CIA-RDP96-00788R001600110004-0

Approvest RorRode
FAYCOUNTABILITY
RECORD
CIA RDP96-00788R001600110004-0
For use of this for , see AR 380-3; the proponent agency is the Office, Assistant Chief of Staff fev Intelligence.
SECTION A - GENERAL
TO:
FROM:
DATE RECEIVED
ACTION OFFICEIS)
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/Incls)
DATE OF
DOCUMENT
ORIGINATOR
CL-003-82
9/NOFORN 1
Cy 1 of 2, Report C1-973/8210/01 W/1
EXHIBIT
. NOTHING FOLLOWS.
SECTION B - ROUTING
TACKNOWLEDGE RECEIPT OF THE MATERIAL DESCRIBED HEREON
TO
COPY NO.
DATE
PRINTED NAME
SIGNATURE
2.
A.
5.
SECTION C - DESTRUCTION CERTIFICATE
( Check appropriate block)
MATERIAL DESCRIBED HEREON HAS BEEN:
PAGE OR COPY NO
DESTROYED
TORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER (AR 380-5)
OFFICE SYMBOL
DATE
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SIGNATURE
DESTRUCTION RECORD NO.
DATE
PRINTED NAME OF CERTIFYING/DESTR. OFF.
SIGNATURE
PAGE OR COPY NUMBER
DATE
PRINTED NAME OF WITNESSING OFFICIAL
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SECTION D - REPRODUCTION AUTHORNY
NUMBER OF COPIES TO BE REPRODUCED
AUTHORIZED BY
DATE
PICEIPT OF DOCUMENTIS) ACKNOWLEDGED
DOCUMENTIS) HAVE NOT BEEN RECEIVED
TRACK & ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED.
DATE
PRINTED NAME. GRADE OR TITLE
SIGNATURE
COMMEI'TS
DA FORM 3964, 1 Jul 79
EDITION OF 1 NOV 72 IS OBSOLETE.
*U.S.GPO:1980-0-310-059
Approved For Release 2000/08/08 : CIA-RDP96-00788R001600110004-0
SECTION E - RECEIST/TRACER ACTION (Check appropriate black)
TVTE
21 DEC 82
-