CIA STARGATE release
CIA-RDP96-00788R001900050003-5
Opens with: For use of this form, ses 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.
ApprovedsforEBEroce :ENfox(26 GRFREIPAY-REC BR901900050003FATE For use of this form, ses AR 380-5; the proponent agency is the Office, Assistant Chief of Staff for Intelligence. 18 MAY 1983 TO: NSA SECTION A - GENERAL FROM: DATE RECEIVED ACTION OFFICEIS! SUSPENSE DATEIS) REGISTER OR CONTROL NO. CONTROL. LOG OR FILLE 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-039-83 $/NOFORN 1 Cyl of 1 cy, Report CL-1011/8304/01 NOTHING FOLLOWS SECTION 8 - ROUTING TO COPY NO. DATE PRINTED NAME SIGNATURE 1. 2. 3. 4. 5 MATERIAL DESCRIBED HEREON HAS BEEN: C 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 DOCUMENTISI 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 DATE PRINTED NAME, GRADE OR TITLE SIGNATURE COMMENTS DA FORM 3964, 1 Jul 79 EDITION OF 1 NOV 72 IS OBSOLETE.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-RDP96-00788R001900050003-5 I ACKNOWLEDGE RECEIPT OF THE MATERIAL DESCRIBED HEREON SECTION C - DESTRUCTION CERTIFICATE (Check appropriate block) PAGE OR COPY NO