CIA-RDP96-00788R001600140003-8

R U.S. GOVERNMENT PRINTING OFFICE 1974 -- 558 057
CLASSIFIED DO
Approved For Release 2006/08/68 SAX RDP96100988R601600140003-8
For use of this form, see AR 380-5; the proponent agency is the Office, Assistant Chief of Staff for Intelligence.
DATE
2 Mar 83
SECTION A - GENERAL
TO:
FROM:
......
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/ incts)
DATE OF
DOCUMENT
ORIGINATOR
CL-013-83
S/NOFORN
1
Cy 1 of 1 cy Report 993/8210/01.
NOTHING FOLLOWS
SECTION B - ROUTING
TO
COPY NO.
DATE
PRINTED NAME
SIGNATURE
5.
SECTION C . DESTRUCTION CERTIFICATE (Check appropriate block)
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
] DOCUMENTOS) HAVE NOT BEEN RECEIVED
TRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED.
DATE
PRINTED NAME, GRADE OR TITLE
SIGNATURE
COMMENTS
DA FORM 3964, 1 Nov 72
REPLACES DA FORMS 1203, 1 SEP 58. 1204. 1 JAN 60: 631, 1 MAR 62 AND
546, 1 OCT 63, WHICH ARE OBSOLETE.
Approved For Release 2000/08/08 : CIA-RDP96-00788R001600140003-8