CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00789R002100270009-1
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: December 4, 1998
• Sequence Number: 9
• Publication Date: March 5, 1990
• Content Type: FORM

Approved For Release 2000/08/08 :CIA-RDP96-007898002100270009-1
CIASSiFiED DOCUMENT ACCOUNTABILITY RECORD
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SECTION B ? ROUTING
1 ACKNOWLEDGE RECEIPT OF TM MATERI L 1
TO
GOPY NO.
DATE
PRINTED NAME
SIGNATURE
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3,
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SECTION C -DESTRUCTION CERTIFICATE (Check appropriate block)
MATERIAL. DESCRIBED HEREON HAS BEEN:
0 DESTROYED 0 TORN IN HALF AND PLACED IN A CLASSIFIED Wl15TE CONTAINER (AR 38x3)
PAGE OR COPY NO
OFFICE SYMBOL
DATE
PRINTED NAME OF CUSTODIAN OR REP
SIGNATURE
DESTRUCTION RECORD NO.
DAT@
PRINTED NAME OF CERTIFYING/DESTR. OFF.
SIGNATURE
PAGE OR COPY NUMBER
DATE
PRINTED NAME OF WITNESSING OFFICIAL
SIGNATURE ~ SG ~ J
SECTION D -REPRODUCTION AUTHORITY
NUMBER OF COPIES TO BE REPRODUCED ,.
AUTHORIZED BY
DATE
SECTION E -RECEIPT/TRACER ACTION (Check appropriate block)
RECEIPT OF DOCUMENTISI ACKNOWLEDGED ~ DOCUMENTIS) HAVE NOT BEEN RECEIVED
ACER ACTIO%N,SIGNED RE
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COMMENTS
~A FoaM pr~UFAd For Release 20~0'6'/0'8T ~~Ik~R0789R002'F~0~2~E~0091~6- 162-374