SURVEY REPORT

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP78-04720A000100040044-7
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 4
• Document Creation Date: November 17, 2016
• Document Release Date: July 14, 2000
• Sequence Number: 44
• Publication Date: March 23, 1954
• Content Type: FORM

'' ,Approved For ReIeW 2000 X0474A000100040044-7
REPORT NUMBER
SURVEY REPORT
DATE 23 Norgh 190
LOCATION INSTALLATION
25X1
ACCOUNTABLE INDIVIDUAL (NAME) RESPONSIBLE INDIVIDUAL
NAME
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DESCRIPTION OF ARTICLES
QUANTITY
UNIT COST
TOTAL COST
NUMBER
(CORRECT NOMENCLATURE; (SEE CIA STANDARD NOMENCLATURE LIST.)
(COST TO BE
INSERTED BY
SUPPLY
BRANCH
WASHINGT
ON, D.C.)
Fia ts, 5 a
3.29
1
2099
0 silvar
50
* frt ,_ Ott fii , w/ r sue,. r
46
3.85
96";p S%Up ,' rAftm
, yellov
f 2.50
16-75
~Q
, W
{gam
.901
L~i~
k
, .
erooftw
1
x '9n
3
26.45
GRAND TOTAL
CERTIFICATION (PROPERTY ACCOUNTABLE OFFICER)
(TO BE COMPLETED ONLY WHEN PROPERTY WAS ISSUED ON MEMORANDUM
RECEIPT BASIS.,
I CERTIFY that the items listed hereon and/or on attached sheets appear on my stock record account and were issued
on 10 19 , by M/R to responsible person initiating this survey.
The condition of the property at the time of its loss or damage was
& r IV*r WAN t MA VIS k lrr m 3Uk
My estimate of the depreciated or replacement value of the property at the time of its loss or damage is
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Approved or Release 2000/08/17 : CIA
9a
6d
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 CIRCUMSTA"Pro" forTReleaseE2000Y0&*7Oi CIA DR7h4a,2MG0O1EOOO40O44e7TIONS, ETC.
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SWORN STATEMENTS SHOULD BE OBTAINED FROM WITNESSES WHENEVER POSSIBLE TO BE ATTACHED AS EXHIBITS)
This statement must show what measures were taken to protect the property prior to and at the time of
its loss or damage.
Attach copy of rules or regulations governing the safekeeping and custody of government property if
such rules or regulations are special and peculiar to the installation. State from personal observa-
tion and knowledge the condition of the property at the time of loss or damage. An estimate of the
depreciated or replacement value should also be given.
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I, , being duly sworn, make the followin
a* 1M>-suo Ift
statement: $ -
*LAcs. The t b.31aw SWOU be is otalad 0590"
"A f . AU 1tI a UnUt we as had ally, ovsUsbla aac - 010 ept t
on,
as ,rD (111011150
4 5 alan
c+rs
7 ft*31ts, 3
a raa 4, tm, Z u
! SUV% - b r - okes)
Dowd ( w ss I - I In
I'm , I r ( )
811.., AIr F (U==VtCftW - tit)
3 MO, = 5 z 9
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NOTE: IF SPACE IS INADEQUATE ADDITIONAL SHEETS MAY BE USED
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194
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Approved For Release 2000/08/17 : CIA-RDP78-0472OA000100040044-7
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 Approved For Relea 2000/08/17 : CIA-RDP78-0472
,&A000100040044-7
FINDINGS (REPORT AND RECOMMENDATION OF INDIVIDUAL MAKING ON-THE-SCENE INVESTIGATION(
the safekeeping and custody of government property which are peculiar to the installation. The report
should contain a recommendation regarding the liability of the responsible individual in connection
witnesses, must be resolved. Testimony of witnesses should be obtained by the investigator when
necessary and attached as exhibits. Reference should be made to any rules or regulations governing
This report of investigation must be complete and in detail. All questions which may have been raised
by statements in "Circumstances" above, or in any statements obtained by the responsible person from
with the loss or damage.
I HAVE PERSONALLY INVESTIGATED ALL AVAILABLE EVIDENCE AS SHOWN IN EXHIBI 1 TO
NOVI)
OR ~ -- Is ter the IA Id
y~-
E
at ius axrvw R t
ftar
e =a taw or so to" vat s emm"".
#3.2. its , t t io I '
mild at t ...~. ~,.-.,,,~.
by b"XUL, 3a~ ale-+ Vila vX
INOTE: IF SPACE IS INADEQUATE ADDITIONAL SHEETS MAY BE USED
Akv&
ov For Release 2000/08/' 7:: Cl
to? >val~tr04011l. Zft items an ia
 ILLEGIB
Approved For Release 2000/08/17 : CIA-RDP78-0472OA000100040044-7
Approved For Release 2000/08/17 : CIA-RDP78-0472OA000100040044-7