CIA STARGATE release
CIA-RDP96-00788R000500030001-4
Opens with: For use of this form, see AR 380-5; the proponent agency is the Office,
Warning: text for all documents has not been verified. Errors are possible. Check the original by document ID on CREST.
1 page, machine transcribed from the CIA’s released scan.
APARSIFIED DOCUMENTS&CAOMONDTAAIDTY RECORDP96-00788FD00500030001-4 For use of this form, see AR 380-5; the proponent agency is the Office, Assistant Chief of Staff for Intelligence. A 9 APR 82 SECTION A - GENERAL TO: HQ, INSCOM ATTN: IAOPS-H-S FT MIADE, MD 20755 FROM: SRD ITAL RM BSE32, FANX I FT MEADE, MD 20755 DATE RECEIVED ACTION OFFICE(S) SUSPENSE DATE(S) REGISTER OR CONTROL NO. CONTROL, LOG OR FILE NO. CLASSIFI- CATION NUMBER OF COPIES DESCRIPTION ( Type. File Ref .. Unclassified Subject or Short Title and Number of Indorsements/Incis) DATE OF DOCUMENT ORIGINATOR S/ NOICON 3 EVAL DE0-56, DE2-59 AND DEC-4 NOTHING FOLLOWS 9 APRIL SADIITAL SECTION B - ROUTING I ACKNOWLEDGE RECEIPT OF THE MATERIAL DESCRIBED HEREON TO COPY NO. DATE PRINTED NAME SIGNATURE 1. 2. 3. 4. 5. SECTION C - DESTRUCTION CERTIFICATE (Check appropriate block) PAGE OR COPY NO MATERIAL DESCRIBED HEREON HAS BEEN: DESTROYED TORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER (AR 380-5) OFFICE SYMBOL DATE PRINTED NAME OF CUSTODIAN OR REP SIGNATURE DESTRUCTION RECORD NO. DATE PRINTED NAME OF CERTIFYING/DESTR. OFF. SIGNATURE PAGE OR COPY NUMBER DATE PRINTED NAME OF WITNESSING OFFICIAL SIGNATURE SECTION D - REPRODUCTION AUTHORITY NUMBER OF COPIES TO BE REPRODUCED AUTHORIZED BY DATE SECTION E - RECEIPT/TRACER ACTION (Check appropriate block) RECEIPT OF DOCUMENT(S) ACKNOWLEDGED TRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED. DOCUMENT(S) HAVE NOT BEEN RECEIVED DATE 19 APR PRINTED NAME, GRADE OR TITLE JACHIM SIGNATURE COMMENTS Approved For Release 2000/08/07 : CIA-RDP96-00788R000500030001-4 . DA FORM 3964, 1 Jul 79 EDITION OF 1 NOV 72 IS OBSOLETE. #U.S. G.P.O. 1979-297-093