CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001100080012-0
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: June 18, 1998
• Sequence Number: 12
• Publication Date: June 17, 1980
• Content Type: FORM

CLASSIFIED DOCUMENT ACCOUNTAE3LITY RECORD
June l98)
For use of this form, see AR 280.5; the proponent agency is the Office, Assistant Chief of Staff for Intelligence.
FROM: US Army i ateriel, Sy t+ Anal eis iotr!
TO: commander
ATTb13 -o' ID (LIC #i B Watt)
TAPH-,*
O 9D 215
rs een Proving rI d, 00
_t, Made 3 -207515
SUSPENSE DATE'S) REGISTER OR CONTROL NO.
DATE i-2ECEIVED ACTION OFFICE(S
8May1980
Ct)NTROL, LOG
CLASSIFI- N
UMBER OF
DESCRIPTION (Type. File Ref., Unclassified Subject
r Short Title and Number of Indorsements/Incls)
DATE OF
DOCUMENT
ORIGINATOR
OR FILE NO.
CATION
COPIES
o
GRLLL
l
Ti
-
80
Ja
AISAA
;SD
I
e:
t
C-91,
ntarlm Note NO.
y
,
980 X31
SA
F
LAME Special Study No. I ..--........-_-
3
FOLLOWS--__......----..
~
I
I
E4 ON
Jul 98
SECTION B B. ROUTING
TO
COPY NO.
DATE
PRINTED NAME
SIGNATURE
2.
3.
4.
5.
SECTION C - DESTRUCTION CERTIFICATE (Check appropriate block)
MATERIAL DESCRIBED HEREON HAS BEEN:
ED 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 E. RECEIPT/TRACER ACTION (Check appropriate block)
RECEIPT OF DOCUMENT(S) ACKNOWLEDGED . DOCUMENT(S) HAVE NOT BEEN RECEIVED
0TRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED.
DATE
PRINTED NAME, GRADE OR TITLE
SIGNATURE
D
DA FORM 3964, Nov 72 REPLACES DA FORMS 1203. (SEP 58: 1204. 1 JAN 60: 63i. I MAR 82 AND
48 1 OCT 63, WHICH ARE CESOLETE.
Approved Fortelease 2000/08/07 : CIA-RDP96-00788R001100080012-0