CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001900190002-1
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: June 23, 1998
• Sequence Number: 2
• Content Type: FORM

ATE
Far use of this Pores, see AN 380-3; the proponent agency is the Office, Assistant Chief of SIGH For Intelligence.
w. _. SECTION A - GENERAL
FROM:
ACSI
DATE RECEIVED
ACTION OFFICE(S)
- -
SUSPENSE DATE(SI
REGISTER OR CONTROL NQ.
I
CONTROL. LOG
OR FILE NO.
CLASSIFI-
CATION
NUMBER OF
COPIES
DESCRIPTION (Type, File Ref., Unclassified Subject
DATE OF
/ ` -W
or Short Title and Number of indorsements/fncls)
DOCUMENT
ORIGINATOR
C1-O44-83
./NOFOR
1
Cy 1 of 1 cy, Report 1020/8305/01 .....
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SECTION R - ROUTING
I ACKN O4YLEDGE RECEIPT OF THE MAT R1 L D S 1 F1
TO COPY NO. DATE PRINTED NAME SIGNATURE
__ __ -
2.
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- _ v
_ SECTION C - DESTRUCTION CERTIFICATE (Cheek appropriate block)
M
MATERIAL DESCRIBED HEREON HAS BEEN
PAGE OR COPY N
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_ i.-_) DESTROYED [:]TORN IN ALF AND PLACED IN A CLASSIFIED WASTE CONTAINER
-
AR 3
1
(
8
-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
om
SIGNATURE
SECTION D
- REPRODUCTION AUTHORITY
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SECTION E - RECEIPT/TRACER ACTION (Check appropriate block)
[-]RECEIPT OF DOCUMENT(S) ACKNOWLEDGED 0 DOCUMENT(S) HAVE NOT BEEN RECEIVED
TRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN
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DATE PRiMTED NAME GRADE OR TITLE SIGNATURE.
COMMENTS.
DAFORM 2 2994 .. ~,u
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