CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001600080010-7
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: June 19, 1998
• Sequence Number: 10
• Publication Date: November 9, 1982
• Content Type: FORM

CLASSUE'r-O 0788R00 0-7
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SECTION A - GENERAL
FROM:
CIA
DATE RECEIVED
ACTION OFFICE.(S)
SUSPENSE DATEIS)
REGISTER OR CONTROL NO.
I
CONTROL, LOG
OR FILE NO,
CLASSIFI-
CATION
NUMBER OF
COPIES
DESCRIPTION (Type, File Ref.. Ulclrrssified Suhieci
or Short Title and Number of A;dorsenrents/Incls)
DATE OF
DOCUMENT
ORIGINATOR
CL-002-82
S/NOFOR
1
y 1 of 2, Report CL-?946/8206/01 w/1
5 Nov 8
exhibit ................................
........
..........
...........
........
........
.........NOTHING FOLLOWS...............
........
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SECTI N B ROUTIN
TO COPY NO. DATE PRINTED N ME SIGNATURE
3.
4.
SECTION C- DESTRUCTION CERTIFICATE (Check appropriate block)
MATERIAL DESCRIBED HEREON HAS BEEN;
1-1 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
1
;~U
TH
&P
IZED
BY DATE
SECTION E - RECEIPT/TRACER ACTION (Check appropriate block)
lRE.CEIPT OF DOCUMENT(S) ACKNOWLEDGED DOCUMENTIS) HAVE NOT BEEN RECEIVED
ElTRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED.
DATE
PRINTED NAME, GRADE OR TITLE
SIGNATURE
COMMENTS
r%A r/9 r0.a '"L A % AI-
REPLACES DA FORMS 1203, I SEP 58: 1204, 1 JAN GO: 631, 1 MAR 62 AND
546, 1 OCT 63, WHICH ARE OBSOLETE.
Approved For Release 2000/08/08 : CIA-RDP96-00788R001600080010-7