General Separation actions
Document Type:
Collection:
Document Number (FOIA) /ESDN (CREST):
CIA-RDP78-04718A002400290051-0
Release Decision:
RIPPUB
Original Classification:
S
Document Page Count:
18
Document Creation Date:
December 9, 2016
Document Release Date:
June 26, 2001
Sequence Number:
51
Case Number:
Content Type:
MISC
File:
Attachment | Size |
---|---|
![]() | 1.02 MB |
Body:
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Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
iteamst,
od.
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stops mod to a
to laws that thmir
or oitmorolooli to tarttoinatOd
1$4 is one.
lamed to
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you no
tit* o
la
maintain of money1 'opty, alainfitiad document*
on issue to 'toff omplaysoisk militazy personnels
0 Um *Awe ditto of asporation of an figrat)70 do
toe of the ooparationl How soon do you mitt*
we offloca?
Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
BEST COPY
AVAILABLE
Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
--CONFIDENTIAL
Adainistrative ,etafte OL
ly DIvisiee
Om?f"ts Regarding ilrepseed
Osparral Soperatten Motions
7401410410he *1) end le and Firm MO. 21 rest the
of toilette@ as the oily alearence paint regarding
AirevetOMMA property that mey be ehargel to the employee.
1. YOU are advised that the eu/y reeore seintained In the
Office of Logistios-of property issued to egeolfic emplagess
La for that peopertyveleseed en memorandum reeelpt er hind
reseipt.directky to the employee eameereed by an defies of Imago.
ties AdmpOnient. Anoordinigly, the Offioe of Logistics' eertifl-
t444,4orelearenee)Aseiatned on Term Mo. 21 indisatee gat
the reomrdeseldUrtalsed in the ?Mee of Legiaticurrelliit
ounitaidinglisoperOyebligatien on the pert if the employee
lAmeisueh asertifieatisa le furnished. .
."thar uppregfriat? soorses or nemespeedahle prefer*
tO Avow 11.34'ese eves
Oillesr at
25X1A fLa34 st1 *bleb the
*Mears in the Memdgmerters
teilditidiemployee Is assigeed.
25X1A ? veneers of Meadomartere sentseaUed
atitt*.. se defined in
fro@other Oevernment implores. te?*ea non#
104er* has been issued.
'than aleempleyee obtains nonempemdelas Government
ProPerty from smother employee (whether or not the emplepie
releasing?the property lath. responsible &floor of reeird),
it in impacted that the employee releasing the property will
protect hisAilimpeisibility therofmr by moons of a.bad roselpt
tinuous knowledge of the looation and ire of the
the peeper* res00121er the 'UMW @OW
tdividual Is eherged with the accountability and
responsibility fbr all Ilona sonempendable property.
Approved ForRelecaNNORIMAle-RDP78-04718A002400290051-0
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Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
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of of mobjeo
follows
eta
sotent ((and I
Advanoo aeent ct$
yet oubmittod for
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for *deb riot
t Acootoit $
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Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
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0WECTI
itSOCII4
0111110.0110.0.1.11111.111040.44MION111111/~111MOMMONOFRO,
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Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
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VIWitt
25X1A
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Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
actin to
aecordanee with
dt rtit ice
account.
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CONF I DENT I AL
Approved For Release 2001/08/10 : CIA-RDP78-04718A00240029005VOE
FINAL PAYMENT CLEARANCE SHEET
LAST WORKING DAY
NAME OF EMPLOYEE Las (First) (Middle)
OFFICE ASSIGNED TO
REASON FOR CLEARANCE
RESIGNATION FOR CONVENIENCE OF GOVT
OVER 60 DAYS LEAVE
RESIGNATION FOR PERSONAL REASONS
OTHER (Specify)
ITEMS TO BE CERTIFIED
I. HOSPITALIZATION AND INSURANCE B. RESERVE STATUS 11. SPECIAL CLEARANCES
2. EXIT INTERVIEW 7. DEBRIEFING 12. SELECTIVE SERVICE MATTERS
3. DRIVERS LICENSE, GAS, OIL. ETC. 8. CLEAR ACCOUNT 13. INTERNAL MATTERS INCLUDI
4. LIBRARY MATERIALS 9. MONETARY FUNDS T/S CONTROL
5 NON.EXPENDARLE PROPERTY 10. TRANSPORTATION ACCOUNTS 14. RECORDS CLEARANCE
CERTIFICATION OF OFFICIALS (Please include comments pertaining to exceptions In an attached memorandum)
I CERTIFY THAT THE ITEMS FOR WHICH I AM RESPONSIBLE HAVE BEEN CHECKED WITH OFFICIAL RECORDS. AND, EXCEPT AS
INDICATED. THE EMPLOYEE NAMED IS CLEAR OF OBLIGATIONS WITH CIA.
EMPLOYEE SERVICES DIVISION (Certify items 1 & 2)
ROOM NO. BUILDING
CLEARED BY
MILITARY PERSONNEL DIVISION (Certify item 6)
ROOM NO. BUILDING
TRANSPORTATION BRANCH (Certify item 3)
ROOM NO. BUILDING
MAIN LIBRARY (OCD) (Certify item 4)
ROOM NO. BUILDING
OTR LIBRARY (Certify item 4)
ROOM NO. BUILDING
MAP LIBRARY (ORR) ( Certify item 4)
ROOM NO. BUILDING
OFFICE OF LOGISTICS (Certify item 5)
ROOM NO. BUILDING
CIA CREDIT UNION (Certify item 8)
ROOM NO. BUILDING
-2-5XIA9a-
CENTRAL PROCESSING BRANCH (Certify item 10)
ROOM NO. BUILDING
OCI (Certify item 11)
ROOM NO. BUILDING
OFFICE OF DIRECTOR OF PERSONNEL (Certify item 12)
ROOM NO. BUILDING
EMPLOYEE OFFICE OF ASGMT (Certify item 13)
ROOM NO. BUILDING
Fl/RECORDS INTEGRATION DIV (Certify item 14)
ROOM NO. BUILDING
_
COMMO SECURITY (Certify item 7)
ROOM NO. BUILDING
OFFICE OF SECURITY (Certify item 7)
ROOM NO. mat BUILDING I
FINANCE DIVISION (Certify item 9)
ROOM NO. 21044 BUILDING I
FISCAL DIVISION (Certify item 9)
ROOM NO Ililsma_1100 "-DING AIWA,
ROOM NO. BUILDING
CERTIFICATION BY EMPLOYEE
I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF I AM NOT INDEBTED TO THE UNITED STATES GOVERNMENT WHATSOEVER
AS A RESULT OF MY CONNECTION WITH THIS ORGANIZATION.
DATE SIGNATURE OF SEPARATING EMPLOYEE
FORWARDING ADDRESS
NUMBER, STREET. CITY. ZONE, STATE
TELEPHONE
FORM NO.
MAR 55
21 REPLACES FORM 34-30.
I APR 54 WIEICH MAY BE USED.
CONF I DENT I AL
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(9-301
(
ApprovecrFor Release 2001/08/10 : CIA-RDP7'84) 738A002400290051-0
RFSIaliaTION
W'aPP(431
. 152 Resignation Submitted
Ated
ales...fflaae
To F
OCI Notified
b., Secret Cance11.6d
**gramma
:learanee Cancel1ed
47 CotIMic V Cancelled
eo Emergency Plan
Properly Cle.,aranoo.
Docteiv.zt signed far:
o/i IQ gqpn, Ste,
:late
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on Description
quested
,Rtipleted
it:. Wath Offtr ..iat
b cet Cards
SC& rt Duty f.:11 dor
n? belig ion and Autnorixiti.rct
12.. Trainir.; Mater-LA
13f. Lid 30E. Materna.
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ItiTS Initit IS la
SLIXIATIOSSI RAS
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Approved For Release 2001/0809,,t 14A002400290051-0
Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
Ffoi441`1
CktrillrAlf
PTA?
TA jp eertif that I do not hare
wr Gott -ramitytt. .-.ritarty tmy potato/tins that all tiorrarrament property
prfiritsmar entrusted to my CV* IMO 14.11 dal, transferred through
Agency supply channels; that :1, have not lost, danased, er destroyeri
say property for velloh a Marvin, vert has not been prepared and a
decision of "relief' fres resomaibility" raodered by the Property
Surrey Sear&
Ar Acrs-lbt
1. esireattort
tura slItrAi
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Approved For For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
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DIVISICV1
ANSIGtalt GiOCK i.74T
SR T.)TVISION
PW4olitti. OFFICL,
Writ 1011-4,
aiRtitla
ROM MO
Et* *Mar amp
Iteriut 142 4
(If similes atm eta
AOLNCX
SUM MI
ROM 1053 4
sr,
ctf martutUtt ore tk
To; 3:410ET IrCtPitrfflit
I:ocular pl.
rm. 1.41 fl rnurl rirnsiu
.PEONFilLA C(7,17-1$ C4r
t:UNDillt, rats 50 SRA Irlf lasers $11fmraa POSCIII*FL AtrlOW
UM'S atl YOU. TIM RA 1inz C.3PIT+S AND WILL Grroi TO "t00
!+,r. Cala' WO* ENtliaTio
TrE ri* Ifj_tins r CREDTT AIDS.
Approved For Release 2001/08/10 :;
DP - 0 4 718A002400290051-0
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Approved For Release 2001/08 1
; CIA-RDPT
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Notificatinn of To'..;r of Duty Expiration
1. This Agency has entered into an agreement with the Department
,T.J)efense whereby three (3) years will be a normal tour of duty for
-cfficir personms1 assigned to CIA, except in the ease of Marine Corps
mval avions whcse normal tour will be of two (2) year duration.
2 uF-re therefore advised that the Agency tour of duty of
will expire on . The following
is the prtnedura to be followed in determining thls. officers status:
a. Procurement of a replacement will require five (5) months,
hoe requisition 'for replacement should be submitted.not later
the?:
"L. If no replacement is required, a statement to that effect
Is desired.
c. If available for rfqxssignment, the parent service concerned
will be notified one hundred and twenty (120 days prior to the
expirstion of tour.
d. Unless information to the contrary is received on or before
, availability date will be reported as any
date within the thirty-sixth (36) month of detail.
3. If it is determined that this officer will be released upon
letion of tour of duty, the following is requested:
,
4T
limit date offioer,will be available for release.
letter fro': the officer coroerned containing the infor-
bn outlined on the reverse side of this memorandum. This in-
formation will be included in the notification of his .release to
his parent service.
4. If it is determined that this officer is a highly. specialized
1'Aihose7reassignMent will adversely affect a. critical operation,
reqteat"that a letter'eflustification for an extension of,bis tour with
PIA be forwarded to the Mi1itary4tersonnel Division, with the concurrence
of the Assistant Director, Senior staff Chief, or Deputy Director who
-exercises jurisdiction over the officer concerned. This justifioation
will serve as a basis for negotiations with his parent service for a tour
of duty extension.
5.. Request this Division be notified of this officer's status not
later than
Approved For Release 2001/08/10:
,Chief, MilitarY
25X1A9a
1- AldrAss letter to Chief, YLlitary Personnel Division
2 Include triejoliowing:
a. Type ntassignment specifying geographical areas desired
in order of preference.
b. Amount of delay enroute you wish specified on reassign-
ment orders.
-
c. Any other pertinent information you desire to be brought
to the attention of the Career Management Division.
3. Any special assignment requests such as schools should be
made a matter fq- separate correspondence in accordance with the ap-
propriate regulation.
' AIR MICE OFFICERS
1. Address letter to the Commander, 1007th Air Intelligence
Service Group, Washington 25, D. C.
Include the followings
Occupational field of assignment preference followed by
omra ical areas.
25X1A
25
25
. or overseas
'preference.
nt limitations, other than physical reasons, such
s ng son, ttrriage to a.German national, approved applioa-
iop tsr schools, hardship eases, eta. ?
0. Amount Of delay enroute you wish specified on reassignment
44*
. TAry5pcisL&i3ignme1t requests such as schools should oe'Miei -
tter of separate correspoWnee in accordance with the appropriate '
tion.
Approved For Release 2001/08/10: CIA-RDP78-04718A002400290051-0
"7,7144.
A roved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
DATE
Returnee Payroll Information
remanent Cnan fStatinn From
Dmpciarylra.ty ari He LeavP from
to t10,. United States
I;VoTE: a-- rti.CE '"')F L'El'APTURF:
? ..1.111012,-
-ak1.43-r: :A11 :
Lt Paid t Stati-n Thrvk
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Ammnt.
_______
DisfJ51t1cn nf
S:np Fiold All tA.TeetIvc
NO
ILNET (PI) (IS NOT) ATIACIND
WYI ) Acccia,ANI FmtlacYrE.
......or?1011111.1111?0?Iilim?
171;14.7.-1(TT-s-15:17-A1071?YO--
Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0
1P?
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-
? ?
C1tLEANCF,
31ATEMErl
-?
-e my CIL cryptocr,pnic ciear,Incc nits been
rei effenivc.' thi:
clelrqnce
r'lLther acce5r, to CI, -Jt%fl cryptogrupi:i,
that _it le fr:-,m my
tfl rr.,:qPct 1th of cryptorapnic irt'crt.ation, the
1.
: !
- '-.--t : ; . I ...wernment
I I:Ate in: C1711, .
r:.v? tire'c1ity15.
dnqerAana tr-tt I !im, iy th:it Act even Plfter tne revocation of
eryptegrEThdc :%!R3 my termirticn frm and that im-
-:T..)7r disclol-urc crypci-.phic infc:rmtior: could s...lbject me to
.?;.h.1cht under tLo provi3iona of the Act.
4. I certify that no CIA staff cryptographic material remains
4-pos3e3:doL.
Date:
Approved For Release 2001/08/10 : CIA-RDP78-04718A002400290051-0