corporate Counsel/Other verifying Official Name/Address Position/ Type of Dates Compensated Telephone Nature of Business (To/From) (Yes/No) Affiliation NAACP Legal Defense Associate Non?profit public Sept. 2004 Yes and Educational Director- interest law firm to Present . Fund, Inc. 99 Hudson Counsel/Full Street, Suite 1600, ~Time, New York, NY 10013 Salaried 212?965?2200 Employee Oberlin College Trustee Private higher 2007 to No 'educational Present institution Philanthropic Advisory Non~profit 2005 to No Initiative on Racial Board Member organization Present Equity b7C Revised 9/2/2008 Supplement to Standard_Form 86 Revised 9/2/2008 Supplement to Standard Form 86 18. b) Please provide the names of all organizations ?ith which you are/were affiliated since age 18 that might present a potential conflict or appearance of conflict of interest with your prospective appointment. Name/Address/ Position/Type of Dates Nature of Conflict Name/AddreSs/ Telephone Business (To/From) Of Interest Telephone of Corporate Counsel Or Other verifying Official IS. c) If an attorney, please provide a listing of major clients and all other clients that might present a potential conflict or appearance of conflict of interest with your prospective appointment. Name/Address/Telephone Dates Nature of Conflict of Name/Address/Telephone_ Of Client (To/From Interest Of Contact Person Client listing will be provided separately Revised 9/2/2008 Supplement to Standard Form 86 ls d) List any current or former professional licenses/memberships, license, real estate license, etc. bar associations, medical Type of License/membership Location License Number Date issued/Date of expiration Bar admission New York State 2153245 September, 1987/November, 2009 ZS. Please list all of your interests in real property, including additional homes, vacation homes, and rental properties. Location/Address of Property (to include zip:code) Nature of Interest owner, investor) Type of Property Other Than Primary (commercial/residential/ Residence, Estimated rental) Residence Annual Days Spent at Residential Primary residence/not applicable b6 b7C Revised 9/2/2008 Supplement to Standard Form 86 38. Have you or any firm, company or other entity with which you have been associated ever been convicted of a violation of any Federal, state, county, or municipal law, regulation or ordinance? If so, please provide details in the table below. Yes No Name/Address/ Dates Violation of Disposition Location of Name/Address/ Telephone Federal/State/ Records Telephone of of Individual, County/Municipal Corporate Firm, or Company Law, Regulation Counsel/Other or Ordinance verifying Official Revised 9/2/2008 Supplement to Standard Form 86 (SF-86) 43. Have you or any firm, company, or other entity with which you have been associated ever been the subject of a Federal, state or local investigation for possible violation of a criminal statute? If so, please provide details in the table below. Yes No Name/Address/ Dates Details of Disposition Investigative Name/Address/Telephone Telephone Criminal Statute Entity 0f General Counsel/ Of Individual, Violated Other verifying Firm, Company Official Investigated 6 Revised 9/2/2008 Supplement to Standard Form 86 (SF-86) SS. Have you ever been involved in civil or criminal litigation, or in administrative or legislative proceedings of any kind, either as a plaintiff, defendant, respondent, witness, or party in interest? Criminal proceeding (entry of plea and sentencing) sentencing hearing No If yes, please provide details in chart below. Type of Proceeding Your Involvement Dates Issue(s) and Location of Records (civil/criminal (plaintiff, Disposition court) litigation or defendant, Name/Address/Telephone of administrative/ respondent, General Counsel/ Other legislative witness, or party verifying Official proceedings) of interest) Character Witness April Testified a ?r a b6 b7C Revised 9/2/2008 Supplement to Standard Form 86 7 lilx GS. Have you ever been disciplined or cited for a breach of ethics or unprofessional conduct by, or been the subject of a complaint to, any court, administrative agency, professional association, disciplinary committee, or other.professional group? Yes No If yes, please provide details in the chart below. Entity/Court/Administrative Date Citation/Disciplinary Disposition Location of Agency/Profes sional Action Complaint Re cords Name . Association/Disciplinary - Address/Telephone Committee/Other . of Contact Person Professional Group Revised 9/2/2008 Supplement to Standard Form 86 7S. a) Have you ever run for or been elected to political office, served on?a political committee or have been identified in a public way with a particular organization, candidate or issue? Identify any complaints lodged against you and/or your political committee with the Federal Election Commission or state or local election authorities. Yes No Political Position Elected/Appointed/ Dates Nature of Complaints Location of Office/Committee volunteer Position Records Organization Campaign volunteer 1991 Not applicable New York State and Board of 2001 Elections IF York City Council b) Have you ever acted as or registered as a lobbyist? Yes appropriate registration information. No If so provide and Educational Fund, Inc., 99 Hudson Street, Suite 1600, NY, NY 10013 Legal Defense Fund?s LD-2 reports at mid? year and year- end 2005 Entity[Address .Dates Registered Level ofggegistration Location of (Yes/No) Foreign/Federal/State/Local Registration Records . . NAACP Legal Defense 1995 Listed in NAACP Federal U.S. Senate Office of the Secretary and Clerk of the U.S. House of Representatives b6 b7C Revised 9/2/2008 Supplement to Standard Form 86 BS. Please provide all affiliations as a member or office holder of any social clubs or organizations since Indicate whether each restricts or restricted membership on the basis of sex, race, color, age 18. religion, national origin, age or handicap? If so, indicate your efforts to change the restrictive policy. . . Social Dates Position Restrictive membership Name/Address/Telephone of Club/Organization (Member/Officer) Policies verifying Mambership Official (Yes/No) None/not applicable 10 Revised 9/2/2008 Supplement to Standard Form 86 98. a) Please identify any adults (18 years or older) currently living with you who are not members of your immediate family (include household employee) and provide complete immigration information if they are not United?States citizens by birth. Current name Date of Place of Country of Immigration Information If an au pair, and name Birth Birth Citizenship (Certificate Number/ identify the name and under which Court/City/State and location of the Issued). sponsoring agency. individual If Alien Registrationr entered the provide the date and U.S. (if name place where the has since individual entered the changed since U.S. entry) None/not applicable ll Revised 9/2/2008 Supplement to Standard Form 86 (SF-86) 93. b) Please identify any'adults (18 years or older) you employ individually who do not reside with you nanny, gardener, babysitter, and housekeeper) and whether all appropriate taxes have been paid regarding each individual. Name Position Dates Employed Have All Appropriate Taxes Been Paid For Listed Individual (Yes/No) NOne/not applicable 12 Revised 9/2/2008 Supplement to Standard Form 86 108. Is there anything in your personal life that could be used by someone to coerce or blackmail you or is there anything in your life that could cause an embarrassment to you or the President if publicly known? Yes No If so, please provide full details. l3 Revised 9/2/2008 :Supplement to Standard Form 86 I understand that the information being provided on this supplement to the SF486 is to be considered part of the original dated May 18, 2009 and a false statement on this form is punishable by law. Jacqueline Ann Berrien Max 28, 2009 Signature Type Full Name Date 14 WULOL Revised 9/2/2908Supplement to Standard Form 86 I und?ratand that the information being provided on this aupylemant to the 13 to he considered part at the original 53-35 dated Kay 13, 2009 and a false statement on this form is puniahlblo by law. I. C. Jacqunlinu A?n Bettina; Max 23, 2009 lg] j?igugtu?g . Type Pull name Date I 14 HAA n-t?I-w IZTI 98V 388 l? 93:81, Cu. IB/xa'd ?7?1 I'ln (3 M: RQKC r0340 (Rev: 1-03) File Number \Ql 6 KHQOZS Field Office Acquiring Evidence Serial of Originating Document Date Received 11? From (Name 4 (Address) (City and State) By Sp To Be Returned Yes No Receipt Given [3 Yes No Grand Jury Material - Disseminate Only Pursuant to Rule 6 Federal Rules of Criminal Procedure Yes No .3 Federal Taxpayer Information (FTI) Yes dNo :LS?gvc%ue\ Me Arm a\ T5. PPS Reference: (Communication Enclosing Material) Description: 615 Original notes re interview of b6 b7C b6 b7C b6 b7C . i? I . .- wwg?o? 99m . 12:53; K7 (ig?w - . Interviewe'e s. Name Ibfficial Title: Aodres OIrganizatIion; Phone nuImb er . .Ireputaticn, assoc1 ates or Il?oyalt'y to uthe United States? Troirezoriment71 RelationshipDoes the appointee appear to live within their means? . APPOINTE TESITIGATIIODIT . I. CASE . is I 57c it Describe relationship Iwith the appointee? Odiiaat?k?? How IlonIg heve you. Ilcnown the. IIappIointee.? How much Contact do you have with, the: I:appointee? Igeq9m\ M951 {119$ . - 6-Wl Rim.? the ?appointee: A 0y: Impm 15mm V3 W6 Would Emu have to question the appointee s- character,N5? . Drug and Alcohol Histoiy: - .. I I *Current anIdI/or past .hisItonI of] alcohol. abuse? ma *Clirrent anti/or IpaIst history. of pzescription- abusejw? fCurrent and/oi: past history of .illegaIlI .drug. to include?rijuan and/or past history of selling, purcha's sing,I possessing,I manufacturing; trafficking, producing, transtetxing, shwoping CI: receiving any illegal substance inclueiing marijLiana'J Identify drug used: . . . . Duration oIf_ use: . . I I- ?Location of use: I I How drugs obtained: Appointee sale/distribute: ContactI of Iwho has knowledge: . ILaw Enforcement (IarrestI etc). Is the appointee financially responsible? '10, 1:1. 13. y? - Foa is. N?d position of trust and confidence w_ith the S: .Government1 Any reason -to believe the appointee harbors any biases or prejudices, either for or against any group or individual based on sex,. race, color, religion national origin and age? Any circumstances known about the appointee. that could' have a bearing. on their .suitability for access to classif-ied hinfomnation1 Q: ?gm$ven . . . ., .Anything that you.believe could be used to influence, pressure,_ coerce or comp-romise the appointee in any way or that could have an adverse impact -.on their character, judgement stability, discretion, trustworthiness or responsibility? Would you recommend the app.ointee for a position of. -trust and confidence with the United States Government? KJWL: Su ervisor Personnel Review Official Personnel File .(Any derogatory info?) Verification of title and dates of employment: f. - "List of co-workers with contact_information: . -Landlords: . I - I - Verification of lease datesz- :Rent payments received on t.ime1 Problems or complaints? 'Neighbors: I Verification of address and dates: ?Ever Witn?ssad,any disturbances/unusual behavior?? 13 .How liVEi at your residence? Do you havle any objections to your name being used in our report? 'h -EGENERAL QUESTIONS IF THE INTERVIEWEE DOES NOT KNOW THE APPOINTEE WELL ENOUGH TO ANSWER THE QUESTIONS: . *Have you ever seen any problems with. the laW', enforcement actions, creditors, etc. )1 *Would you have any reason not to recommend the appointee for a. cases. ?gb THE APEOINTEE EVER ILLEGALLY- USED A.CONTROLLED SUBSTANCE WHILE EMPLOYED AS A LAW ENFORCEMENT OR COURTROOM OFFICIAL - . - WHITE nncc?mcc?TM-m m. (AWE - I I II I I "i Him; (saw . 'sz'lE .. CASE News: iComMGmeeig 5- DOE-S the appointee to live within their meansInterxriewee?s Name: If'Official Title: Address 5 Qrgani zatIions. Phone number1.. RelationshipDescribe relationship with. the appointee? fg?e?d J?ow long have Ihnown the appointee? How much Contact do you have' with the appointeeL-Da. - . 2. \g?iiaracterize/?escrihe the "appointee: j: revevr?f "it IbwmathII wsmeyvhw caravgweaawmt maniac 3. Would you have any 1reason to question the' appointee' character, ._reputation, associates? or loyalty to the United States" Government'J Drug and Alcohol History: . *Current and/or past historyI of alcohol. abuse? Na . *Current and/or past history. of prespription Firti??!? 3131-153?? *Current and/or past IhistozyI of illegal ?drug to Iinclude Ma --*C1nrrent and/or past history of selling-J. purchasing, rIecIi-EiIvingI any. IillegalI substance including marijuana-J Identify drug used: Duration of -use: ?Looation of use: How drugs obtained: Appointee sale/distribnte: Contact_ of Iwho has knowledge: Law Enforcement: (arrest etc) . . Is the appointee financially responsible? possessing,- . manufacturing,- trafficking, producing, transits-Hing, e5 Any reason to believe the appointee harbors any biases or prejudices, either for or against any group or individual based on sex, race, color, religion national origin and age? IN- . . ., Any circumstances known about the appointee. that could' have a hearing on their suitability for access to classi?-ied information?? mike" . . . ,Anything that you. believe could- he used to influence; pressure,I coerce or compromise the appointee in any way' or that could have an adverse impact -Ion their character judgement stability, discretion, trustworthiness or responsibility? MI ?10. _WouId you recommend the appointee for a position of. trust and confidence with the United States Government? 1-1.. Supervisor/Personnel Review Official. Personnel File (Any derogatory info?) Verification o? title and dates o?I employment: @05an 301??; . - - - use ?List of _co-workejrs with Contact information: i . . \Ao oierIech/?Iv?li?? 0 Landlords.NT mirke?i 68583 Verification Iof lease dates:- I Rik); baa-eni?? ills-m: PaYm?D-ts received on time? I Ji-Iei? SN W500 Problems or complaints? _3 13. Neighbors: Veri?ication of address and dates: Ever witnessed_.any dis turbances/unusualI behavior? ,How longhave you lived at. your residence;J lIe. "Do you. have any .obj actions to your name Being used in our report? .M GWERE QUESTIONS IF THE INTERVIEWEE DOES NOT KNOW THE WELL ENOUGH TO ANSWER THE . *Have you ever seen any problems with the appointee-I I.(i Ie. llaw' enforcement actions, creditors, etc. .*Would you have any reason not to recommend the appointee 'for a . g? p?d'sition of trust and confidence with the SI. .Government? - FOE 77Aji515?/16111151J cases: lift) HAS THE APPOIMEE EVER ILLECAIELY USED A CONTROLLED WHILE AS A LAW ENFORCEMENT PROSECUTOH. OE COURTROOM OFFICIJL. -- - - . .- WHITE . - - {Ewe/W - - - . Inn: msneanovr . - . CASE: NAME. LY-Eaalmame -b6- IntervieweIe' IName: . b7c TOEfiCial Title: .nf? ii?m? Andreas/Qrganization; Phone number: 1.. RelationshipQ?serihe relaItionship Iwith the Iappointee? ?3le long have Iknown the. IappIoinItee? qujlg'1??q?. a4?5w much contaot -no have wit-hI Ehe appointee7,t)as - -.: a. 2. Chijaoterize/Deseribe the appointee: I.- e2? \kmb Pleaso?M- hquMIe sumac Isfv? awn Aam?g?; ?w 3. Would you?hawe anyJ?eason to guestion'the appointee? s- Character,?Q?I Ireputation or Iloyalty to Ithe United States?Covernment1 4; Drug and Alcohol History: - $0 .Iifiu; '*Current and/or past historyI ofI alcoho_l. abuse? 6 . I Wigs-1E.? . *Current and/or past Ihistory. of- prescription drug?ahuse1 IOI *Current and/or -past historyI of illegal drug use to Iinolude Marijuan -v?Cnrrent and/or past history o-E sellingI, purchasing - - manufacturing; trafficking, prodnoing, transferring, sh1pping receiving Iany illegal substance including marijuanaj Identify drug usedDuration of -uee: 5 1 . 3" I 'Looation ,of use: I I How Idrugs obtainedAppointee sale/distributeContactI of Iwho has knowledge: . . - ..- . ?It. ILaw Enforcement-' (arrestI etc). . '1 ?l I 5. Does the appointee appear to live within their means? 5" Is IIthe IappoinIteeI financially Iresponsihle?I - I 7. Any reason to believe the appointee harbors any biases or prejudices_ . either for or against any group or color, religion, national-origin and age? f? a. Any circumstances known about the appointee. that could have Ia bearingI Ion their suitability for access to classif-ied information? a . .. I seas" 9. .Anything thatI you.believe could he used to influence, pressure, coerce, or compromise the appointee in any way or that could have an adverse impact -Ion their character, judgement, stability, true tworthines or respon sih ility? '1 '10, _Would you recommend the appointee for a position of. trust and confidence with the United States Government? i I: 1-1. Supervisor/Personnel Review Official. Personnel File derogatory info?) Verification of title and dates of Iemployment: I . .. c. .en?aas?r ideas? ..List? of can?workers with Contact information: 3? ?ot?dmkt . . . - JTQSO (9 ST ~12 . - Landlords: 'r 3/ Verification of lease dates:- - . . c-No. skeezjfwicb?o 'IRent payments received on time?! . Problems or complaints'I?TeighborsILLWW 10 Verification of address and dates: Ever witnessed any disturbances/musual behaviorIZJ' {553' How IongI have you lived at Iyour residence? is. Do you have any .obj actions to _your name being used in our report? ?8 GENERAL QUESTIONS THE INTERVIEWEE DOES NOT SQTOW TE-IEE AEPOINTEE WELL ENOUGH TO ANSWER THE QUESTIONS: . *Have you ever seen any probiems with the appointee e. ,?drugs,_ law 5 enforcement actions, creditors. etc .*Would you have any reason not to recommend the appointee ?for a . p'o'sition of trust and confidence with the I.LT SI. .Government? wilt CASES: 0 HAS THE EVER ILLECALLY- USED A CONTROLLED SUBSTANCE WHILE EMPLOYED ES A LAW ENFORCEMENT OFFICER .PEOSECUTOR. HOE COURTROOM OFFICIAL: WHILE . 1. \7 Ebfm?" I :Official Title: I C. .- . ?;W1?wfge W5 . Interviewee' 5 'Name: AEdress/Qrganization; Phone member: 1.. 3 . .reputation, assoIciatesf or loyalty to the United States" Government1 A - ..- Does. the appointee apgear to live within their meansIESHTIGATION I, i. i 0- 1: ?30??.pr . . ELEME. \Cal (3102?; ..156 b7C Relationship: n. .. .5 .. . Describe relationship with the Iappointee? Clkumk??- Nf.How long have you .known the. Iappointee.? er%f??s . contact do .you have' .wiIE-h Ehe appointee?k?)m Characterize/Describe She _a nointee: I. Would you have any 'Eeason to guestion.the 'appointee' s- . Drug and Alcohol HistoEy: - I . '*Current and/or past hisEory of alcohol abuse? VXDO . *CuErent and/or pas.t Ihistory of pzrescription- drugiabuseji7C General Indices conducted by concerning JACQUELINE ANN BERRIEN aka JACKIE BERRIEN. b5 revealed negative results. . APPROVED SPECIAL AGENT . IN CHARGE DO NOT WRITE IN SPACES BELOW COPIES MADE: 2 - FBIHQ (161B-HQ-1619023) #6 SIGBIU, ROOM 10861 ATTN: PSQ I 196 1- WFO (161 NC DISSEMINATION RECORD OF ATTACHED REPORT Notations Agency Request Recd. Date Fwd. How Fwd. By. COVER PAGE FIB-204 (Rev! 12-1-95) . . UNITED STATES DEPARTMENT OF JUSTICE Federal Bureau of Investigation Copy to: Reporter; emce- be Date: 06/17/2009 1370 Case ID 161 Title: JACQUELINE ANN BERRIEN Character: Level WHITE HOUSE (OPF), SENATE LOBBYIST REGISTRATION, HOUSE LOBBYIST nopsiS' REGISTRATION, CTOC CHECKS, U.S. (DC), US. ATTY (VA), DIVIV (DC), U.S. PARK PD AND DEPT. OF JUSTICE (PUBLIC INTEGRITY) RECORDS WERE CHECKED CONCERNING BERRIEN. - CLOSED - DETAILS WFO INVESTIGATION IS COMPLETE. I This document contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and is loaned to your agency; it and its contents are not to be distributed outside your agency. . . 1 . WHITE HOUSE OFFICE CHECK - Of?ce of the Executive Clerk Of?ce of Administration Executive Of?ce of the President Room 4 Old Executive Of?ce Building Washington, D. C. The following investigation was conducted by Investigative Operations Analyst GOA: on June ?15, 2009, concerning JACQUELINE ANN BERRIEN. A search of the index cards and the computer database of the Executive Clerk?s Of?ce of the White House reflects no record concerning JACQUELINE ANN BERRIEN. . . 1 RECORD CHECK US. SENATE Secretary of the Senate Of?ce of Public Records 232 Hart Building Washington, DC. 20510 On June 11, 2009, Investigative Operations Analyst (IOA) l?eceived and initiated a lead at the US. Senate, in an effort to determine if JACQUELINE BERRIEN is a registered A computerized search of the US. Senate, Office of Public Records database contained 6 records in the name of JACQUELINE BERRIEN. The following data was obtained: JACQUELINE BERRIEN registered as a lobbyist in 2005, and is currently inactive. BERRIEN lobbied on behalf of the NAACP LEGAL DEF NSE EDUCATIONAL FUND. INC.. 1441- Street, Northwest, 10th Floor, Washington, DC, Contact Name: :3 JACQUELINE BERRIEN registered as a lobbyist for the NAACP LEGAL DEFENSE EDUCATIONAL FUND, from 2005-2008. The Office of Public Records did not disclose any grievances or complaints that may or may not have been ?led against JACQUELINE BERRIEN and the NAACP LEGAL DEFENSE EDUCATIONAL FUND, No additional information was obtained. . . 1 RECORD CHECK US. HOUSE OF REPRESENTATIVES Legislative Resource Center B-106 Cannon Building Washington, DC. 20515 On June 11, 2009, Investigative Operations Analyst Ireceived and initiated a be lead at the US. House of Representatives, in an effort to determine if JACQUELINE ANN BERRIEN is a registered 1370 lobbyist. A computerized search of the US. House of Representatives (US. HOR), Lobbying Disclosure Act Database contained 6 records in the name of JACQUELINE BERRIEN. The following data was obtained: JACQUELINE BERRIEN registered as a lobbyist in 2005, and is currently inactive. BERRIEN lobbied on behalf of the NAACP LEGAL DEW 4 Street, Northwest, 10th Floor, Washington, DC, Contact name: be b7c JACQUELINE BERRIEN registered as a lobbyist for the NAACP LEGAL DEFENSE EDUCATIONAL FUND, INC., from 2005-2008. The Office of Public Records did not disclose any grievances or complaints that may or may not have been ?led against JACQUELINE BERRIEN and the NAACP LEGAL DEFENSE EDUCATIONAL FUND, NC. No additional information was obtained. WFO 161 B-HQ-1619023 AME 1 ARREST CHECK COMMAND AND TACTICAL OPERATIONS Metropolitan Police National Criminal Investigation Center(NCIC)/ Interstate Identi?cation Index Washington, DC On June 10, 2009, Investigative Operations Analyst (IO initiated the following 135 investigation: . 107?: On June 11, 2009, CTOC Specialist of the Command and Tactical 1?35 Operations Center (CTOC)?conducted a computerized searm of the records of and database 1979 to obtain a criminal arrest record concerning JACQUELINE ANN BERRIEN, date of birth: 11/28/1961, social security number: 577925628. The search revealed no identi?able criminal arrest record concerning the above-named individual(s). . . BIRTH STATE CENTER for HEALTH STATISTICS VITAL RECORDS DIVISION DISTRICT OF COLUMBIA DEPARTMENT OF HEALTH GOVERNMENT OF THE DISTRICT OF COLUMBIA LEGAL UNIT 825 North Capital Street, FLOOR Washington, DC. On June 15, 2009, Investigative Operations Analyst (lOA)%Iinitiated an inquiry with the b6 STATE CENTER for HEALTH STATISTICS, Vital Records Division 0 van I record of JACQUELINE ANN 3370 BERRIEN, dob: November 28, 1961. On June 15, 2009] IVitaI Records Clerk, Of?ce of Vital Records Division, for the b5 Bureau of Vital Statistics, advised that the records reflect birth certi?cate number 032427-1961, ?led on January 9, 1070 1962 for a JACQUELINE ANN BERRIEN with a birth date of November 28, 1961, at Washington, DO. The birth certi?cate lists the parents as ANNA (NMN) BERRIEN and CLIFFORD BERRIEN. No additional information was obtained. wi=o 161B-HQ-1619023 AMB:amb . . RECORD CHECK UNITED STATES SECRET SERVICE Investigative Support Division 950 Street, NW. Washington, DC On June 16, 2009, investigative Operations Analyst Isubmitted a request for b5 the records to be searched concerning JACQUELINE ANN BERRIEN, aka: JACKIE BERRIEN, date of birth: 137?: November 28, 1961, social security number: 577925628. On June 16, 2009mlnvestigative Support Division advised that the search disclosed no b6 records concerning the above?name IVI ual. 1?70 wi=o 161 . RECORD CHECK UNITED STATES DEPARTMENT OF JUSTICE Of?ce of the United States Attorney District of Columbia Judiciary Center 555 Fourth Street, NW Washington, DC On June 16, 2009, Investigative Operations Analyst (IDA: submitted a request for the b6 records to be searched concerning JACQUELINE ANN BERRIEN aka: JACKIE BERRIEN, date of birth: November b7C 28 1961, social security number. 577925628. On June 16, ASSISTANT, US. Attorney Of?ce, Narcotics, Public b6 Corruption, Economic Crime, Transnational and Major Crimes Unit, advised that no identi?able record was located b7C concerning the above-named individual. On June 16, 2009, DOCKET CLERK, US. Attorney Office, Civil Division, advised that no b5 identi?able record was located the above-named individual. b7c It Should be noted that the index system of the Civil Division, US. Attorney Office (USAO) contains only names of plaintiff, except in civil actions brought by the United States against a particular defendant. Suits against government employees who are represented by the United States Attorney would be ?led by plaintiffs name and docket number. Wi=o 161 . . RECORD CHECK UNITED STATES OFFICE Eastern District of Virginia 2100 Jamieson Avenue Alexandria, Virginia 22314 On June 16, 2009, investigative Operations Analyst Isubmitted a request for the records to be searched concerning JACQUELINE ANN BERRIEN, aka: JACKIE date of birth: November 28, 1961, social security number: 577925628. On June 16, 2009' ILegal Assistant conducted a search of all pending/closed civil and criminal indexes. The search disclosed the following: A search of the database, which cover the period from 1985 to the present and encompasses the Alexandria, Newport News, Norfolk and Richmond regional area in addition to the United States Magistrate Courts, disclosed no record concerning the above-named individual. Also an additional search of their Index Card System which covers the period prior to 1985 revealed no record concerning the above-named individual. 1:36 1370 b6 b7C AM Bzamb . . RECORD CHECK GOVERNMENT OF THE DISTRICT OF COLUMBIA Department of Motor Vehicles 95 Street, Southwest Washington, DC. On June 15, 2009, Investigative Operations Analyst (IOAI ubmitted a request for the records to be searched to obtain a full history driving record concerning A BERRIEN, aka: JACKIE BERRIEN, date of birth: November 28, 1961, social security number: 577925628. On June 15, 2009] I Program Support Assistant advised that the above?named individual has no motor vehicle operator?s permit and/or driving record in the data communications system computer ?les. 136 1370 136 1370 Wi=o . . MAB:mab RECORD CHECK UNITED STATES PARK POLICE 1100 Ohio Drive, SW Washington, DC 20242 On June 11, 2009, Investigative Operations Analyst submitted a request for the records to be searched concerning JACQUELINE ANN BERRIEN, Ka: mom: murmur?, date of birth: November 28, 1961, social security number: 577925628. On June 11, 2009 : File Clerk, advised that the search disclosed no records concerning the above-named individual. b6 b7C b6 b7C W?o 161B-HQ-1619023 . . RECORD CHECK DEPARTMENT OF JUSTICE PUBLIC INTEGRITY SECTION 1400 New York Avenue, NW, Room 12100 Washington, DC 20005 On June 11, 2009, Investigative Operations Analyst (IOA submitted a request b6 for the records to be searched concerning JACQUELINE ANN BER a a: date of birth: b?7C November 28, 1961, social security number: 577925628. On June 11, 2009 : Case Management Administrator advised that the search disclosed no b5 records concerning the above?named individual. b7c ?v (Rev. 9-8-97) FEDERAL BUREAU OF INVESTIGATION REPORTING OFFICE OFFICE OF ORIGIN DATE INVESTIGATIVE PERIOD EL PASO BUREAU 06/16/2009 06/15/2009 TITLE OF CASE REPORT MADE BY TYPED BY JACQUELINE ANN BERRIEN . IOAI I CHARACTER OF CASE LEVEL II PAS REFERENCE Security Electronic Communication (EC) to Baltimore, et al dated 06/10/2009. ADMINI STRATIVE BUDED is 06/18/2009 . Credit Check was conducted. No further investigation remains at El Paso. All investigative leads should be considered covered. 63/9 SPECIAL AGENT APPROVED AL I IN CHARGE DO NOT WRITE IN SPACES BELOW COPIES MADE: (Attn: SIGBIU Room 10861, PSS //ua FED ICE mjjg?l. CEVOEL DISSEMINATION RECORD OF ATTACHED REPORT Notations Agency Request Reed. Date Fwd. How Fwd. By COVER PAGE b6 b7C b6 b7C - 4 . . lip-204 (Rev. 12-1?95) Copy to: Report of: Date: Case ID Title: Character: Synopsis: UNITED STATES DEPARTMENT OF JUSTICE Federal Bureau of Investigation IOAI Of?ce: EL PASO 106 06/16/2009 1?70 l6lB-HQ-l6l9023 ANN BERRIEN LEVEL II PAS was contacted reference the candidate's credit account. DETAILS CREDIT was telephonically contacted in an attempt to ascertain the status of the candidate's credit account. Writer was advised that no credit information would be provided to the FBI unless the candidate was on the telephone line to give his/her verbal authorization. Writer was also advised the release form signed by the candidate was not sufficient to obtain the requested credit information. This document contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and is loaned to your agency; it and its contents are not to be distributed outside your agency. . . FEDERAL BUREAU OF INVESTIGATION FD-263 (Rev. 9-8-97) REPORTING OFFICE OFFICE OF ORIGIN DATE INVESTIGATIVE PERIOD BOSTON FBIHQ 06/17/2009 06/10/2009?06/17/2009 TITLE OF CASE REPORT MADE BY TYPED BY JAQUELINE ANN BERRIEN b6 LEVEL II PAS aCk b7C CHARACTER OF CASE BUDED: 06/18/2009 REFERENCE: Bureau E.C. to Boston dated 06/10/2009. ADMINISTRATIVE: All persons interviewed were furnished with the appropriate provisions of the Privacy Act. Express promises of confidentiality have not been granted. No derogatory information was developed. I SPECIAL AGENT APPROVED IN CHARGE DO NOT WRITE IN SPACES BELOW COPIES MADE: 2 BUREAU ATTE: SIGBU. RM 10861 PSS EXT 6859 be l- BOSTON (l61B-HQ?l6l9023) b7C RECORD OF ATTACHED RFPORT Notations Aqen cv Request Reed. Date Fwd. How Fwd. Bv A .k COVER PAGE . . FD-204 (Rev. 12-1-95) UNITED STATES DEPARTMENT OF JUSTICE Federal Bureau of Investigation b6 Copy to: PS b7C Report of: I I Of?ce; BO on Date: 06/17/2009 c?unm Title: JACQUELINE ANN BERRIEN Character: PRESIDENTIAL APPOINTMENT WITH SENATE CONFIRMATION Education at Harvard Law School verified. Supervisor while employed at the Lawyer's Committee for Civil Rights Law interviewed. Investigation at Boston is complete. This document contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and is loaned to your agency; it and its contents are not to be distributed outside your agency. l6lB-HQ?l6l9023 ACK: ack EMPLOYMENT Lawyers Committee for Civil Rights Under Law 1401 New York Avenue N.W. Washington, D.C. 20005 On 06/11/2009. Itelephone was interviewed regarding the candidate, 5 a ed she was the Iwhi the candidate was employed at the Lawyers Committee for Civil Rights Under Law (LCCRUL) in Washington, the candidate in the mid?19908 durin a search for Staff Attorneys at the LCCRUL and hired her. does not recall the exact dates the candi worke but believes it was three years or so. recalle candidate left the LCCRUL to work for the NAACP Legal Defense Fund in New York in 1997. sees the candidate two or three times a year when ey attend legal conferences and events and communicates via telephone or email with the candidate occasionally. considers the candidate to be a professional assoc1ate as well as a friend and describes the candidate as a top?notch Attorney with a sterling reputation. considers the candidate to possess tremendous talent and integrity and stated the candidate was a joy to work with. believes the candidate to be trustworthy, honest,reliable and law?abiding and considers the people that the candidate associates with to be of the same caliber. stated the candidate possesses a wonderful reputation among her peers and the legal community. believes the candidate is respected, well?liked and admired for her work in the Civil Ri programs at the Ford Foundation and never known the candidate to show bias or prejudice 0 any kind toward anyone and would be astonished to hear of anything like that since the candidate has worked so diligently in the legal defense of civil rights. ACK:ack b6 b7C b6 b7C b6 b'7C believes the candidate lives within her financial means and has no knowled of the candidate abusing alcohol or prescription no knowledge of the candidate using illegal drugs or ein involved with their distribution, manufacture, or unaware of any conduct or activity in the candidate ac ground that may be used to pressure, influence or coerce the candidate or that may impact negatively on the candidate's reputation or character. advised she had met the candidate's parents and descrioed them as "the salt of the earth" and the very good people. without hesitation the candidate for a position of trust and responsibility with the United States Government. b6 b7C b6 b7C l6lB-HQ?l6l9023 ACKzack EDHQAELQH Harvard University 1563 Massachusetts Avenue Cambridge, MA 02138 On 06/11/2009, Harvard University Police Department, telep onel advised that their department records date from November 1998 to present which is not the time frame in which the candidate was enrolled. A check of the existing incident reports was negative regarding the candidate. On Harvard University Student Receivables, telephonel [advised the candidate has no outstanding debt to Harvard's Student Receivables Office or Student Loan Office. Harvard Law School Office of the Registrar Pound Hall 3rd Floor 1525 Massachusetts Avenue Cambridge, MA 02138 On June 17, Data a copy of the candidate?s transcript, summarized as follows: Jacqueline Ann Berrien attended Harvard Law School from the fall of 1983 through the spring of 1986. The candidate was awarded the Juris Doctor on June 5, 1986. The candidate's transcript did not contain a numerical grade point average or class rank. A review of the candidate's letter grades would indicate an approximate average of B. The candidate's record did not contain any disciplinary or derogatory information. b6 b7C b6 b7C b6 b7C FD-263 (Rev. 3-8-97) FEDERAL BUREAU OF INVESTIGATION REPORTING OFFICE OFFICE OF ORIGIN DATE INVESTIGATIVE PERIOD BIRMINGHAM FBIHQ 06/18/2009 06/16/2009 TITLE OF CASE REPORT MADE BY TYPED BY JACQUELINE ANN BERRIEN b5 LEVEL I I PAS SA 90m b7C CHARACTER OF CASE LEVEL REFERENCE: FBIHQ EC to BA, 06/10/2009. PENDING (All BH investigation completed) 4 ENCLOSURE: Enclosed for SIGBIU, FBIHQ, is the following: An containing the interview/investigative notes of SA concerning the candidate's background b5 inveSZigation. b7c PECIAL ARGE DO NOT WRITE IN SPACES BELOW FBIHQ (161 Eng.) (Attn: PSS b6 SIGBIU, Room 10861) WC 1 - BIRMINGHAM (l6lB?HQ-l6l9023) \9 DISSEMINATION RECORD OF ATTACHED REPORT Notations? Agency Request Reed. Date Fwd. glilw How Fwd. By A COVER PAGE l6lB?HQ?l6l9023 ADMINISTRATIVE: The person interviewed was furnished the appropriate provisions of the Privacy Act. No express promise of confidentiality, limited and/or unlimited, have been granted. Bi: Cover Page . . FD-204 (Rev. 12-1-95) UNITED STATES DEPARTMENT OF JUSTICE Federal Bureau of Investigation Copy to: Report of: SAI Of?ce: BIRMINGHAM b6 Date: 06/18/2009 1?70 Case ID l6lB?HQ?l6l9023 Title: JACQUELINE ANN BERRIEN LEVEL II PAS Character: BACKGROUND INVESTIGATION - LEVEL I I PRESIDENTIAL APPOINTMENT REQUIRING SENATE CONFIRMATION SF 86?listed reference recommends. .. DETAILS: Birmingham investigation is complete. This document contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and is loaned to your agency; it and its contents are not to be distributed outside your agency. l6lB?HQ-l619023 1 REFERENCES The following investigation was conducted by Special b6 Agent lat Birmingham, Alabama: . b7c On June 18. 2009. b6 b7c I provided the following information: advised that he first met the candidate when she b6 was a student at Oberlin College and he was invited by b7C I Iof an on?campus re?law organization, to speak to a Black Studies program? that he estimated_tha? this speaking engagement occurred between 1984 and 1987. advised that the candidate was a good friend of I Iwhile growing up in the Washington, D.C. area and followed her in College. He advised that the candidate then followed to Harvard Law School. He advised that the candidate began when he was i . advised that he considers his relationship with the candidate to be professional, but that they are also friends. He advised that the candidate returned to Birmingham for I advised that the candidate's character is :36 impeccable and that he has never heard a derogatory word uttered concerning her. He further advised that she is a brilliant lawyer who is very committed to equal rights and justice. He stated that the candidate, rather than working at a law firm, has alw been geared to work for public service organizations. advised that he knows of no associates connected to the candidate who would be considered questionable in nature. He advised that he has no reservations in stating that he considers the candidate to be loyal to the United States government. advised that he has no firsthand or hearsay knowledge of any prescription drug or alcohol abuse or any illegal use of any controlled substances. He advised that he has never known the candidate to have ever possessed, manufactured, purchased, distributed, sold, or rave had any other involvement with, illegal drugs. advised that he has no reason to believe that the candidate has ever illegally used a controlled substance while employed as a law enforcement officer, prosecutor, or courtroom official; or while possessing a security clearance, or while in a position directly and immediately affecting the public '5 I IN safety. He advised that, in terms of financial responsibility, if the candidate ever ad any financial difficulties, he was not aware of them. advised that he has never observed or heard of any instance where the candidate expressed or manifested any bias or prejudice against any individual or group for any reason, based upon sex race color, religion, national origin, handicap, or that he is unaware of any information about the can 1 a that could subject her to coercion, compromise, or duress, or that could possibly have an adverse effect on the candidate in any other way, affect her character, judgement, trustworthiness, discretion. advised that the candidate's professional reputation and legal abilities are both excellent and her courtroom experience, based on what he has heard, is very good; however, he ex lained that he has never seen her in a courtroom that he knows the candidate to have worked voter rig ts?type cases and, most recently, to be very familiar with all aspects of civil rights law in her position as Assistant Director?Counsel of the National Association for the Advancement of Colored People Legal Defense Fund. He stated that because he had not been in the courtroom with th candidate he was unable to comment on her courtroom demeanor. advised that the candidate had an excellent reputation or airness as well as an excellent judicial temperament. He added that the candidate's ability to weigh conflicting testimony to arrive at the truth is good and her oral and written skills are excellent. by recommending the candidate for the position or she is being considered. as advised of the provisions of the Privacy Act of 1974, but he did not request confidentialitybW: Automated Serial Permanent Charge?Out (1-5-94) Date: 06/19/09 Time: 12:12 Case ID: Description of Document: Type FD263 Date :?06/18/09 To FBI HEADQUARTERS From NEW YORK Topic: CANDIDATE Reason for Permanent Charge?Out: DID NOT INCLUDE ALL INFORMATION Employee: b6 b7C It a FD-263 (Rev. 9?3-97) 4 FEDERAL BUREAU OF INVESTIGATION REPORTING OFFICE OFFICE OF ORIGIN DATE INVESTIGATIVE PERIOD FBIHQ 06/18/2009 06/11/2009?06/18/2009 TITLE OF CASE REPORT MADE BY TYPED BY JACQUELINE ANN BERRIEN - 06/18/2009 SA alt CHARACTER OF CASE BACKGROUND INVESTIGATION LEVEL PAS lGlB-HQ?l6l9023 2 LEADS ADMINISTRATIVE: Persons interviewed were furnished the appropriate provisions of the Privacy Act of 1974 and no express promises of confidentiality were granted. On 6/15/09. New York Office indices and file review was conducted by SST regarding the candidate, JACQUELINE ANN aka JACKIE BERRIE DOB: 11 28 61 and listed relative, This search had yield negative results 4 SPECIAL AGENT APPROVED IN CHARGE DO NOT WRITE IN SPACES BELOW COPIES MADE: 1? FBIHQ (l6lB?H ?1 (Attn: PSS 1? NEW YORK MWD DISSEMINATION RECORD OF ATTACHED Notations Agency Request Reed. Date Fwd. 995 "Del How Fwd. Law By Am?\ nri COVETIPAGE b6 b7C b6 b7C b6 b7C A - I (Rev. 12-1-95) UNITED STATES DEPARTMENT OF JUSTICE Federal Bureau of Investigation Copy to: FBIHQ meum' SA (?hm New York b5 06/18/2009 b7? CaseID#: Title: JACQUELINE ANN BERRIEN LEVEL PAS Character: LEVEL I I - PAS Candidate interview completed. Residences verified. Employments verified. Reference interviewed. Two references developed. Arrest, DMV, Bar, and USAO checks conducted. I This document contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and is loaned to your agency; it and its contents are not to be distributed outside your agency. in I a FD-302 (sz. 10-6-95) -1- FEDERAL BUREAU OF INVESTIGATION Date of transcription The following investigation was conducted by Special Agents on June 16, 2009 regarding the candidate JACQUELINE ANN BERRIEN: JACQUELINE ANN BERRIEN, date of birth November 28, 1961, home addressl I home telephone number I I Associate Director?Counsel, National Association of the Advancement of Colored People (NAACP), Legal Defense Fund (LDF) work address 99 Hudson Street, Suite 1600, New York, New York 10013, work telephone number (212) 965?2277, work cellular telephone number (212)300-7416, was interviewed at the Federal Bureau of Investigation New York Office at 290 Broadway, New York, New York. BERRIEN (hereinafter referred to as "the candidate") was advised of the identities of the interviewing agents and the nature of the interview. The candidate was advised that the WHITE HOUSE has requested the FEDERAL BUREAU OF INVESTIGATION (FBI) to conduct a background investigation (BI) of the candidate in connection with the position for which the candidate is being considered. The candidate was advised that the purpose of the interview was to ensure that the FBI has all information necessary to conduct the BI and that the information, as requested during the interview and/or as reflected on her Questionnaire for National Security Positions (SF-86) executed May, 18, 2009, was complete, current and accurate. The candidate was advised that the results of the BI would be furnished to the WHITE HOUSE, and that her failure to provide the information requested could hinder the FBI's investigative efforts and cause delay in forwarding to the WHITE HOUSE a completed BI for its use in the decision?making process regarding the position for which she is being considered. The candidate was advised that the answers provided during this interview are to cover her entire adult life, that is, since her 18th birthday. The candidate was shown a copy of her as signed by the candidate, dated May 18, 2009. Each of the candidate's answers to the questions therein were reviewed with the candidate. The candidate advised that, to the best of her knowledge and 06/16/2009 New York, New York File 15 Date dictated (36/16/2009 by SA This document? contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and is loaned to your agency; it and its contents are not to be distributed outside your agencyb7C (REV. 10-6-95) JACQUELINE ANN BERRIEN ?On06/16/2009 ,Mg recollection, all information provided on her and accompanying supplement is accurate and correct. The candidate provided the following information: The the namel I telephone number as a co?worker at the candi e's .LDF. The candidate also provided work telephone number land personal telephone number Ias possible contacts for her time as an Adjunct Professor at the NEW YORK LAW SCHOOL from July of 1995 through June of 2000. The candidate advised that the NEW YORK LAW SCHOOL did not have a supervisory program for Adjunct Professors and can?hot recall any other names of former colleagues because it was a position in which there was little oversight and most of the work was completed individually with self supervision. candidate providedl I currently at telephone numberl Ias an additional reference as a person that knows her well. The candidate provided the following addresses of residences she has lived in since her 18th birthday, not previously disclosed on her SF-86: *1987?1992 265 St. James Place, Brooklyn, New York, 11238 *1986?1987 Ski Lodge 3 Apartment Complex, Apartment number 2301, Birmingham, Alabama *1985?1986 94 Beacon Street, Somerville, Massachusetts *1984?1985 70 Park Street Somerville, Massachusetts *1983?1984 WYETH HALL Dorm at Harvard Law School, Cambridge, Massachusetts *1982?1983 On campus at *1979~l982 SOUTH HALL at OBERLIN COLLEGE The candidate advised that the additional address of 626 Geranium Street NW, Washington, District of Columbia, 20012, which b6 b7C b6 b7C ., a 10-6-95) . 1 I JACQUELINE ANN BERRIEN n06/16/2009 3 Continuation of FD-302 of Page was reflected on her credit report, was the home she grew up in with her family from the age of five to seventeen. The candidate advised that she has not had any personal or business financial problems including, but not limited to, repossessions, delinquent child support and/or alimony payments, or liens placed against her- The candidate did advise. however that a The candidate advised that she believes there was a period of time where she was delinquent on her student loans due to financial difficulty, but has since paid all of her student loans in full and can not find any records of delinquency. In regards to debts placed for collection, the candidate recognizes the past incidents listed on her to include a CITI CARD account that was turned over to a collection agency as well as a LORD TAYLOR store credit account, two CITI CARD charge accounts, and a JP MORGAN CHASE charge account that have been delinquent in previous years. According to the candidate each of the accounts now are either paid in full and closed or current and up to date with payments. The candidate advised that she did not have any unpaid tax obligations and that she was current on all Federal, State and local tax obligations. She advised that she has filed for extensions regarding the submission of her taxes in the past, but has not had any problems with meeting an extension deadline. The candidate taxes. The candidate no civil law suits have The candidate any criminal matters as advised that she has never had to pay back advised that to the best of her knowledge, been filed against her. advised that she has not been involved in a subject or suspect, or been arrested, b6 b7C charged, and/or convicted of any crime. As described in her the candidate did testify as a character witness forl b6 . a (R'ev. 10-6-95) fr}! u: JACQUELINE ANN BERRIEN n06/16/2009 Continuation of FD-302 of Page I The candidate advised that attorney requested her to testify on his behalf. The candidate advised that she has never been denied employment, fired, suspended, left under unfavorable circumstances or through mutual agreement with an employer, been denied a security clearance, or had a security clearance revoked or suspended. The candidate advised that as of 2005 she was registered as a lobbyist for NAACP LDF because she was involved in legislative activity, which comprised approximately 15-20% of her work load prior to 2005 when she worked on the Re?authorization of the Voting Rights Act. This issue is the only issue that she has participated in legislative activity for. There is no record of legislative activity after 2005 for-the candidate, but the NAACP LDF legislative report continues to list her as a lobbyist. The candidate is currently working with the organization to fix the reporting problem. The candidate advised that she has had foreign travel for both business and personal reasons. The candidate advised that all travel since 1994 has been accurately disclosed on her based on what was evident in her passport and records with her current employer NAACP LDF and her former employer, the FORD FOUNDATION. The candidate advised that during all foreign travel, the candidate was never contacted by representatives of a foreign country, was never approached by a foreign intelligence office, nor does she ever remember anything strange or unusual happening. The candidate does not have any continuing contacts with any individuals from foreign travel. The candidate has traveled to the following foreign countries: Location Dates of Event Event Sponsor Purpose of - Event Aruba 01/2005 National Bar Speaker for NBA Association (NBA) Bahamas 03/2004 None Tourism Brazil 03/2003 The Ford Peer Exchange Foundation Meeting b6 b7C 1 (R?ev. 10-6-95) l6lB-HQ-16l9023 JACQUELINE ANN BERRIEN 06/16/2009 Continuation of FD-302 of Page Canada 04/2004 The Ford Annual Meeting Foundation 05/2001 The African Invited Speaker Canadian Legal Clinic Chile 03/2003 The Ford Foundation's Foundation Governance and Civil Society program officers Colombia 05/1995 Partido Liberal Invited Speaker Colombiano from NAACP LDF India 10/2002 The Ford Peer Exchange Foundation Meeting Nigeria 04/2007 National International Democratic Observer Institue Delelgation Training and Post Election Meeting and Press Conference Senegal 08/2006 None Changed planes en route to South Africa South Africa 08/2006 No event Tourism 08/2001 The United World Nations Conference against Racism 08/1999 Black Lawyers Training Association of Program South Africa Vietnam 10/2003 The Ford Meeting for Foundation worldwide grant making officials. In (th. 10-6-95) \t JACQUELINE ANN BERRIEN 0 6/16/2 0 9 Page Continuation of FD-302 of On Indonesia 10/2003 The Ford Peer Exchange Foundation Meeting 02/2 0 02 The Ford Worldwide Foundation Foundation Human Rights program officers meeting The candidate advised that she has never had any foreign financial businesses, foreign bank accounts, or other foreign financial interests of which she had direct control or direct ownership; has never had any foreign financial interests that someone controls on her behalf; has never owned real estate in a foreign country; nor has she ever received any educational, medical, retirement, social welfare, or other such benefits from a foreign country. The candidate advised that she did not travel very much prior to 1994 and received her first passport in 1995. The candidate did however travel to Mexico and Canada prior to 1994 for tourism. In January of 1989 the candidate visited Acapulco, Mexico with her husband for approximately 7 days. Sometime in 1987 Or 1988 the candidate recalled a day trip from San Diego to Tijuana, Mexico. The candidate also recalled a short trip sometime between 1987?1992 to Montreal for a Jazz Festival. The candidate advised that her current employment with the NAACP LDF could give the appearance of a conflict of interest because of the nature of her cases with NAACP LDF. She further advised that she is no longer a front line attorney for NAACP LDF cases and has not been since 2001. The candidate is now mainly involved with administrative and management duties within the organization. However, the candidate explained that her name appears in the Federal and Appellate Courts due to her title at the NAACP LDF as the Associate Director-Counsel. The candidate advised that she does not currently have a day to day responsibility for any cases. The candidate advised that she is currently involved with two other organizations that were accurately listed in her The candidate is a Trustee for OBERLIN COLLEGE, which is a private higher educational institution. She has been in this position Continuation of FD-302 of a 10-6-95) lGlB-HQ-l6l9023 JACQUELINE ANN BERRIEN On06/16/2009 Mg since 2007, she has not been compensated in this position, but has been reimbursed for travel for the aforementioned organization is with telephone number The candidate also advised that she has been an Advisory Board Member for Philanthropic Initiative on Racial Equity, which is a non?profit organization, since 2005. She has never been compensated by this organization except for travel reimbursement. The contact inf ic Initiative on Racial Equitv is iWith telephone numberl The candidate advised that she and the NAACP LDF were currently working on a list of major cases that will be provided by the candidate at a later date. The candidate advised that all of her professional licenses were accurately disclosed on her The candidate was admitted into the New York State Bar Association in September of 1987. Her license number for the Bar is 2153245. The candidate advised that her membership is due to expire in November of 2009. The candidate advised that she has not been the subject of any professional complaints or non-judicial disciplinary actions. The candidate advised that in 1991 and 2001 she worked as a campaign volunteer forI I the New York City council. The campaign was named The candidate advised that lboth elections. The records can be found a the Ne York State Board of Elections. The candidate advised that she has not received any counseling in the last 15 years from or other qualified mental health professionals or physicians for a mental health related problem. The candidate advised that she has never abused alcohol and has never received counseling/rehabilitation for drug/alcohol abuse. The candidate advised that when she was in her freshman and sophomore year in approximately 1979 and 1980 at OBERLIN b6 b7C b6 b7C 3 1213-30221 (R?ev. 10-6-95) 9 9 JACQUELINE ANN BERRIEN ,On06/16/2009 college she smoked marijuana approximately 10 times. The candidate advised that other than the aforementioned incidents she has never illegally used any controlled substances or illegally used prescription drugs. The candidate advised that she has never been involved in the illegal purchase, possession, manufacture, trafficking, production, transfer, shipping, receiving, or sale of any controlled substances. The candidate advised that she has never illegally used a controlled substance while employed as a prosecutor or courtroom official; while possessing a security clearance; or while in a position directly and immediately affecting the public safety. The candidate advised that she has never been involved or associated with any organization which advocates the use of force to overthrow the U.S. Government or had any involvement in the commission of sabotage, espionage, or assistance of others in terrorism. The candidate advised that she did'not include an organization that she is associated with on her because she was not aware that it should be included. The candidate currently belongs to the Delta Sigma Theta Sorority as an alumnus of Oberlin College and has been a member since April of 2006. The Brooklyn Chapter contact for the sorority isl The candidate advised that by definition the club/organization of a sorority precludes males from being members, but she does not feel this club is discriminatory in nature. Other than the above mentioned club the candidate advised that she is currently not a member of any organization whose policies have restricted membership on the basis of age, sex, race, color, religion or national origin, including private and social organizations. The candidate advised there is no activity or conduct in her life, past or present, that could be used to influence, pressure, coerce or compromise her in any way, or that could have an adverse impact on her character, judgement, stability, discretion, trustworthiness or responsibility. Page b6 b7C lSlB?HQ?l6l9023 ALTzalt RESIDENCE VERIFICATION November Zoos?Present The following investi onducted by Special Agent land Ion June 11, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): - I I'date of birth unknown, home addressl lhome phone numberl Iwork telephone numberl was interviewed at her officel on June 11, 2009. was advised of the nature of the interview and the identities of the interviewing agents. the following information: advised that she first met the candidate in 1996 (estimated) when the candidate worked as an attorney for the NAACP Legal Defense Fund (LDF) and where] also knows the candidate because she lives within close prox1m1ty to the candidate's current residence at escribed her relati the candidate as a personal friendship as neighbors. maintains frequent contact with the candidate, speaking With her regularly. had the opportunity to visit the candidate current residence at multiple occasions. I Istated that the only other individual living at the residence is the candidate is engaging, honest, trustworthy, level headed and very stable. urther described the candidate as a "Peace Maker". has never been given any reason to question the candidate's character or that of any of the candidate's associatesb7C IL stated that the candidate has an excellent reputation and has never had any reason to question her reputation either personally or professionally. never had any reason to question the candidate's loyalty to the United States Government. Istated that she has never had any reason to believe the candidate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. She further stated that she has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for his own intended profit or that of another. that she has no reason to believe that the candidate harbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. Iis unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. is unaware of any activity or conduct in the candidate's background that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. the candidate is financially responsible and living within her financial means. advised that she is unaware of anything that is pertinent to the candidate's suitability for access to classified material that she was not asked about. recommend the candidate for a position of trust and confidence with the United States Government. was advised of the appropriate provisions of the Privacy Act and verbally waived her right to confidentiality. b6 b7C b6 b7C b6 b7C 136 1070 1:36 1370 136 1376 b6 b7C 136 1:376 136 b7C b6 b7C I. i l6lB?HQ?l6l9023 ALTzalt NEIGHBORHOOD VERIFICATION b6 b7C November JUUb-Present The following investigation was conducted by Special Agent (SA) and SAI Ion June 11, b6 2009, with regard to JACQ ELINE ANN BERRIEN (hereinafter b7C referred to as the "candidate"): On June 11. 2009 SAI Iarrived at 106 I I which was a non- b7c doorman, three story walk-up. It appeared that the residence was a one family home. b6 A neighbor ho identified himself asI I answered his door at [aha b7c advised that he has briefly met the candidate in the past, rsgmetimes waves hello, but that he does not know her well. stated that he has shaken toI I I more often. never visited the candidate's resi ence, but does not believe there is anyone else besides the candidate andI Iliving on the premises. has never seen anything strange or unusual going on at the candidate's residence or an thin that would cause him to become suspicious or uneasy. was advised of the appropriate provisions of the Privacy Act and verbally waived his right to confidentiality. A neighbo ho identified herself asI 136 an her door at I b7c and advised that she has seen the candidate come and go all the time for work, but has never spoken to her. stated that she has spoken tol I I I more often. Iwas unsure about how long the candidate has resided at I but thinks it has been since the candidate and have moved in. has never visited the candidate's residence, but [dffE:EfE:Effieve there is anyone else besides the candidate and living on the premises. Ihas never seen anything strange or unusual going on at the candidate's residence or anything that would cause her to become suspicious or uneasy. I. a 2 was advised of the appropriate provisions of the Privacy Act and verbally waived her right to confidentiality. A neighbor who identified himself asl Iwas standing in front of his residence at both the candidate and stated that he has shaken to 'he land advised that he has been friendlv With moved in. more of1 how long the candidate has resided at :en. I believes it has been a; least a couple of years since candidate and moved in to the neighborhood. never visited the candidate's residence, but does not believe there is anyone else besides the candidate and has never seen anything strange or unusual or anything that would was advised of on the premises. going on at the candidate's residence cause him to become suspicious or uneasy. Iwas unsure about I but has living the appropriate provisions of the Privacy Act and verbally waived his right to confidentiality. b6 b7C b6 i a . l6lB-HQ?l6l9023 ALT:alt IH NEIGHBORHOOD VERIFICATION 280 St. James Place Brooklyn, New York 11238 October l992?November 2005 The following investi ation was conducted by Special Agent and SAI Ion June 11, b6 2009, with regard to JAC UELINE ANN BERRIEN (hereinafter b7C referred to as the "candidate"): On June 11, 2009 SAI Iarrived at b5 I which was a non? b7c doorman, four story walk~up. It appeared that the residence was a multiple family home. A neighbor who identified herself asI Iof b6 I Iadvised that she lived b7C next door to the candidate in 2004.] Iremembered the candidate vaguely, but had never spo en to erI Iwas unsure how long the candidate resided atl I but believed the candidate and moved out of the neighborhood a few years ago. I ?has never visited the candidate's residence, but did state there are other residents living at 280 St. James Place currently. advised of the appropriate provisions of the Privacy Act and verbally waived her right to confidentiality. A neighbor who identified himself standing in front of his residence at 280 St. James Place, Apartment Brooklyn, New York and advised that he did not live in the bu1 1ng when the candidate resided there. advised tha of the owners to 280 St James Place are I Iphone numberI I A current resident of 280 St. James Place, Apartment . Iadvised that she has been living in the apartment for only be months, but her room-mate would know the candidate. b7c Neighborhood canvas cards with identifying information were left for the two other residents in the apartment building that may have known the candidate. ., I. I lSlB-HQ-l6l9023 ALT:alt RESIDENCE VERIFICATION 280 St. James Place Brooklyn, New York 11238 October l992-November 2005 The following investigation was conducted by Special Agent (SAN Ion June 12, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): I Idate of birth unknown, home address I I telephone number I I was interviewed telephonically on June 12, 2009. I Iwas advised of the nature of the interview and the identity of the interviewing agent. provided the following information: - that she f'rst met the candidate in 1982 (estimated when the candidate and were in law school the candidate lost contact for a period of time, but were re-acquainted when the candidate moved iTEf :Ef neighborhood at 280 St James Place, Brooklyn, New York. res1 ence. lives within close proximity to the candidate's former her relationship with the candidate as a persona riendship as neighbors and stated that she and the candidate also have a networking/social relationship. maintains somewhat frequent contact with the candidate, speaking with her approximately once per month. never visited the inside of the candidate's former that when she visited the candidate at 280 St. James Place, they would always talk outside. has never visited the candidate "t her current residence at I Istated that the only other individual living at the apartment wasl did however state that there were other apartments in the building. stated the candidate is honest, trustworthy, dependable, reliable, and described the b7C candidate as hard working and committed to both the community and to justice. never been given any reason to question the candidate's aracter or that of any of the candidate's associates. stated that the candidate has an excellent reputation and has never had any reason to question her reputation either personally or professionally. never had any reason to question the candidate?s loyalty to the United States Government. stated that she has never had any reason to believe t.e cancidate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. She further stated that she has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for her own intended profit or that of another. advised that she has no reason to believe that the candi ate arbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. is unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. is unaware of any activity or conduct in the candidate's background that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. believes the candidate is financially responsible and living Within her financial means. advised that she is unaware of anything that is pertinent to candidate's suitability for access to classified material that she was not asked about. would recommend the candidate for a position of trust and confidence with the United States Government. b6 b'7C b6 b?7C b6 b7C b6 b?7C b6 b7C b6 b?7C b6 b7C b6 b7C b6 b?7C b6 b?7C i l? I 1 Ito was advised of the appropriate previsicns-of the Privacy Act and verbally waived her right to confidentiality. I I, ALT:alt RENTAL RECORD VERIFICATION 280 St. James Place Brooklyn, New York 11238 October 1992-November 2005 'nvestigation was conducted by Special Agent (SA) June 12, 2009, with regard to JACQUELINE ANN BERRI (hereinafter referred to as the "candidate"): I Idate of birth unknown, home address not provided, home phone number. was interviewed telephonically on June 12, 2009. as advised of the nature of the interview and the identity of the interviewing agent. provided the following information: not personall know the candidate very well, but verified that the candidate I rented an apartment a Klyn, New York, 11238 for many years, are the the apartment. advised that she could not recall the exact dates, but believed the candidate moved into the apartment around 1992 or 1993 and stayed until a few years ago. that the candidate was always on time with er rent payments and was always "polite and lady? like". never observed anything strange or unusual gOing on at the residence of the candidate and nothing ever caused her to become suspicious or uneasy. did not think there was anything that could or should disqualify the candidate from obtaining a position of trust and confidence with the United States Government. advised of the appropriate provisions of the Privacy Act and verbally waived her right to confidentialityb7C I I, lGlB-HQ-l5l9023 ALT:alt IH NEIGHBORHOOD VERIFICATION 280 St. James Place Brooklyn, New York 11238 October 1992?November 2005 I The followin investigation was conducted by Special Agent (SA) IJune 16, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): nt at 280 St. James Place, Brooklyn, New Yor 11238. called in response to the contact information provided on the nei hborhood ca: sly left at her residence by SAI IAND SA on June 11, 2009. number 280 St. James Place for approximatelyl years. I stated that she and the candidate both lived in the ui ing for a year (estimated). not have any continuing contact with the candidate, but sometimes ran into her o? Iwhen they lived at the apartment. visited inside the candidate's residence. saw anything strange or unusual going on at the residence and nothing caused her to become suspicious or uneasy. that the candidate and her husband were very nice people. advised that there is nothing at all about the candidate that she believes could or should disqualify her from obtaining a position of trust and confidence with the United States Government, and/or from being given access to classified material and/or sensitive information. was advised of the appropriate provisions of the Privacy Act and verbally waived her right to confidentialityb7C . 1? .l OFFICIAL PERSONNEL FOLDER NAACP LEGAL DEFENSE AND EDUCATION FUND 99 Hudson Street, Suite 1600 New York, New York 10013 September 2004 to Present September 1994 to November 2001 was conducted by Special Agent on June 15, 2009 regarding JACQUELINE b6 ANN BERRIEN (herein referred to as "the candidate"): IHuman Resources, NATIONAL ASSOCIATION b6 FOR THE ADVANCEMENT OF COLORED PEOPLE (NAACP) LEGAL DEFENSE AND b7C FUND, date of birthl Work telephone I?work address 99 Hudson Street, Suite 1600, New Yor New York, 10013 provided the candidate's personnel folder after being advised of the identity of the interviewing agent. The personnel folder contained the following: The candidate's name as it appeared on the folder was JACQUELINE BERRIEN. The candidate's position in September 1994? November 2001 was ASSISTANT COUNSEL. The candidate's position from September 2004?present is ASSOCIATE DIRECTOR, COUNSEL FOR LEGAL DEFENSE FUND. The personnel folder did not in any records of awards received or special recognition. advised that it b6 was not normal for employees to receive awards. b7C The personnel folder did not contain any disciplinary actions or performance evaluations. The candidate's beginning salary at time of hire was $51,750 in 1994. In 2001 the candidate's beginning salary at time of re?hire was $215,000. There were no records of an increase in salary contained in the personnel folder. The personnel folder contained a copy of the candidate's resume at the time of hire. The information in the resume was consistent with what the candidate reported on her 86. . advised that, based on her knowledge of the b6 candidate's present performance, she would continue to be b7c eligible for re-hire. A ALTzalt NAACP Legal Defense and Educational Fund (LDF) 99 Hudson Street, Suite 1600 New York, New York 10013 September 2004-Present September 1994?November 2001 Th 11 ring investigation was conducted by Special Agentl on June 11, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): date of birth not provided, work address 99 Huds York, New York, 10013, and work telephone number Iwas interviewed telephonically on June 11, 2009. After being advised of the ide?titf ff the interviewing agent and the nature of the interview, provided the following information: isl Ifor NAACP Legal Defense Fund (LDF). stated that he first met the candidate in the early 1990's Zestimated) when the candidate was a Staff Attorney for the Lawyer's Committee for Civil Rights Under Law in Washington, District of Columbia. his relationship with the candidate as overwhelmingly professional in nature, with l' ocial interaction, but does consider her a friend. maintains regular contact with the candidate, speaking with her every day due to their current positions at LDF. - never visited the candidate at her residence. that the candidate's current title is te Director Counsel for LDF and has been since 2001. lfurther advised that the candidate left LDF in 1994 to wor or THE FORD FOUNDATION and then returned to LDF in 2001. in March of 2008. advised that the candidate's primary responsibility and duties at LDF are general supervision and management of the LDF office, fund?raising, and public?speaking. that the candidate is dependable and reliable in her attendance at work. b6 STE: 136 b7C b6 b7C b6 2370 b6 b7C b6 b7C b6 HR: 136 I370 b6 2370 136 b7C that the candidate is amenable to supervision, instruction, and correction, but further noted that the candidate does not require supervision. : advised that the candidate is able to work under pressure, handle stress, and meet deadlines. believes the candidate to be mature and emotionally stable. described the candidate as a person who "brings obvious depth of experience that allows her to easily show leadership in areas they (LDF) exceed in, for example social? justice". that a specific contribution the candidate has made to the organization would be her resourcefulness. that the candidate has strong oral and written communication skills. not generally observe the candidate's presentations, but trusts that she is strong in that area of her work.? that the candidate works well with others. the candidate has never been the subject of any disciplinary or adverse action or of any complaints. stated the candidate is ethical, honest, dependable, trustworthy, discreet, and reliable. has never been given any reason to question the candidate?s character or that of any of the candidate's associates. stated that the candidate has a strong reputation and has never had any reason to question her reputation either personally or professionally. I 'has never had any reason to question the candidate oyaity to the United States Government. stated that he has never had any reason to believe the candidate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. He further stated that he has no reason to believe the candidate b7C lb?) has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for his own intended profit or that of another. advised that he has no reason to believe that the candidate harbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. is unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. is unaware of any activity or conduct in the candidate's background that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. . believes the candidate is financially responsible and living within her financial means as far as he is aware of. advised that he is unaware of anything that is pertinent to the candidate's suitability for access to classified material that he was not asked about. recommend the candidate for a position of trust and con i ence with the United States Government. was advised of the appropriate provisions of the Privacy Act and verbally waived his right to confidentialityb7C I-I I ?5 a ALTzalt SUPERVISOR NAACP Legal Defense and Educational Fund 99 Hudson Street, Suite 1600 New York, New York 10013 September 2004-Present September 1994?November 2001 The following investigation was conducted by Special Agent! lon June 12, 2009, with regard to JACQUELINE b6 ANN ereinafter referred to as the "candidate"): b7C I I date of birth not Drovided. rk b5 addressl . b7C Icellular tele hone numberl lanc work telephone number was interviewed telephonically on June 12, 2009. After being advised of the identity of the interviewing agent and the nature of the the following information: currentlv al I be I Iwas b7C formerlv thel I Istated that he first met the candidate approximately 20 years ago before she worked for LDF. his relationship with the candidate as b5 professional in nature, but does consider her a friend? b7C maintains regular contact with the candidate, speaking with her every few weeks. I Ihas visited the candidate at her current residence b5 I Iadvised that the candidate?s title be I has Associate Director Counsel for LDF and has b7c been Since 2001 to the advised that the candidate left LDF in 1994 to work for the Ford Foundation and then returned in 2001. in the summer of 2004?2008. 1 that the candidate's primary b6 responsibility and duties at LDF were running the LDF office, b7C fund-raising, speeches, testimony, and to oversee litigation. 3 A l6lB?HQ?l6l9023 Istated that the candidate was dependable and reliable in her attendance at work. advised that the candidate was amenable to supervision, instruction, and correction, but further noted that the candidate does not require supervision. that the candidate was able to work under pressure, handle stress, and meet deadlines. believes the candidate to be mature and emotionally stable. the candidate as a person who commands the respect of staff, and is also well respected in the civil rights community through her work with LDF and on her own. that a specific contribution the candidate has made to the organization would be her resourcefulness. that the candidate has strong oral and written communication skills. that the candidate works well with others. the candidate has never been the subject of any disciplinary or adverse action or of any complaints. the candidate is ethical, ?fi:f: dependable, trustworthy, discreet, and reliable. further described the candidate as a calm, grounded, and so 1 person in every way. never been given any reason to question the candidate's character or that of any of the candidate's associates. stated that the candidate has a strong reputation and has never had any reason to question her reputation either personally or professionally. never had any reason to question the candidate's loyalty to the United States Government. that he has never had any reason to believe the candidate has abused alcohol or prescription drugs or that the candidate-has illegally used any controlled substance. He further stated that he has no reason to believe the candidate has b6 b?b?7C b6 b7C b6 b7C b6 b'7C b6 b7C b6 b?7C b6 b7C Ibo ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for his own intended profit or that of another. advised that he has no reason to believe that the candidate harbors any biases or prejudices,_either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. is unaware of any activity or conduct in the candidate's background that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. believes the candidate is financially responsible and living within her financial means as far as he is aware of. that he is unaware of anything that is 'pertinent to the candidate's suitability for access to classified material that he was not asked about. would recommend the candidate for a position of trust and confidence with the United States Government. advised of the appropriate provisions of the Privacy Act and verbally waived his right to confidentialityb7C ALTzalt CO-WORKER NAACP Legal Defense and Educational Fund 99 Hudson Street, Suite 1600 New York, New York 10013 September 2004?Present September 1994?November 2001 The following investigation was conducted by Special Agentl Ion June 17, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): I I date of birth not provided, work address 99 Hudson Str?sti_5uits_i?n91 New York, New York, 10013 work telephone number was interviewed telephonically on June 17, 2009. After being advised of the identity of the interviewing agent and the nature of the the following information: I Iis currentlv thel I Istated that he first met the candidaEf in 1224 when they worked on litigation together for a case. worked for a different law firm at the time, but the candidate was working for LDF. his relationship with the candidate as rofessional in nature, but does consider her a friend. regular contact with the candidate, speaking Wit er several times per week. has not visited the candidate at her residence. advised that the candidate is able to work under pressure, handle stress, and meet deadlines. believes the candidate to be mature and emotionally stable. described the candidate's leadership abilities as strong, he stated that she is a knowledgeable civil rights advocate, who has a thoughtful and calm voice in the community. that the candidate has made many contributions to the organization first as a litigator and now administrativelyb7C t? A that the candidate has strong oral and written communication skills. that the candidate works well with others. Etated the candidate has never been the subject of any disciplinary or adverse action or of any complaints. the candidate is honest, dependable, trustworthy, discreet, and reliable. has never been given any reason to question the candidate's character or that of any of the candidate?s associates. that the candidate has a strong reputation and has never had any reason to question her reputation either personally or professionally. has never had any reason to question the candidate's loyalty to the United States Government. tated that he has never had any reason to believe the candidate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. He further stated that he has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for his own intended profit or that of another. that he has no reason to believe that the candidate harbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. is unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. unaware of any activity or conduct in the candidate's ac ground that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyaltyb7C ?e (A Ibo believes the candidate is financially responsibue and living within her financial means as far as he is aware of. . advised that he is unaware of anything that is pertinent to the candidate's suitability for access to classified material that he was not asked about. would recommend the candidate for a position of trust and confidence with the United States Government. advised of the appropriate provisions of the Privacy Act an verbally waived his right to confidentiality. b6 b7C b6 b7C 136 I370 b6 b7C a ALT:alt NAACP Legal Defense and Educational Fund 99 Hudson Street, Suite 1600 New York, New York 10013 September 2004-Present September 1994?November 2001 The folloving investigation was conducted by Special Agent on June 17, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): I Idate of birth not provided, work address NAACP Legal Defense Fund (LDF) 1444 I Street NW, Suite 1000, of Columbia, 20005, home telephone number was interviewed telephonically on June 17, 2009. After being advised of the identitT of the interviewing agent and the nature of the interview, provided the following information: - currently in retirement froml I that she first met 7 idate Icandidate began working ?or LDF.I 's the I ldescribed her relationship with the candidate as professional and personal in regular contact with the candidate. has not visited the candidate at her residence. that the candidate is able to work under pressure, handle stress, and meet deadlines. believes the candidate to be mature and emotionally sta le. escribed the candidate as a people person, which makes her a strong leader. She further described the candidate as encouraging of others and an empathetic and superb leader. stated that the candidate made an important contribution to the organization around 1994?2001 with regards to her involvement in the Voting Rights Act. that the candidate has strong oral and written communication skillsb7C that the candidate works well with others. stated the Candidate has never been the subject of any disciplinary or adverse action or of any complaints. stated the candidate is honest, dependable, trustworthy, discreet, and reliable. has never been given any reason to question the candidate character or that of any of the candidate's associates. stated that the candidate has a strong reputation and has never had any reason to question her reputation either personally or professionally. has never had any reason to question the candidate's loyalty to the United States Government. I stated that she has never had any reason to believe the candidate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. She further stated that she has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for her own intended profit or that of another. advised that she has no reason to believe that the candidate harbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. is unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. is unaware of any activity or conduct in the candidate's background that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. believes the candidate is financially responsible and living within her financial means as far as she is aware of.b7C bsb7C . 0' I lElB-HQ-l6l9023 w advised that she is unaware of anything that is pertinent to the candidate's suitability for access to classified material that she was not asked about. recommend the candidate for a position of trust and confidence with the United States Government. was advised of the appropriate provisions of the Privacy Act and verbally waived her right to confidentiality. b6 b6 b7C b6 b7C JJD:jjd 1 OFFICIAL PERSONNEL FOLDER THE FORD FOUNDATION 320 East 43rd Street New York, New York 10017 November 2001 to August 2004 The following 'nvestigation was conducted by Special Agent on June 15, 2009 regarding JACQUELINE b5 ANN BERRIEN (herein referred to as "the candidate"): b7C IHuman Resources, TH ION, b6 date of birthl Iwork telephone work address 320 East 43rd Street, New York, New York 10013, provided the candidate's personnel folder after being advised of the identity of the interviewing agent. The personnel folder contained the following: The candidate's name as it appeared on the folder was JACQUELINE A. BERRIEN. The candidate's position was PROGRAM OFFICER, GOVERNMENT AND CIVIL SOCIETY. The personnel folder did not any records of awards received or special recognition. Iadvised that it b6 awar s. was not normal for employees to receive b7C The personnel folder did not contain any disciplinary actions. The candidate received two performance appraisals. The first appraisal was dated June 11, 2003 and the candidate received an overall "outstanding" appraisal. The second appraisal was dated June 11, 2002 and the candidate received an overall "excellent" rating. The candidate's beginning salary at time of hire Was $118,000. The candidate received several increases in salary, ultimately receiving an annual salary of $123,000 at termination of employment. The personnel folder contained a copy of the candidate's resume at the time of hire. The information in the resume was consistent with what the candidate reported on her 86. advised that the candidate was eligible for re? b6 hire and terminated her employment after receiving an offer for a b7C three year extension. . I- ALT:alt THE FORD FOUNDATION 320 East 43rd Street New York, New York 10017 November 2001?Auqust 2004 The following investigation was conducted by Special Agentl Ion June 12, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): I I date of birth not provided, work addressl I Iwork telephone numberl Iwas interviewed telephonically on June 12, 2009. After being advised of the identity of the interviewing agent and the nature of the interview, Iprovided the following information: I I Iis currentlv theI lat THE FORD FOUNDATION. I stated that he first met the candidate in approximately 2001. his relationship with the candidate as professional in nature, but does consider her a friend. maintains infrequent contact with the candidate, speaking Wit her approximately once per year. has never visited the candidate at her residence. advised that the candidate's title at THE FORD FOUNDATION was Program Officer. that the candidate would be eligible for re-hire. I Iin approximately 2001. bould not remember the exact date. that the candidate's primary responsibility and duties at THE FORD FOUNDATION was that of a Program Officer, who would find Opportunities to create grants, establish a strategy for an issue (for example electoral reform), then she would analyze the proposal and either reject or write a recommendation for a grant. She was also responsible for following up with the organization to ensure that they were meeting the requirements of their grant'b7C b6 b7C lSlB-HQ?l6l9023 I Iadvised that the candidate was dependable and reliable in her attendance at work. that the candidate is amenable to supervision, instruction, and correction. [;;:;;Jadvised that the candidate is able to work under pressure, an stress, and meet deadlines. Ibelieves the candidate to be mature and emotionally stable. the candidate as a person who is very strong, but serene and competent. stated that the candidate conveyed authority and expertise and generally attracted people to want to work for her. He believed these qualities add to her leadership abilities. that a specific contribution the candidate made to the organization would be her crafting of unique strategies concerning her program issues as well as her dedication to create a diverse work staff at THE FORD FOUNDATION. that the candidate had strong oral and written communication skills. advised that the candidate worked well with others. stated the candidate had never been the subject of any disciplinary or adverse action or of any complaints. stated the candidate was ethical, honest, and dependable. further described the candidate as a person with remarkab integrity. never been given any reason to question the candidate's aracter or that of any of the candidate's associates. stated that the candidate has a strong reputation and has never had any reason to question her reputation either personally or professionally. never had any reason to question the candidate's oyalty to the United States Governmentb'b7C . .5 r- Ibo that he has never had any reason to believe the candidate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. He further stated that he has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, . trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for his own intended profit or that of another. advised that he has no reason to believe that the candidate harbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. is unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. unaware of any activity or conduct in the candidate's ac ground that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. lbelieves the candidate is financially responsible and living within her financial means as far as he is aware of. that he is unaware of anything that is pertinent to the candidate's suitability for access to classified material that he was not asked about. recommend the candidate for a position of trust and confidence with the United States Government. advised of the appropriate provisions of the Privacy Act and verbally waived his right to confidentiality. b6 b7C b6 b7C 136 I370 136 b7C b6 b7C b6 b7C b6 I370 136 b7C I II- ALTzalt THE FORD FOUNDATION 320 East 43rd Street New York, New York 10017 November 2001?Auqust 2004 ring investigation was conducted by Special Agent on June 12, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): I Idate of birth not provided, home addressl I work telephone numberl Iwas interviewed telephonically on June 12, 2009. After being advised of the identity of th in erviewing agent and the nature of the the following information: I Iis currently al at the Istated that he first met the candidate when she was hired in 2001. described his relationship with the candidate in nature, but does consider her a friend. maintains regular contact with the candidate, speaking with her approximately once every three months. never visited the candidate at her residence. . advised that the candidate's title at the FORD FOUNDATION was Program Officer. advised that the candidate was able to work under pressure and handle stress, however did not believe the candidate was as strong in meeting deadlines. said that the candidate did miss some basic administrative deadlines. believed the candidate to be mature and emotionally stable. the candidate as a person who has very strong leadership skills and is well respected throughout the communityb7C - 5 l6lB-HQ?l6l9023 2 stated that a specific contribution the b6 candidate made to the organization would be her development of an b7C framework for reformation of the voting system. stated that the candidate was directly responsible for crafting a unique program for electoral reform and handled her responsibilities very well at THE FORD FOUNDATION. that the candidate had strong oral and b6 written communication skills. b7C that the candidate worked well with b6 others. b7c the candidate had never been the subject he of any disciplinary or adverse action or of any complaints. b7c stated the candidate is ethical, honest, and b6 dependable. further described the candidate as a person b7C who is extremely committed, but not ideologically rigid to her work in civil rights. He also described her as very passionate and extremely energetic person with a positive attitude. never been given any reason to question the b5 candidate's character or that of any of the candidate?s b7c associates. stated that the candidate has a strong b6 reputation and has never had any reason to question her b7c reputation either personally or professionally. has never had any reason to question the b5 candidate's loyalty to the United States Government. b7C stated that he has never had any reason to b5 believe the candidate has abused alcohol or prescription drugs or b7c that the candidate has illegally used any controlled substance. He further stated that he has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for his own intended profit or that of another. advised that he has no reason to believe that b6 the candidate harbors any biases or prejudices, either for or b7C against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. Mi i 9 ?k lSlB-HQ?l6l9023 [w unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. I Iis unaware of any activity or conduct in the candidate ac ground that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. the candidate is financially responsible and living within her financial means as far as he is aware of. advised that he is unaware of anything that is pertinent to the candidate's suitability for access to classified material that he was not asked about. recommend the candidate for a position of trust and confidence with the United States Government. was advised of the appropriate provisions of the Privacy Act and verbally waived his right to confidentiality. b6 b7C b6 b'7C b6 b7C b6 b?7C b6 b7C b6 b7C t9 l6lB?HQ-l6l9023 ALT:alt THE FORD FOUNDATION 320 East 43rd Street New York, New York 10017 November 2001?Auqust 2004 The following investigation was conducted by Special Agent on June 15, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): I Idate of birth not provided, work address,I I work telephone number I I home phone numberl was interviewed telephonically on June 15, 2009. After being advised of the id the interviewing agent and the nature of the interview,E:Eiff:jprovided the following information: I lie ?11'r'r?2ntly al I stated that he first met the candidate when she was hired in 2001. his relationship with the candidate a professional in nature, but does consider her a friend. no longer maintains contact with the candidate. He has not spoken to her in approxi a year, but stated that he still considers her a friend. also advised that he and his wife have had dinner with the candidate and in the past. never visited the candidate at her residence. that the candidate is able to work under pressure, an stress, and meet deadlines. believes the candidate to be mature and emotionally stable. described the candidate as a person who is a very solid leader, who was very knowledgeable about her programs. HARRIS also described the candidate as a leader with a very personable style. stated that a specific contribution the candidate has made to the organization would be her intellectual depth and breadth of experience in bridging the gap between society and the Peace and Justice Programs at THE FORD FOUNDATION. stated that the candidate was directly b7C .u responsible for crafting a unique welcoming program for international colleagues of THE FORD FOUNDATION who visited the United.States. stated that the candidate had excellent oral and written communication skills. that the candidate worked well with others. the candidate had never been the subject of any disc1p inary or adverse action or of any complaints. stated the candidate is highly ethical, honest, dependable, reliable and trustworthy. HARRIS further described the candidate as a person who has a high professional standard. never been given any reason to question the candidate?s aracter or that of any of the candidate's associates. stated that the candidate has a strong reputation and has never had any reason to question her reputation either personally or professionally. never had any reason to question the candidate's loyalty to the United States Government. stated that he has never had any reason to believe the candidate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. He further stated that he has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for his own intended profit or that of another. that he has no reason to believe that the candi ate arbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. is unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. 136 1370 136 b7C b6 b7C b6 b7C b6 b7C 136 1370 b6 b7C b6 b7C 136 1370 136 b7C Hr l6lB?HQ-l6l9023 loo is unaware of any activity or conduct in the candidate's background that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. I: believes the candidate is financially responsible and living within her financial means as far as he is aware of. that he is unaware of anything that is pertinent to candidate's suitability for access to classified material that he was not asked about. would recommend the candidate for a position of trust and confidence with the United States Government. advised of the appropriate provisions of the Privacy Act an verbally waived his right to confidentiality. 136 I370 b6 b7C b6 2370 b6 b7C b7C .i . !at the New York Law School, work telephone numberl a lGlB-HQ-l6l9023 ALT:alt IH EMPLOYMENT: OFFICIAL PERSONNEL FILE NEW YORK LAW SCHOOL 57 Worth Street New York, New York 10013 JulV 1995?June 2000 The following investigation was conducted by Special Agentl Ion June 11, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): 'was interviewed telephonically on June 11, 2009. After being work addressl I advised of the ide of the interviewing agent and the nature of the interview, provided the following information: stated that the Human Resources department of the New York Law School does not keep personnel records for employees beyond five years, furthermore she stated that the school was using a new digital system that was not in effect when the candidate worked at the school. verified that both the old filing system and the new digital personnel system was checked for information on the candidate. advised that the candidate was listed as an Adjunct Pro essor in previous years, but had no other information regarding the candidate. As of June 18, 2009, SA was unable to locate any individuals that worked at the New York Law School at the same time as the candidate. was also unable to provide any information due to the lack of human resource records maintained at the schoolb7C 4 l6lB-HQ?l619023 ALTzalt EMPLOYMENT VERIFICATION New York Law School 57 Worth Street New York, New York, 10013 JulV 1995?June 2000 The followin investigation was conducted by Special Agent on June 18, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): I I date of birth unknown, work address New York Law School, Street, New York, New York, 10013, home telephone numberI I and work telephone number I was interviewed telephonically on June 18, 2009. . was advised of the nature of ?he interview and the identity of the interviewing agent. provided the following information: that she first met the candidate around 1991 (estimated), but got the chance to know her in 1999 when further advised that she and the candidate did not work together at the New York Law School, however she can verify that when theyl was aware that the candidate was an adjunct professor at the New York Law School. described her relationship with the candidate as a personal friendship as well as frequent contact with the candidate, speaking er regularly. never Visited the candidate at her residence. stated the candidate is honest, trustworthy, discreet, and re- iable. never been given any reason to question the candidate's character or that of any of the candidate's associates. stated that she has never had any reason to question her reputation either personally or professionallyb7C A: 2 :has never had any reason to question the candidate's loyalty to the United States Government. stated that she has never had any reason to believe the candidate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. She further stated that she has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for her own intended profit or that of another. that she has no reason to believe that the candidate harbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. is unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. is unaware of any activity or conduct in the candidate 5 background that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. believes the candidate is financially responsible and living within her financial means. advised that she is unaware of anything that is pertinent to the candidate's suitability for access to classified material that he was not asked about. recommend the candidate for a position of trust and con 1 ence with the United States Government. was advised of the appropriate provisions of the Privacy Act and verbally waived her right to confidentialityb7C I ALT:alt LISTED REFERENCE INTERVIEW - The following investigation was conducted by Special Agent on June 11, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): I I Fla-Fa n'F kiwi-1n 11h?lrhnu'r'n addresd I work telephone numberl Iwas interviewed telephonically on June 11, 2009.I Iwas advised of the nature of the interview and the identity of the interviewing agent. provided the following information: Iadvised that he first met the candidate in 1994 (estimated) whenl I Iin New York. his relationship with the candidate as a personal friendship as well as professional. maintains fre uent contact with the candidate, speaking with her regularly. that he and his wife get together for planned events with the candidate and lmaybe twice per year, but he sees her more regularly because ey work in the same building. never visited the candidate at her residence. . believes the candidate travels to foreign for work purposes, but is unsure where or when. thought the candidate may have traveled p0 South Africa or Brazil for work with the Legal Defense Fund. is unaware of any foreign contacts the candidate may have. I Istated the candidate is honest, trustworthy, and very reliableJ Ifurther described the candidate as a "thoroughly impressive and admirable person". never been given any reason to question the candi a aracter or that of any of the candidate's associatesb7C a 2 that the candidate has an excellent reputation and has never had any reason to question her reputation either personally or professionally. as never had any reason to question the candidate's loyalty to the United States Government. stated that he has never had any reason to believe the candidate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. He further stated that he has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for her own intended profit or that of another. Iadvised that he has no reason to believe that the candidate harbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. . is unaware of any activity or conduct on the part of tne candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. is unaware of any activity or conduct in the candidate's background that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. the candidate is financially reSponsible and living within her financial means. advised that he is unaware of anything that is pertinent to the candidate's suitability for access to classified material that he was not asked about. recommend the candidate for a position of trust and confidence with the United States Government. advised of the appropriate provisions of the Privacy an verbally waived his right to confidentialityb7C 136 1370 b7C a ALTzalt DEVELOPED REFERENCE Ehe_fnlloming_1nvestigation was conducted by Special Agent (SA) on June 17, 2009, with regard to JACQUELINE ANN BERRIEN (hereinafter referred to as the "candidate"): I I date of birth unknown, work address I iwork telephone numberl Iwas interviewed telephonically on June 17, 2009. was advised of the nature erview and the identity of the interviewing agent. rovided the following information: advised that she first met the candidate in the early 1990's (estimated) when the candidate began described her relationship 1' andidate as professional, but considers her a friend . maintains frequent contact with the candidate, speaking with her every day. has never visited the candidate at her residence. stated the candidate is honest, trustworthy, discreet, dependable and very reliable. described the candidate as a great leader, who is excellent-at handling critical information and organizing it in the most professional way possible. stated that specific contributions the candidate has made to LDF is the organization of sensitive materials, the administrative structure of meetings and paperwork, and constantly having to deal with problems from the forty or so board members on LDF. never been given any reason to question the candidate's character or that of any of the candidate's associates. b6 b?b?7C b6 b?7C b6 b?7C b6 b?7C b6 b7C 2 stated that the candidate has an excellent reputation and has never had any reason to question her reputation either personally or professionally. I Ihas never had any reason to question the candidate to the United States Government. . stated that she has never had any reason to believe the candidate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. She further stated that she has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, reCeiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for her own intended profit or that of another. advised that she has no reason to believe that the candi ate harbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. is unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. is unaware of any activity or conduct in the candidate's background that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. believes the candidate is financially responsible and living within her financial means. that she is unaware of anything that is pertinent to the candidate's suitability for access to classified material that he was not asked about. recommend the candidate for a position of trust and confidence with the United States Government. advised of the appropriate provisions of the Privacy Act and verbally waived her right to confidentialityb7C ui lGlB-HQ-l6l9023 ALTzalt . DEVELOPED REFERENCE The following investigation was conducted by Special Agent on June 17, 2009, with regard to b6 JACQUELINE ANN BERRIEN (hereinafter referred to as the b7c "candidate"): I I?r-H-p of hi ri'h unknown. b6 I work 1?73 telephone numberl Iwas interviewed telephonically on June 17, 2009. was advised of the nature of the interview and the identity of the interviewing the following information: I Iadvised that he first met the candidate in 1992 b6 (estimated) whenl litigating a voting b7C rights case in Mississippi. The candidate was working for the Lawyers Committee for Civil Rights Under Law andl I I further advised that he and the candidatel described his relationship with the candidate as a be personal friendship as well as b7c frequent contact with the candidate, speaking with her regularly. never visited the candidate at her residence. be He has however dropped her off at her residence. b7C stated the candidate is honest, trustworthy, and be very relia further described the candidate as a person b7C with terrific character and sense of justice. He believes the candidate to have the most integrity of anyone he has worked with in the realm of social justice. has never been given any reason to question the b6 candidate's character or that of any of the candidate's b7c associates. I istated that the candidate has an excellent b6 reputation and has never had any reason to question her b7c reputation either personally or professionally. 4+ I .2. never had any reason to question the candidate's loyalty to the United States Government. stated that he has never had any reason to believe the candi ate has abused alcohol or prescription drugs or that the candidate has illegally used any controlled substance. He further stated that he has no reason to believe the candidate has ever been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving or sale of any narcotics, depressant, stimulant, hallucinogen or cannabis, for her own intended profit or that of another. dvised that he has no reason to believe that the candidate harbors any biases or prejudices, either for or against, any group or individual, based on age, sex, race, religion, color, national origin or handicap. is unaware of any activity or conduct on the part of the candidate that might be used to coerce or influence her in any way, or that might be used as a basis for blackmail or compromise. is unaware of any activity or conduct in the candidate's background that would impact negatively on her character, reputation, judgement, discretion, trustworthiness, responsibility or loyalty. believes the candidate is financially responsible and living within her financial means. dvised that he is unaware of anything that is pertinent to the candidate's suitability for access to classified material that he was not asked about. recommend the candidate for a position of trust and confidence with the United States Government. advised of the appropriate provisions of the Privacy Act and verbally waived his right to confidentiality. -b6 2370 136 b7C b7C I JTF:jtf New York City Police Department One Police Plaza New York, New York 10038 On June 16, 2009, Investigative Operations Analyst I Iconducted a search of the criminal records of b6 the New York City Police Department in regards to JACQUELINE ANN b7C BERRIEN, Date of Birth: November 28, 1961. This search met with negative results. .. KADzkad RE: JACQUELINE ANN BERRIEN NEW YORK STATE DEPARTMENT OF MOTOR VEHICLES RECORD CHECK On 6/10/09, 21 check of the New York State Department of Motor Vehicles was conducted for the candidate, JACQUELINE ANN BERRIEN. BERRIEN maintains a valid Class New York State driver?s license with Client ID 247837299, expiration date 11/28/2010. Restrictions: Corrective Lenses Bail Forfeitures: None 9' 161B-HQ-1619023 KADzkad RE: JACQUELINE ANN BERRIEN UNITED STATES ATTORNEYS OFFICE On 6/10/09, the records of the United States Attorneys Of?ce were searched regarding the candidate, JACQUELINE ANN BERRIEN. There were no records found in any of the four departments. (EDNY SDNY . KADzkad RE: JACQUELINE ANN BERRIEN NEW YORK STATE BAR ASSOCIATION . . . 6 On 6/10/2009, Personnel Security Spe01alist (PSS), :70 caused a search ofthe OFFICE OF COURT ADMINISTRATION (OCA), so CENTRE STREET, NEW YORK, NY. 10013 regarding the candidate, JACQUELINE ANN BERRIEN. BERRIEN was admitted to the New York State Bar, First Department on 9/28/87. BERRIEN is in good standing, current on registration dues with no public disciplinary actions or grievances noted. BERRIEN is due to re-register in November, 2009. w-mn. 'u MM . - . 77". 3?34 5 ?row?3 we .. . ?an. rmn.ww??e- .1 . ?is: Ill" PE- in fat 57 7-92-5628 NUMBER HAS BEEN ESTABLISHI JACQUELINE: A BERR IEN . mam: I mum-JP? 'vPWMLE 1 . ww-g?u awn-M gamma.? Contact any social security of?ce immediately if you: . a? lose your cardmto get a duplicate card. . change your name-?to get a card in your new name? are unable to work because of a severe disability 5' pected? to last a yea?r or more. are 62 or older-40 ask about retirement checks. are within 201' 3 months of age 65, even if you don?t pfan togetiremto sign up foi: Medicare. LES. Dep?rtment (3: Health, Education and Welfare Social Security Administration . .1. 1w ?nae: ?in '5?qu ?int-1 ilk-n11 ~l 5:223? "3513:?: .: .- 11 1.: k?mu My awn-MP? 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I 777/. :m?mnNJewif ZZ 9; xx $st m?/r/MW/W?y A, 94., A 4/ /x . .H x??f $3 $31? a gay\wva y/mM/W/zd, 37,? 4, ?kZNf?Wa :v 2 ..sv $399; $334., vb; 340/. I. f/?9/3 @wy f4 m7 AV, . zha1\4 .z . Za/ 5y? 1 ,va/W/u/m, xr?/H . a? ?uwmw w/ i i . Z. 7 \Ng/mwowwk/ h/ ,7 3 7: $9 2/44 13% 3,74?? ., Zr, \Nbx/ $33, . /z Maryann/Haw ,Am I 4 I fad/2,43. 1,3.75 z? 45.. . Ir 1 I 9, (J. i . .. *(Rev. 05-01-2008) . UNCLASSIFIED FEDERAL BUREAU OF INVESTIGATION Precedence: ROUTINE Date: 06/18/2009 Security Attn: PSS I be SIGBIU b? From: Phoenix b6 Contact: b7c Approved By: Drafted By: Case ID lGlB-HQ?l6l9023zrfg/ Title: JACQUELINE ANN BERRIEN LEVEL Synopsis: Results of background investigation. Details: On 06(1612009. a check of Phoenix electronic and manual indices bV HRA was negative regarding the b5 b7C UNCLASSIFIED: . UNCLASSIFIED To: Security From: Phoenix Re: l6lB-HQ-l6l9023, 06/18/2009 Set Lead 1: (Info) 09 SECURITY AT SIGBIU: DC For Information Only UNCLASSIFIED 2 . . (Rev. 05-01-2003) UNCLASSIFIED FEDERAL BUREAU OF INVESTIGATION Precedence: DEADLINE 06/25/2009 a Date: 06/22/2009 To: Phoenix From: Security Special Inquiry and General Background Investigations Unit (SIGBIU), Room 10861 Contact: PSSI I Approved By: '14 Drafted By: Case ID 16lB?HQ?l6l9023 (Pending) Title: JACQUELINE ANN BERRIEN LEVEL II PAS Synopsis: Request for investigative assistance. Details: By SIGBIU EC dated 06/10/2009, Serial 2, the Baltimore Field Office was requested to verify the current status of candidate's account with JP MORGAN however, Baltimore advised that this lead should be handled by the Phoenix Field Office. In light of the above, Phoenix is requested to conduct investigation as set forth in the Lead section of this communication. ?0 [9025 lib UNCLASSIFIED b6 UNCLASSIFIED To: Phoenix From: Security Re: l6lB?HQ?l619023, 06/22/2009 LEAD (S) Set Lead 1: (Action) PHOENIX AT PHOENIX, AZ Verify current status of candidate's account with JP MORGAN CHASE. Investigation should also include.the date the account was opened/closed; credit limit/high balance; if appropriate, the amount placed for collection; any correspondence or contact with the candidate regarding attempts to resolve the debt; and the agreement initiated to have the debt resolved. 9. UNCLASSIFIED 2 I e-Egli?: Investigation Request #5708674Compact Copy 4 Page 14 of 14 Date satis?ed Not Applicable Month/Year: I Amount of property value involved 1,547.43 Loan/account number 5260210080883100 Bankruptcy type: Name of agency/organization/individual to whom debt is/was owed JP Morgan Chase Name action/debris recorded under Jacqueline Berrien Status of action or debt A customer service representative for the card issuer stated that the account was closed in 2006. As of May 10, 2009 the account was current, with a total outstanding balance of 1,547.43. Name of company, court or agency handling case Chase Cards Address of company, court or agency handling case Street: P.O. Box 15298 City: Wilmington State: DE Country: Zip Code: 19850-5298 Section 27: Use of Information Technology Systems a. In the last'7 years, have you illegally or Without proper authorization entered into any information technology system? No b. In the last 7 yearsyhave you illegally or without authorization modi?ed, destroyed, manipulated, or denied others access to information a. residing on an information technology system? No c. In the last 7 years, have?you introduced, removed, or used hardware, software, or media in connection with any information technology system without authorization, when speci?cally prohibited by rules, procedures, guidelines, or regulations? No (N 0 Entry Provided) Section 28: Involvement in on-Criminal Court Actions In the last 7 years (if an SSBI go back 10 years), have you been a party to any public record civil court action(s) not listed elsewhere on this form? No (No Entry Previded) Section 29: Association Record a. Have you EVER been an of?cer or a member of, or made a contribution to, an organization dedicated to terrorism, and which engaged in illegal activities to that erid, either with an awareness of the organization's dedication to that end or with the speci?c intent to further such illegal activities? No b. Have you EVER been an of?cer or a member of, or made a contribution to, an organization dedicated to the use of violence or force to overthrow the U.S. Government, and which engaged in illegal activities to that end, either with an awareness of the organization's dedication to that end or with the speci?c intent to further such illegal activities? No c. Have you EVER?been an of?cer or a member of, or made a contribution to, an organization that unlawfully advocates or practices the commission of acts of force or violence to discourage others from exercising their rights under the U.S. Constitution or any state of the U.S. with the speci?c intent to further such unlawful activities? No d. Have you EVER advocated any acts of terrorism or activities designed to overthrow the U.S. Govemment by force with the speci?c intent to incite others to unlawful action in furtherance of such aims? No e. Have you EVER knowingly engaged in any activities designed to overthrow the U.S. Government by force? No f. Have you EVER knowingly engaged in any acts of terrorism? Neither your truthful" response nor information derived from your response to this question'will be used as evidence against you in any subsequent criminal proceeding. No g. Have you EVER participated in militias (not including of?cial state govemment militias) or paramilitary groups? No Explanation Additional Comments Additional Comments -l t, 4, Expected Attachments Expected Attachments (No Entry Provided) blips? 5/21/2009 WE iv (Rev. 05-01-2008) 0 UNCLASSIFIED FEDERAL BUREAU OF INVESTIGATION Precedence: DEADLINE 06/25/2009 Date: 06/22/2009 To: Kansas City From: Security Special Inquiry and General Background Investigations Unit (SIGBIU). Room 10861 Contact: P38 b6 1370 Approved By: A Warn/~3- Drafted By: :mrg Case ID (Pending) Title: JACQUELINE ANN BERRIEN LEVEL II PAS Synopsis: Request for investigative assistance. Details: By SIGBIU EC dated 06/10/2009, Serial 2, the Minneapolis Field Office was requested to verify the current status of candidate's three accounts with however, Minneapolis advised that this lead should be handled by the Kansas City Field Office. In light of the above, Kansas City is requested to conduct investigation as set forth in the Lead section of this communication. [(0113qu 1qu 002.3 L3 UNCLASSIFIED To: Kansas City From: Security Re: 06/22/2009 UNCLASSIFIED Set Lead 1: (Action) KANSAS CITY AT KANSAS CITY, MO Verify current status of candidate's three accounts with CITICARD. Investigation should also include the date the accounts were opened/closed; credit limit/high balance; i: appropriate, the amount placed for collection; any correspondence or contact with the candidate regarding attempts to resolve the debts; and the agreement initiated to have the debts resolved. Q0 UNCLASSIFIED 2 erQlP: investigation Request #5708674Compact Copy Page 13 of 14 m. Have you been over 180 days delinquent on any debt(s)? No n. Are you currently over 90 days delinquent on any debt(s)? No 0. Have you EVER experienced ?nancial problems due to gambling? No p. Are you currently delinquent on any Federal debt? No 1 Date satisfied Month/Year: 10/2004 (Estimated) Amount of property value involved 5250.00 (est.) Loan/account number 5424180553021640 Bankruptcy type: (7) Name of agency/organizedon/individual to whom debt is/was owed CitiCard Name action/debt is recorded under Jacqueline A. Berrien Status of action or debt Listed as "charge off" on credit report; I was advised by the card issuer in May, 2009 that the account history shows a "zero balance" as of October, 2004. I believe that the account was turned over to a? collection agency, but! do not recall the name of the collection agency. I have used information from an Equifax credit report dated 12/27/07 to estimate the outstanding balance on the account when it was closed. ?1 Jr?, Name of company, court or agency handling case CitiCard Address of company, court or agency handling case Street: P.O. Box 6077 City: Sioux Falls State: SD Country: Zip Code: 57117 Additional comments: i have been unable to obtain the name of the collection agency through CitiCard Customer Service. 2. Check corresponding question h) Had an account or credit card suspended, charged off, or cancelled for failing to pay as agreed? .. Date satis?ed Month/Year: 10/2004 (Estimated) Amount of property value involved 900.00 (est) Loan/account number 0013363107 Bankruptcy type: Name of agency/organization/individual to whom debt is/was owed Lord Taylor Name action/debt is recorded under Jacqueline A. Berrien Status of action or debt The account was closed by the card issuer, but i believe that the outstanding balance was paid in full. Name of company, court or agency handling case GEM BIL Address of company, court or agency handling case Street: P.O. Box 981400 City: El Paso State: TX Country: Zip Code: 79998 Additional comments: I called the customer service number for Lord Taylor charge customers and was informed that "no match was found" for this account number. The representative stated that GE Money Bank has assumed responsibility for Lord Taylor charge accounts, and may not have records concerning accounts closed more than two years ago. 3. Check corresponding question h) Had an account or credit card suspended, charged off, or cancelled for failing to pay as agreed? a. Date satisfied Month/Year: 01/1998 (Estimated) Amount of property value involved 3200.00 (est) Loan/account number 461657004069 Bankruptcy type: Name of agency/organization/individual to whom debt is/was owed CitiCard Name action/debt is recorded under Jacqueline A. Berrien Status of action or debt 'My credit report indicates that this account was "paid satisfactorily" but "closed by [the] .credit grantor." contacted CitiCard customer service for more information because I do not recall the circumstances surrounding the closing of this account. I was advised that the account number does not appear in theirirecords. i believe that I have paid this account in full and have estimated the date the account was closed and the amount at issue based upon an Equifax credit report dated 12/27/2007. Name of company, court or agency handling case CitiCard - Address of company, court or agency handling case Street: P.O. Box 6077 City: Sioux Falls State: SD Country: Zip Code: 57117-6077 4. Check corresponding question h) Had an account or credit card suspended, charged off: or cancelled for failing 1. Check corresponding question 9) Had bills or debts turned over to a collection agency? to pay as agreed? Date satis?ed Not Applicable Month/Year: I Amount ofproperty value involved 2,341.04 Loan/account number 5424180129887136 Bankruptcy type: Name of agency/organizedon/individual to whom debt is/was owed CitiCard Name action/debt is recorded under Jacqueline A. Berrien Status of action or debt A CitiCard customer service representative stated that the account was closed in 2003. As of May 10, 2009 the total outstanding balance on the account was $2,341.04 and payments were current Name of company, court or agency handling case CitiCards Address of company, court or agency handling case Street: PO. Box 6077 City: Sioux Falls State: SD Country: Zip Code: 57117-6077 5. Check corresponding question h) Had an account or credit card suspended, charged off, or cancelled for failing to pay as agreed? 5/21/2009 b7E Fb-263 (Rev. 9-8-97) . . REPORTING OFFICE OFFICE OF ORIGIN DATE INVESTIGATIVE PERIOD NEWARK ADMIN SERVICES 06/19/2009 06/19/2009 TITLE OF CASE REPORT MADE BY TYPED BY JACQUELINE ANN BERRIEN . LEVEL II PAS SA CHARACTER OF CASE PAS II ADMINISTRATIVE: Reference telcal to PSSI regarding the inability of investigator to locate referenced lead facility. The lead to verify the Candidate?s account at Mahwah, New Jersey was not completed. SPECIAL AGENT RITE IN SPACES BELOW APPROVED 1N CHARGE DO NOT AA COPIES MADE: 2 Administrative Services SIGBIU, Room l086l PSS 1? W023) DISSEMINATION RECORD OF ATTACHED REPORT Notations Agency - 1' Request Reed. Date Fwd. How Fwd. By A COVER PAGE b6 b7C b6 b7C 1:36 1370 4% FD-204 (Rev. 12-1-95) Copy to: Report of: Date: Case ID Title: Character: Synopsis: UNITED STATES DEPARTMENT OF JUSTICE Federal Bureau of Investigation SAI O?ma 06/19/2009 l6lB~HQ~l6l9023 JACQUELINE ANN BERRIAN LEVEL II - PAS LEVEL II - PAS Newark Unable to verify creditor from information provided. This lead is considered covered. DETAILS: This document contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and. is loaned to your agency; it and its contents are not to be distributed outside your agency. b6 b7C ?11. 611 The lead to verify the account status for the Candidate was not completed due to a lack of information. As referenced in the ec detailing the candidate's account status with TD ELLSABETH, no credit information was provided to conduct appropriate interview. A search of the internet and telephone directory proved negative for TD ELLSABETH. w? 1' . FD-263 (Rev. 9-8-97) FEDERAL BUREAU OF INVESTIGATION cu REPORTING OFFICE OFFICE OF ORIGIN DATE INVESTIGATIVE PERIOD CLEVELAND BUREAU 06/23/2009 06/23/09 TITLE OF CASE REPORT MADE BY TYPED BY JACQUELINE ANN BERRI EN . LEVEL I I PAS SA CHARACTER OF CASE SI BACKGROUND INVESTIGATION BUDED: 06/18/09 REFERENCE Directors communication to Cleveland, dated 06/10/09. ENCLOSURES: Enclosed for IGBIU FBIH are two copies of an insert of the interview of Oberlin College. ADMINISTRATIVE All persons interviewed were furnished the appropriate provisions of the Privacy Act. SPECIAL AGENT DO NOT WRITE IN SPACES BELOW APPROVED IN CHARGE c0 IES MADE: - Bureau Attn: PSS (SIGBIU, Room 10861) 1- CLEVELAND (l6lB? 1619023) 2w? 5? WW DISSEMINATION RECORD OF ATTACHED REPORT Notations Agency Request Recd. Date Fwd. How Fwd. By A COVER PAGE 136 b7C b6 b7C b6 b7C I FD-204 (Rev. 12-1-95) Copy to: Report of: I)ate: Case ID Title: Character: Synopsis: . 1? UNITED STATES DEPARTMENT OF JUSTICE Federal Bureau of Investigation SA I if Of?ce: 06/23/2009 l6lB?HQ-l619023 JACQUELINE ANN BERRIEN LEVEL II - PAS BACKGROUND INVE I GAT I ON PAS -P- Cleveland On June 23, 2009, candidate's affiliation with Oberlin Colle was verified through listed verifier, Oberlin College. DETAILS: Cleveland investigation is complete. This document contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and is loaned to your agency; it and its contents are not to be distributed outside your agency. b6 b7C b6 b7C The followin investigation was conducted by Special Agentl I On 6/23/09, Oberlin College, office telephone cell telephone telephonically contacted SAI Iat the Elyria Resident Agency to be interviewed regarding the background investigation of JACQUELINE ANN BERRIEN. After being advised of the identity of the interviewing agent and the purpose of the interview, Iprovided the following information: I I Ifirst met BERRIEN in August 2007. Ihad and BERRIEN was an Oberlin College Trustee and Board member. his relationship with BERRIEN as collegial and professional. The majority of time that he spent with her was in a board or group setting. not socialize with BERRIEN, although he has attended one or two events related to the school where BERRIEN was also present. that he and BERRIEN know a lot of the same people in the legal community and he has only heard positive comments about BERRIEN and that she is very highly regarded in the legal community. has never seen BERRIEN drink alcohol to excess. never heard of a situation where BERRIEN drank to excess, was drunk, or had her judgement or demeanor impaired by his use of alcohol. no knowledge of BERRIEN ever using, possessing, manufacturing, distributing, selling or having any other involvement with illegal drugs. never known BERRIEN to use or abuse prescription medication. that to the best of his knowledge, BERRIEN lives within her financial means. that BERRIEN has never exhibited any bias or preju ice against any individual or group because of their race, sex, religion, sexual orientation, age, or any other reasonb7C lSlB?HQ-l6l9023 Ito no reason, nor is he aware of anyone else having reason, to question BERRI icter, associates, reputation or loyalty to the U.S. is not aware of any information about BERRIEN that could subject her to coercion, compromise, or duress, that could possibly have an adverse effect on BERRIEN in any way. that BERRIEN certainly possesses the capacity and competence to perform well, and highly recommends BERRIEN for a position with the U.S. Government involving trust and confidence. At the conclusion of the that he was not aware of anyone who could or would provide anything but a positive recommendation for BERRIEN. b6 b7C b6 b7C b6 b7C U.S. Department of Justice Federal Bureau of Investigation Washington, D. C. 20535-0001 WM 2 5 2009 BY COURIER b6 b7C Counsel to the President The White House Washington, D.C. Dear Based on a request from your office dated May 12, 2009, received in our office on June 8, 2009, a Level II background investigation has been conducted concerning Ms. Jacqueline Ann Berrien. Enclosed is a summary memorandum containing the results of this investigation. Also enclosed is a copy of your May 12, 2009, request, initialed and dated by a representative of my Unit. This completes our investigation. Should you have an ues ion they may be directed to me at telephone number b6 b7C Sincerely yours, b6 b7c Chief Special Inquiry and General Background Investigations Unit Security Division Enclosures (2) IQIB- ?a b6 b7C Re: Jacqueline Ann Berrien NOTE: This case was opened 06/10/2009. Ms. Berrien is currently employed by the National Association for the Advancement of Colored People Legal Defense and Education Fund, New York, New York, as an associate director. She is being investigated for a Presidential appointment with the Equal Employment Opportunity Commission, which requires Senate confirmation. Some FBI manual field office indices were not searched as they are being automated and are unavailable. Therefore, there may be FBI files identifiable with Ms. Berrien and/or her close relatives that were not reviewed during the background investigation. During her interview, Ms. Berrien advised that between 1979 and 1980 she smoked marijuana on approximately ten occasions. Sent to the White House was a copy of the following: Ms. Berrien's interview which is incorporated in the summary memorandum. PCD: 06/22/2009 CLOSED Non FBI delay 05 - credit leads (determined not needed) U.S. Department of Justice Federal Bureau of Investigation Washington, D. C. 20535-0001 HUN 2 ?5 2009 JACQUELINE ANN BERRIEN This summary memorandum contains the results of a Level II background investigation concerning Ms. Berrien, which, unless otherwise indicated, addressed the past fifteen years of her life. Inquiries were conducted in the United States as to Ms. Berrien's character, loyalty, and general standing, but no inquiries were made as to the sources of her income. Birth Ms. Berrien was born on November 28, 1961, in Washington, D.C. Education Ms. Berrien received a Juris Doctor degree in June, 1986, from Harvard Law School, Cambridge, Massachusetts. Military Ms. Berrien has indicated no prior military service. Employment June, 1994, to Continued to be employed August, 1994 by the Lawyers' Committee for Civil Rights Under Law, Washington, D.C., as a staff attorney September, 1994, to National Association for November, 2001; and the Advancement of Colored September, 2004, to . People (NAACP) Legal Defense the present and Education Fund, initially as an assistant counsel, and subsequently as Associate Director, Counsel for Legal Defense Fund This document contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and is loaned to your agency; it and its contents are not to be distributed outside your agency. She has indicated tha Jacqueline Ann Berrien July, 1995, to New York Law School, New York, June, 2000 New York, as an adjunct professor of law November, 2001, to The Ford Foundation, New York, August, 2004 New York, as Program Officer, Government and Civil Society In addition to the above, Ms. Berrien is also a trustee for Oberlin College, Oberlin, Ohio; and an advisory board member of the Philanthropic Initiative on Racial Equity, Washington, D.C. Familv Status Ms. Berrienl;1 Ms. Berrien's mother, Anna Smith Clifford Berrien, are deceased. In addition to Ms. Berrien has listedl I Interviews Twenty?one persons, consisting of current and former supervisors and coworkers, present and former neighbors, references, professional associates, and social acquaintances, were interviewed. They provided favorable comments concerning Ms. Berrien's character, associates, reputation, and loyalty. All persons interviewed during the course of this background investigation stated they are unaware of any illegal drug use or alcohol or prescription drug abuse by Ms. Berrien, nor have they ever known her to exhibit any type of bias or prejudice against any class of citizen or any type of religious, racial or ethnic group. They also commented that they believe Ms. Berrien lives within her financial means. None of the individuals contacted was aware of information concerning Ms. Berrien that could be used to compromise or coerce her. All persons interviewed recommended her for a position of trust and responsibility. Among those interviewed are the following: 136 b7C b6 b7C Jacqueline Ann Berrien Two additional individuals were contacted and stated that they did not know Ms. Berrien very well, but were unaware of anything that could disqualify her from obtaining a position of trust and confidence with the United States government. Financial Responsibility A search of computerized credit records, which was conducted at FBI Headquarters in June, 2009, disclosed no pertinent information concerning Ms. Berrien, except as noted below. The results of an additional inquiry concerning this debt are set forth below: Ms. Berrien's credit history disclosed one charged off account in August, 2005, with TD RCS/Ellsabeth, Mahwah, New Jersey. Based on the information provided, attempts to verify this account proved negative. Additionally, Ms. Berrien's computerized credit record disclosed an additional address associated with her name that was not included on her Standard Form 86 (Refer below to Ms. Berrien's interview to obtain her comments regarding this address.) Law Enforcement Agency Checks Information has been received from appropriate law enforcement agencies indicating their files contain no pertinent information concerning Ms. Berrien. b6 Jacqueline Ann Berrien Professional Affiliation Ms. Berrien is eligible to practibe law in the State of New York. According to information available, no grievances have been filed against her. Miscellaneous A check of the records of ChoicePoint, a public source information database, conducted at FBI Headquarters, disclosed no pertinent information concerning Ms. Berrien. A check of the records of LEXIS, a computerized public records retrieval service concerning criminal and civil litigation, conducted at FBI Headquarters, revealed no pertinent information concerning Ms. Berrien. A check of the records of NEXIS, a computerized news retrieval service, conducted at FBI Headquarters, revealed no pertinent information concerning Ms. Berrien. During her routine interview conducted by the FBI on June 16, 2009, Ms. Berrien advised, as indicated on her of several accounts that were delinquent or sent to collections. Since these accounts are indicated as paid or not appearing on her credit history, no additional investigation is being conducted concerning these accounts. The results of her interview are incorporated in this summary memorandum and follow below in their entirety. Agency Checks Records of the Lobbyist Registration, United States House of Representatives and United States Senate, Washington, D.C., disclosed that Ms. Berrien registered as a lobbyist in 2005 on behalf of the NAACP Legal Defense and Education Fund, Incorporated, and is currently inactive. The Office of Public Records did not disclose any grievances or complaints filed against Ms. Berrien or the NAACP Legal Defense and Education Fund. During the course of this background investigation, the records of the following entities were checked and found to contain either no record or no pertinent information concerning Ms. Berrien, unless otherwise noted in this summary memorandum: Jacqueline Ann Berrien b7E Defense Clearance and Investigations Index; Office of Personnel Management; Public Integrity Section and appropriate United States Attorneys, Department of Justice; Office of Public Records, United States Senate; Legislative Resource Center, United States House of Representatives; United States Secret Service; and the White House Office. Searches of the various indices of the FBI, including but not limited to the central index maintained at FBI Headquarters, the index of the Criminal Justice Information Services Division (Ms. Berrien by fingerprints and other known identifying data and her close relatives by name and other known identifying data only), the indices of appropriate field offices and other appropriate computer data bases did not identify any documents that contain pertinent information identifiable with Ms. Berrien and her relatives. It should be noted that results of the above indices searches reveal only data entered into those indices as of the date each was searched. However, it should also be noted that some delays may occur as to the entry of such data. Some manual field office indices searches could not be conducted during the background investigation as the FBI is in the process of automating its manual indices records established through October, 1985, and those records are currently unavailable. As a result, there may be FBI files identifiable with Ms. Berrien and/or her close relatives that were not reviewed. - FD-3 02 (Rev. 10-6-95) -1- FEDERAL BUREAU OF INVESTIGATION Date of transcription Special Agents on June 16, 2009 regarding the candidate JACQUELINE ANN BERRIEN: JA birth November 28, 1961, home address home telephone number IAssociate Director?Counsel, National Association of the Advancement of Colored People (NAACP), Legal Defense Fund (LDF) work address 99 Hudson Street, Suite 1600, New York, New York 10013, work telephone number (212) 965-2277, work cellular telephone number (212)300?7416, was interviewed at the Federal Bureau of Investigation New York Office at 290 Broadway, New York, New York. BERRIEN (hereinafter referred to as "the candidate") was advised of the identities of the interviewing agents and the nature of the interview. The candidate was advised that the WHITE HOUSE has requested the FEDERAL BUREAU OF INVESTIGATION (FBI) to conduct a background investigation (BI) of the candidate in connection with the position for which the candidate is being considered. The candidate was advised that the purpose of the interview was to ensure that the FBI has all information necessary to conduct the BI and that the information, as requested during the interview and/or as reflected on her Questionnaire for National Security Positions executed May, 18, 2009, was complete, current and accurate. The candidate was advised that the results of the BI would be furnished to the WHITE HOUSE, and that her failure to provide the information requested could hinder the FBI's investigative efforts and cause delay in forwarding to the WHITE HOUSE a completed BI for its use in the decision~making process regarding the position for which she is being considered. The candidate was advised that the answers provided during this interview are to cover her entire adult life, that is, since her 18th birthday. The candidate was shoWn a copy of her SF-86, as signed by the candidate, dated May 18, 2009. Each of the candidate's answers to the questions therein were reviewed with the candidate. The candidate advised that, to the best of her knowledge and Investigation on 06/16/2009 at New York, New York File# l6lB?HQ-l619023 Date dictated 06/16/2009 SAI alt by SAI I (.7 This document contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and is loaned to your agency; it and its contents are not to be distributed outside your agency. b6 b7C b6 STE: 136 b7C (Rev. 10-6-95) 3 l6lB?HQ-l6l9023 Continuation ofFD-302 of JACQUELINE ANN BERRI Page 2 recollection, all information provided on her and accompanying supplement is accurate and correct. The candidate provided the following information: The candidate provided the namel I be telephone numberl Ias a co?worker at the candi ate?s b7c current employment, NAACP LDF. The candidate also provided I work telephone number iand personal telephone number I as a possible contacts for her time as an Adjunct Professor at the NEW YORK LAW SCHOOL from July of 1995 through June of 2000. The candidate advised that the NEW YORK LAW SCHOOL did not have a supervisory program for Adjunct Professors and can not recall any other names of former colleagues because it was a position in which there was little oversight and most of the work was completed individually with self supervision. candidate providedl Icurrently at the :Sc telephone numberl Ias an additionai erence as a person that knows her well. The candidate provided the following addresses of residences she has lived in since her 18th birthday, not previously disclosed on her *1987?1992 265 St. James Place, Brooklyn, New York, 11238 *1986?1987 Ski Lodge 3 Apartment Complex, Apartment number 2301, Birmingham, Alabama *1985?1986 94 Beacon Street, Somerville, Massachusetts *1984?1985 70 Park Street Somerville, Massachusetts *1983?1984 WYETH HALL Dorm at Harvard Law School, Cambridge, Massachusetts *1982?1983 On campus at OBERLIN COLLEGE *1979?1982 SOUTH HALL at OBERLIN COLLEGE The candidate advised that the additional address of 626 Geranium Street NW, Washington, District of Columbia, 20012, which ?7 (Rev. 10-6-95) CmmeWW?mamof JACQUELINE ANN BERRIEN ,0n06gl612009 ,ch 3 was reflected on her credit report, was the home she grew up in with her family from the age of five to seventeen. The candidate advised that she has not had any personal or business financial problems including, but not limited to, repossessions, delinquent child support and/or alimony payments, or liens placed against her. The candidate did advise, however that a 1:36 1370 The candidate advised that she believes there was a period of time where she was delinquent on her student loans due to financial difficulty, but has since paid all of her student loans in full and can not find any records of delinquency. In regards to debts placed for collection, the candidate recognizes the past incidents listed on her to include a CITI CARD account that was turned over to a collection agency as well as a LORD TAYLOR store credit account, two CITI CARD charge accounts, and a JP MORGAN CHASE charge account that have been delinquent in previous years. According to the candidate each of the accounts now are either paid in full and closed or current and up to date with payments. The candidate advised that she did not have any unpaid tax obligations and that she was current on all Federal, State and local tax obligations. She advised that she has filed for extensions regarding the submission of her taxes in the past, but has not had any problems with meeting an extension deadline. The candidate advised that she has never had to pay back taxes. The candidate advised that to the best of her knowledge, no civil law suits have been filed against her. The.candidate advised that she has not been involved in any criminal matters as a subject or suspect, or been arrested, charged, and/or convicted of any crime. As described in her the candidate did testify as a character witness b6 b7C FD-3 02a (Rev. Continuation ofFD-302 of JACQUELINE ANN BERRIEN msan (I 16lB?HQ?l6l9023 .011 0611612009 ,Page 4 The candidate advised that attorney requested her to testify on his behalf. The candidate advised that she has never been denied employment, fired, suspended, left under unfavorable circumstances or through mutual agreement with an employer, been denied a security clearance, or had a security clearance revoked or suspended. The candidate advised that as of 2005 she was registered as a lobbyist for NAACP LDF because she was involved in legislative activity, which comprised approximately 15?20% of her work load prior to 2005 when she worked on the Re?authorization of the Voting Rights Act. This issue is the only issue that she has participated in legislative activity for. There is no record of legislative activity after 2005 for the candidate, but the NAACP LDF legislative report continues to list her as a lobbyist. The candidate is currently working with the organization to fix the reporting problem. The candidate advised that she has had foreign travel for both business and personal reasons. The candidate advised that all travel since 1994 has been accurately disclosed on her based on what was evident in her passport and records with her current employer NAACP LDF and her former employer, the FORD FOUNDATION. The candidate advised that during all foreign travel, the candidate was never contacted by representatives of a foreign country, was never approached by a foreign intelligence office, nor does she ever remember anything strange or unusual happening. The candidate does not have any continuing contacts with any individuals from foreign travel. The candidate has traveled to the following foreign countries: Location Dates of Event Event Sponsor Purpose of Event Aruba 01/2005 National Bar Speaker for NBA Association (NBA) Bahamas 03/2004 None Tourism b6 b7C (Rev. 10-6-95) 9 Continuation of FD-302 of JACQUELINE ANN BERRIEN ,On 06/16/2009 ,Page 5 Brazil 03/2003 The Ford Peer Exchange Foundation Meeting Canada 04/2004 The Ford Annual Meeting Foundation 05/2001 The African Invited Speaker Canadian Legal Clinic Chile 03/2003 The Ford Foundation's Foundation Governance and Civil Society program officers Colombia 05/1995 Partido Liberal Invited Speaker Colombiano from NAACP LDF India 10/2002 The Ford Peer Exchange Foundation Meeting Nigeria 04/2007 National International Democratic Observer Institue Delelgation Training and Post Election Meeting and Press Conference Senegal 08/2006 None Changed planes en route to South Africa South Africa 08/2006 No event Tourism 08/2001 The United World Nations Conference against Racism 08/1999 Black Lawyers Training Association of Program South Africa IQ (Rev. 10-6-95) 0! 16lB-HQ-l6l9023 JACQUELINE ANN BERRIEN ,On06116/2009 ,My 6 Vietnam 10/2003 The Ford Meeting for Foundation worldwide grant making officials. Indonesia 10/2003 The Ford Peer Exchange Foundation Meeting 02/2002 The Ford Worldwide Foundation Foundation Human Rights program ?officers meeting The candidate advised that she has never had any foreign financial businesses, foreign bank accounts, or other foreign finanCial interests of which she had direct control or direct ownership; has never had any foreign financial interests that someone controls on her behalf; has never owned real estate in a foreign country; nor has she ever received any educational, medical, retirement, social welfare, or other such benefits from a foreign country. The candidate advised that she did not travel very much prior to 1994 and received her first passport in 1995. The candidate did however travel to Mexico and Canada prior to 1994 for tourism. In January of 1989 the candidate visited Acapulco, Mexico with her husband for approximately 7 days. Sometime in 1987 or 1988 the candidate recalled a day trip from San Diego to Tijuana, Mexico. The candidate also recalled a short trip sometime between 1987-1992 to Montreal for a Jazz Festival. The candidate advised that her current employment with the NAACP LDF could give the appearance of a conflict of interest because of the nature of her cases with NAACP LDF. She further advised that she is no longer a front line attorney for NAACP LDF cases and has not been since 2001. The candidate is now mainly involved with administrative and management duties within the organization. However, the candidate explained that her name appears in the Federal and Appellate Courts due to her title at the NAACP LDF as the Associate Director?Counsel. The candidate advised that she does not currently have a day to day responsibility for any cases. ll (Rev. 10-6-95) JACQUELINE ANN BERRIEN ,On0611612009 7 l6lB-HQ-l6l9023 The candidate advised that she is currently involved with two other organizations that were accurately listed in her The candidate is a Trustee for OBERLIN COLLEGE, which is a private higher educational institution. She has been in this position since 2007, she has not been compensated in this position, but has been reimbursed for travel expensis. The contact information for the aforementioned organization i with telephone number The candidate also advised that she has been an Advisory Board Member for Philanthropic Initiative on Racial Equity, which is a non?profit organization, since 2005. She has never been compensated by this organization except for travel reimbursement. The contact information for the Philanthropic Initiative on Racial Eauitv isl I lwith telephone numberl I The candidate advised that she and the NAACP LDF were currently working on a list of major cases that will be provided by the candidate at a later date. The candidate advised that all of her professional licenses were accurately disclosed on her The candidate was admitted into the New York State Bar Association in September of 1987. Her license number for the Bar is 2153245. The candidate advised that her membership is due to expire in November of 2009. The candidate advised that she has not been the subject of any professional complaints or non?judicial disciplinary actions. The candidate advised that in 1991 and 2001 she worked as a campaign volunteer for lthe New York City council. The campaign The candidate advised that Iboth elections. The records can be found at the New York State Board of Elections. The candidate advised that she has not received any counseling in the last 15 years from or other qualified mental health professionals or physicians for a mental health related problem. b6 b7C b6 b'7C (Rev. 10-6-95) l6lB-HQ-16l9023 JACQUELINE ANN BERRIEN ,0n06gl612009 8 The candidate advised that she has never abused alcohol and has never received counseling/rehabilitation for drug/alcohol abuse. The candidate advised that when she was in her freshman and sophomore year in approximately 1979 and 1980 at OBERLIN college she smoked marijuana approximately 10 times. The candidate advised that other than the aforementioned incidents she has never illegally used any controlled substances or illegally used prescription drugs. The candidate advised that she has never been involved in the illegal purchase, possession, manufacture, trafficking, production, transfer, shipping, receiving, or sale of any controlled substances. The candidate advised that she has never illegally used a controlled substance while employed as a prosecutor or courtroom official; while possessing a security clearance; or while in a position directly and immediately affecting the public safety. The candidate advised that she has never been involved or associated with any organization which advocates the use of force to overthrow the U.S. Government or had any involvement in the commission of sabotage, espionage, or assistance of others in terrorism. The candidate advised that she did not include an organization that she is associated with on her because she was not aware that it should be included. The candidate currently belongs to the Delta Sigma Theta Sorority as an alumnus of Oberlin College and has been a member since April of 2006. The Brooklyn Chapter contact for the sorority isI The candidate b6 advised that by definition the club/organization of a sorority precludes males from being members, but she does not feel this club is discriminatory in nature. Other than the above mentioned club the candidate advised that she is currently not a member of any organization whose policies have restricted membership on the basis of age, sex, race, color, religion or national origin, including private and social organizations. The candidate advised there is no activity or conduct in her life, past or present, that could be used to influence, pressure, coerce or compromise her in any way, or that could have an adverse impact on her character, judgement, stability, discretion, trustworthiness or responsibility. L3 (Rev. 9-8-97) . FEDERAL BUREAU OF INVESTIGATION REPORTING OFFICE OFFICE OF ORIGIN DATE INVESTIGATIVE PERIOD Phoenix Bureau 06/29/2009 06/29/2009 - 06/29/2009 TITLE OF CASE REPORT MADE BY TYPED BY JACQUELINE ANN BERRIEN b6 IOA b7C ER OF CASE LEVEL I I - PRES IDENTIAL APPOINTMENT SENATE CONFIRMATION BUDED 06/25/2009 REFERENCE Bureau EC to Phoenix, et al, 06/22/2009. - PENDING (All PX investigation completed) - ADMINISTRATIVE All persons interviewed were furnished the appropriate provisions of the Privacy Act. Express promises of confidentiality have not been granted. 3. . SPECIAL AGENT DO NOT WRITE IN SPACES BELOW APPROVED IN CHARGE - 5a [My PIES MADE: 2 - Bureau b6 (Attn: PSS b7c 1 - Phoenix (l61B?HQ?l6l9023 DISSEMINATION RECORD OF ATTACHED REPORT Notations Agency Request Recd. Date Fwd. How Fwd. By A COVER PAGE FD-204 (Rev. 12-1-95) ., . UNITED STATES DEPARTMENT OF JUSTICE Federal Bureau of Investigation Copy to: Report of: IOA Of?ce: Phoenix b6 Date: Jun- .49, .4003 b7C l6lB-HQ-l5l9023 Title: JACQUELINE ANN BERRIEN Character: LEVEL II PRESIDENTIAL APPOINTMENT, SENATE CONFIRMATION Synopsis; Verify account with JP Morgan Chase. DETAILS This document contains neither recommendations nor conclusions of the FBI. It is the property of the FBI and is loaned to your agency; it and its contents are not to be distributed outside your agency. -HQ?l6l9023 CLR/clr Chase Bank 150 West University Drive Tempe, Arizona 85281 The following investigation was conducted bv Investigative Operations Analyst (IOA) at Phoenix, Arizona: On June 23, 2009, a request for review of credit records regarding the candidate, Jacqueline Berrien, was forwarded via facsimile to Chase Bank at (480) 902?7493. On June 26, 2009, a telephonic request was made to Chase Bank for review of records regarding the candidate Jacqueline Berrien. On June 29, 2009, Chase disclosed the following information: Jacqueline Berrien has a Chase account that was opened on April 1, 1985, and was issued account number 5260 2100 8088 3100. The last payment of $150.00 was made on June 19, 2009. The outstanding balance is $1,548.17. This account is active and in good standing. b6 b7C