CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001600390004-0
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: June 19, 1998
• Sequence Number: 4
• Publication Date: July 29, 1983
• Content Type: FORM

For use of this form, sere AR 31104: than proponent agency is the Office, Assistant Chief of Staff for Intolligrncj
29 Jul 83
SECTION A- GENERAL
TO: FROM:
NSA
DATE I,ECEWED
ACTION QFFI
CE(S' SUSPENSE D.ATEISI
REGISTER OR CONTROL NO.
CONTROL. LOG
CLASSIFI-
NUMBER OF
DESCRIPTION (Type. File Ref. Unclassified Subject
DATE OF
OR FILE NO.
CATION
COPIES
or Short Title and Number of Lrdorsernertts/lrecls)
ORIGINATOR
DOCUMENT
CL-053--83
/NOFO
I
Cy I of cy Report 1029/8307/01 ........
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...............NOTHING FOLLOWS .......
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SECTION 8 - ROUTING
.--I A K N OWL E D G U R E C -L I j;-T O F T ki
? M A T
TO
COPY NO
DATE
PRINTED NAME
SIGNATURE
2.
3
_
A.
5
SECTION C - DESTRUCTION CERTIFICATE (Che(k apprap,mte Klock)
MATERIAL DESCRIBED HEREON HAS BEEN
PACsE OR COPY NO
-
I-77
- --, DESTROYED ..._..._,. _-_.~__.____ `?^-s TORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER (AR 380.5)
UIFtCE SYMBOL DATE PRINTED NAME OF CUSTODIAN OR REP SIGNATURE
DESTRUCTION RECORD NO. DATE PRINTED NAME OF CERTIFYING/C.)ESTR OF F SIGNATURE
....... _.. ._.___. __----,- _.-__ _._...-
('AGE: OR COPY NUMBER DATE PRINTED NAME. OF WI IMES3ING OFFICIAL SIGNATURE
SECTION D - REPRODUCTION AUTHORITY
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NOME{ER CIF C'OPtEB TO E3 E REWRODUCED-AUTHORIZED ERY.-,_.,-~.LL-?.~v-~''~.T. DATE
SECTION E - RECEIPT/TRACER ACTION i (`heck appropriate black)
E_]RECCEIP-F Or DOCUMENT(S) ACKNOWLEDGED DOC I IMENPISI HAVE NOT BEEN RECEIVED
[11 TRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED.
DATE ]PNTEDNAMGGRAOFOR RITITLE SIGNATURE
COMMENTS k ~~. __ ,... `.~-...~..
~`+N JI JVC,\.1-,.rV1-_RCICQJC LVVV/VV/VV . L-1/'1'RL/r.7V VV/ VG