CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001900320003-5
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: June 25, 1998
• Sequence Number: 3
• Content Type: FORM

Approved For Release 2000/08/08-: C1A-RDP96-00788R001900320003-5
CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD
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For use of Mis 9orrnN see AR 3SO S; the proponent agency is th Offrce , Assistant Chief of Staff for I. I*IIiyence.
SECTION A - GENERAL
T
NSA
DATE F ECEIVED ACTION r1FFICE(S!
SUSPENSE DATE iS) REGISTER OR CONTROL NQ
CONTROL, LOG
OR FILE NO
CLASSIFI-
NUMBER OF
DESCRIPTION i Type. File Ref. (inclossifaed Suh(e(t
DATE OF
CATION
COPIES
or Shy Title and Number of G)do!sements/Inels)
DOCUMENT
ORIGINATOR
CL-056-f33
S/NOFOR
1
Cy 1 of 1 cy, Report HU-1031/8309/0.1..
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........
...........NOTHING FOLLOWS..........
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SECTION 8 - ROUTING
._._~_ .,?..~.-W__-,~._.
AC KNC)Wfd EDGE F2C'E"1 P1 OF Th1
~; MATESii, L C)C7 E:~ f't iv
TO
COPY NO.
DATE
PRINTED NAME
SIGNATURE
b.
------ -._____.___.____._.._-.__
SECTION C - DESTRUCTION CERTIFICATE (Cheek uppropriutehlock
. ?_
_ ___ _ _-_ ~_ _ u- _._.
MATERIAL D
E
S
C RPBED HEREON HAS BEEN
..
PACE OR 'IF'Y NO
B
-
y
F-y
d_.J DESTROYED L _,p TORN IN HALF AND F LAC.EL) IN A CLASSIFIED WASTE CONTAINER tAR JN(l
OFFICE'. SYMBOL DATE. PRINTED NAME OF CUSTODIAN OR REp SIGNATURC
i
Il
-T, RI"JTCD NAME OF CERTIFYINGI'D FSTR Of r SIGNATURE
NA_____
PAGE COPY NUMBER DATE PRINTED NAME OF WITNESSING OFFICIAL SIGNATURE
SECTION 0 - REPRODUCTION AUTHORITY
NUMBER OF COPIES 5 BE REPR7DUCED Ac Ts-tt)RIZED BY ijDATE
SECTION E RECEIPT/TRACER ACTION (Check appropriate Mork(
RECEIPT OF DOCUMENTISI ACKNOWL.EOCLD E J DOCUMENT(S) HAVE NOT BEEN RECEIVED
[F''
El TRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOf BEEN RECEIVED.
DATE {PRINTEONAMLGRADEORnTLE SIGNATURE
COMMENTS
Approved For Release 2000/08/08 : CIA-RDP96 00788R001900320003-5
r-A A FORM WWA
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~
~a6
~ EDITION OF 1 NOV 7:2 IS OBSOLETE