CONTROL AND COVER SHEET FOR TOP SECRET DOCUMENT

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP85G00105R000100180012-2
• Release Decision: RIPPUB
• Original Classification: T
• Document Page Count: 1
• Document Creation Date: December 9, 2016
• Document Release Date: July 18, 1998
• Sequence Number: 12
• Publication Date: August 31, 1966
• Content Type: FORM

UNCLAS aVe lk- tac*riEa`een?o~'o~Q1~i4Q~flyZd~wngraded
to SECRET whet filled in form is detached from controlled document.
CONTROL AND COVER SHEET FOR TOP SECRET DOCUMENT
DOCUMENT DESCRIPTION
REGISTRY
SOURCE
D/OCR
CIA CONTROL NO.
0039188
DOC. NO.
DATE DOCUMENT RECEIVED
[~
DOC. DATE 3
1 Aug 1966
C"
COPY NO. 1 & 2
LOGGED BY
NUMBER OF PAGES 3
NUMBER OF ATTACHMENTS
0
ATTENTION: This form will be placed on top of and attached to each Top Secret document received by the Central Intelligence Agency
or classified Top Secret within the CIA and will remain attached to the document until such time as it is downgraded, destroyed, or
transmitted outside of CIA. Access to Top Secret matter is limited to Top Secret Control personnel and those individuals whose official
duties relate to the matter. Top Secret Control Officers who receive and/or release the attached Top Secret material will sign this form
and indicate period of custody in the left-hand columns provided. Each individual who sees the Top Secret document will sign and
indicate the date of handling in the right-hand columns.
REFERRED TO
RECEIVED
RELEASED
SEEN BY
OFFICE
SIGNATURE
D TE
TIME
D TE
TIME
SIGNATURE
OFFICE/DIV.
DATE
CTSC
A DDI for
SP 95XI APP
NOTICE OF DETACHMENT: When this form is detached from Top Secret material it shall be completed In the appropriate spaces below
and transmitted to Central Top Secret Control for record.
DOWNGRADED
DESTROYED
DISPATCHED (OUTSIDE CIA)
TO
BY (Signature)
TO
BY (Signature)
WITNESSED By (Signature)
BY (Signature)
OFFICE
un~c
OF DATE
FICE
OFFICE
DATE
ORM 2C pp PYft pQr.
F
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