CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001600150004-6
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: May 17, 2000
• Sequence Number: 4
• Publication Date: February 16, 1982
• Content Type: FORM

Approved For Release 2000/08/08 : CIA-RDP96-00788R001600150004-6
CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD UA FE
Ib FES 82
For use of this form, see AR 380.5; the proponent agency is the Office Astistoni Chief of Staff for Intelligence.
SECTION A - GENERAL
FROM:
UR FL ENO- CATION
DATE U' OR r;:NAI OR
UCK_UMENT
SECTION C - DESTRUCTION CERTIFICATE ("(h(-el; app-prialrhhrck)
L_JTORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER (AR Oil) 5)
_
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_
N AME OFCU4STODIAN OR REP SL .YNATURE
PRINTED
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PR rIt YING/DESTK U
OFF. SIGNATURE
CER ,
ED NAME. OF
INT
SECTION D - REPRODUCTION AUTHORITY
SECTION E - RECEIPT/TRACER ACTION (Clocir ,ipproprialc (lock)
DATE PRINTED NAME. GRADE OR TITLE 5if,;NA1 UHE
?RECEIPT OF DOCUMENTISI ACKNOWLEDGE[.) DOCUMENTISI HAVE NOT BEEN RECEIVED
[TRACER ACTION SIGNED RECEIPT FOR MAIERIAL. DESCRIBED ABOVE HAS N01 BEEN RECEIVED
ACTIUfd ;JFFIC E(Sl I SUSPENSE DATEIS'
NUMBER OF DESCRIPTION r7'ypC. File Rq I.;ncfnssrjrrcl S0hicrl
COPIES r,r .tihnrr 77tlr,,m! .,SJuml>er ~r/ IrrClu,SemcrII.S/I tcls)
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....... .......NOTHING FOLLOWS ................
RCP LAC. ES 0A FORMS 1201. 1 SE P 'S8 1204. 1 JAN 60 631. 1 MA17 62 AND
t54, I Z- C ( I 1-I. yI1I1Cl1 AUF l,30 50) 1 F E
Approved For Release 2000/08/08 : CIA-RDP96-00788R001600150004-6