CIA STARGATE release
CIA-RDP96-00788R002000010008-2
Opens with: For use of this form, see AR 380-5; the proponent agency is the Office,
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1 page, machine transcribed from the CIA’s released scan.
#U.S. GOVERNMENT PRINTING OFFICE: 1974 -558 - 057 Approved16FIREReBSC20UN08/07QUNAARDR 9600R88R002000010008-2 For use of this form, see AR 380-5; the proponent agency is the Office, Assistant Chief of Staff for Intelligence. 21 Nov 78 SECTION A - GENERAL TO: FROM: HQDA ( DAMI-ISH) WASH DC 20310 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 S/ ORCON 2 Memo for USofA, subject: 20Nov78 DAMI- ISH RECEIPT - PLEASE SON AND RETURN SECTION B - ROUTING TO COPY NO. DATE PRINTED NAME SIGNATURE 1. CSA 2. USofA 3. 4. 5. 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 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 Approved For Release 2001/03/07 : CIA-RDP96-00788R002000010008-2 DA FORM 3964, 1 Nov 72 REPLACES DA FORMS 1203, 1 SEP 58: 1204, 1 JAN 60: 631, 1 MAR 62 AND 546. 1 0 OCT 63, WHICH ARE OBSOLETE. 2 21 Nov 78 W.M. NOLAN A. M. Holan SECTION C - DESTRUCTION CERTIFICATE (Check appropriate block) USofA GRILL FLAME Request (U) w/TABS A and B. NOTHING FOLLOWS: