FORM: CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R002000230001-5
• Release Decision: RIFPUB
• Original Classification: U
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: June 29, 1998
• Sequence Number: 1
• Publication Date: January 10, 1979
• Content Type: FORM

Ap&b4F f1 rER6i W?gkgOI /Oi .rtY M6-00788R002 WI MOM 9.@0M 79
Foj~v%* zA-th13 ernu son AR 380-5; the proponent agency is the Oif ce., Assis"ant Chiefof Staff for Intelligence.
SECTION A - GENERAL
TOt W -
Dr. Haley
DARCOM
Wash, DC
Fi?O)4:
Mr. Clinton
USAMIA, USk 4fIRADCOM, RSA, AL
DATE RECEIVED
ACTION-OFFICE(S)
SUSPENSE DATE(S)
REGISTER OR CONTROL NO.
CONTROL. LOG
OR FILM NO.
CLASS)F1-
CATION
NUMBER OF
COPIES
DESCRIPTION (Type, Filo Rol., Vnclassllied SubJect
or Short Title and Nenibor of Indorsements/Incls)
DATE OF
DOCUMENT
ORIGINATOR
011079
----------
H/C to Dr
SECRET/
NOFORN
--------
Haley
1
---------
y Pat 0
Zerox copy of paper entitled: Proposed
Program for Dev of a1R~-mote PK Switch
(u) 3 pages---------------------------
------- NOTHING FOLLOWS-----------------
iver 11 Jan 79
UNDATED
-------
USAMIA
DRDMtI-YS
-----------
SECTION B - ROUTING
TO
COPY NO.
DATE
PRINTED NAME
SIGNATURE
WILLIS P. OLIVER
WILLIS P. OLIVER
2. _
3.
4.
5.
SECTION C - DESTRUCTION CERTIFICATE (Check appropriate block)
MATERIAL DESCRIBED HEREON HAS BEEN.
DESTROYED [::] TORN IN HA1..F AND PLACED IN A CLASSIFIED WASTE .CONTAINER (AR 38-0-3)
OFFICE- SYMBOL
DATE
PRINTED NAME. OF CUSTODIAN OR REP.
SIGNATURE
DESTRUCTION RECORD NO.,
DATE
PRINTED NAME OF CERTIFYING/D-ES A. OFF.
SIGNATURE .,._
PAGE OR COPY NUMBER
DATE
PRINTED NAME OF WITNESSING OFFICIAL
SIGNATURE
SECTION D - REPRODUCTION AUTHORITY
-~--
1JUMI3FR i9F COPIES TO BE REPRODUCED
AUTHORIZED BY
DATE
SECTION E - RECEIPT/TRACER ACTION (Check appropriate block)
D. 13z.CEIPT OF DOCUMENT(S) ACKNOWLEDGED LTiDOCUMENT(S) HAVE NOT SEEN RECEIVED
TRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED.
pA r E
PRINTED HAMS, GRADE OR TITLE
SIGNATURE
)MN N S Approved For Release 2001/04/02: CIA-RDP96-00788R002000230001-5
DA FORM 3964, 1 Nov 72
REPLACES DA FORMS 1203, 1 SEP 581 1204. I JAM 601 Sgt. 1 M
546, 1 OCT 63, WHICH ARE OBSOLETE.