CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001600220003-9
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: May 16, 2000
• Sequence Number: 3
• Publication Date: February 15, 1983
• Content Type: FORM

`:ApproVed=For-Release 2'000/08708': CIA-RD P96-00788R061600220003-9
C_. UVERNMENT PRINTING OFFICE: 1474 ---558 057
CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD
For use of this form, see AR 380.5; the proponent agency is the Office, Assistant Chief of Staff for Intelligence.
SECTION A - GENERAL
1 FROM:
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SECTION B - ROUTING
SECTION C - DESTRUCTION CERTIFICATE (Chuck approprtalc oczl ~~
L-I DESTROYED
OFFICE SYMBOL ~
DATE
L-1 TOT/N IN HALF AND P
PRINTED NAME OF CUSTODIAN OR REP
SIGNATURE
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DESTRUCTION RECORD NO
DATE
PRIN LED NAME OF CERTIFYING/DLSTR UF=F
SIGNATUR.
PAGE OR COPY NUMBER
DATE
tNTTITCIA L
SIGNATURE
SECTION D - REPRODUCTION AUTHORITY
NUMBER OF COPIES TO BE REPRODUCED
U THORIZ.ED RY _
DATE
SECTION E RECEIPT/TRACER ACTION (Cheek appiipr'iale block
LIRECEIPT OF DOC:UMENT(S) ACKNOWLEDGED DOCUMENT (S) HAVE NOT BEEN RECEIVED
QTRACER ACTION. SIGNED RECEIPT FOR MAT WAI. DL:',CHIHED AEIOVL HAS NOT Lat EN RECEIVED. _--
DATE PT RINTED NAME, GHADL UR III LE SIGNATURE
" Approved For Release 2000/08/08 :CIA-RDP96-00788R00160020003-
9 y..Y
1 MAR 62 AND
1
LACED IN A CLASSIFIED WASTE CONTAINER (A.R :180-5)
CLASSIFI- I NIJMFSLR OF-
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DATE OF
DOCUMENT