Document DD3ZozyxByQ6g4x4O445g4GEO

The W hite House Presidential Personnel Office S K C /S E S BIO S H E E T NOTICE: Return this form to the Presidential Personnel Office as soon as complete. This information is necessary to begin the clearance process. Return to White House Liaison when completed. PART I: PERSONAL INFORMATION (TO BE COMPLETED BY THE CANDIDATE) 1. FULL NAME (Last, First, Middle): 2. SOCIAL SECURITY NUMBER: 3. CURRENT RESIDENTIAL ADDRESS (Number, Street, City, State, ZIP Code) 4. VOTING ADDRESS IN 2016 (Number, Street, City, State, ZIP Code, if different than current address) 5. PLACE OF BIRTH (City, State; if not U.S., state, country) 6. GENDER 7. DATE OF BIRTH 8. ETHNIC HERITAGE 9. RACE 10. POLITICAL PARTY 11. HOME PHONE 12. CELL PHONE 13. WORK PHONE 14. PERSONAL EMAIL 15. WORK EMAIL 16. CURRENT POSITION (Title, Company) 17. WORK ADDRESS (Number, Street, City, State, Zip) 18. PLEASE LIST ALL SOCIAL MEDIA ACCOUNTS (Or say none if you have none) 19. EDUCATION (Degree, Institution, Year) 20. AWARDS 21. MILITARY SERVICE (Rank, Branch, Years) 22. PREVIOUS PRESIDENTIAL APPOINTMENTS PART II: POSITION INFORMATION (TO BE COMPLETED BY WHITE HOUSE LIAISON) 1. POSITION TITLE 2. AGENCY 2. APPOINTMENT TYPE 3. GRADE 4. OPM NUMBER 5. WH LIAISON NAME 6. WH LIAISON PHONE 7. WH LIAISON EMAIL INTERNAL WHITE HOUSE DOCUMENT, NOT FOR RELEASE WITHOUT PRIOR WHITE HOUSE APPROVAL Sierra Club v. EPA 18cv3472 NDCA Tier 10 ED 002061 00144405-00001