Document yk8odwobzXyXbBYaLDY9zYN9r
O FFICE OF THE PRESIDENT Presidential Personnel O ffice
A P P O IN TE E IN FO R M A TIO N S H E E T
NOTICE: Return to the Office of Presidential Appointments as soon as complete. This information is necessary
to begin the clearance process. Return via email to incomingPPOdocs@i Ex. 6 lor contact the office for
alternate submission methods.
PART I: TO BE COMPLETED BY POTENTIAL APPOINTEE
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)
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. SPOUSE
19. CHILDREN
20. NAME AND HOME STATE (For official announcement and nomination)
21. EDUCATION (Degree, Institution, Year)
22. AWARDS
23. MILITARY SERVICE (Rank, Branch, Years)
24. PREVIOUS PRESIDENTIAL APPOINTMENTS
1. POSITION
PART II: TO BE COMPLETED BY PRESIDENTIAL PERSONNEL
2. TYPE
3. VICE
4. TERM
5. POTUS APPROVAL
6. SECURITY PACKAGE SENT
7. COUNSEL START
INTERNAL WHITE HOUSE DOCUMENT, NOT FOR RELEASE WITHOUT PRIOR WHITE HOUSE APPROVAL
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