CIA STARGATE release
CIA-RDP96-00788R001600210003-0
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.
ApprovedFB. Relay: 2066/08/08 BUTA -6P56-00788R00 1600210003-0 For use of this form, see AR 380-5; the proponent agency is the Office, Assistant Chief of Staff for Intelligence. 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/ Incls) DATE OF DOCUMENT ORIGINATOR CL-008-83 S/NOFORN 1 Cy 1 of 1, Report CL-986/8211/07 .NOTHING FOLLOWS SECTION B - ROUTING I ACKNOWLEDGE RECEIPT OF THE MATERIAL DESCRIBED REREON TO COPY NO. DATE PRINTED NAME SIGNATURE 1. 2 3 4. , 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 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 DOCUMENTIS) ACKNOWLEDGED DOCUMENT(S) 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 DATE PRINTED NAME, GRADE OR TITLE SIGNATURE COMMENTS DA FORM 3964, 1 Jul 79 EDITION OF 1 NOV 72 IS OBSOLETE. U.S.GPO:1980-0-319-050 Approved For Release 2000/08/08 : CIA-RDP96-00788R001600210003-0