SIGNATURE RECORD AND COVER SHEET (SANITIZED)

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80B01676R001000140010-7
• Release Decision: RIPPUB
• Original Classification: T
• Document Page Count: 1
• Document Creation Date: December 22, 2016
• Document Release Date: July 21, 2010
• Sequence Number: 10
• Publication Date: January 1, 2000
• Content Type: FORM

Sanitized Copy Approved for Release 2010/07/21: CIA-RDP8OBO1676ROO1000140010-7
ATTENTION: This form will be attached to each Top Secret document received by the Central Intelligence Agency or elan ified I Bret
within the CIA and will remain attached to the document until such time as it is downgraded, destroyed, or transnttted a; of
CIA. Access to Top Secret material is limited to those individuals whose official duties relate to the material. Each al :rnat ist-
ant Top Secret Control Officer who receives and/or releases the attached Top Secret material will sign this form and iri iicate of.
an-
custody in the left-hand columns provided. The name of each individual who has seen the Top Secret document and ae da -- -
dling should be indicated in the right-hand columns.
NOTICE OF DETACHMENT: When this form is detached from Top Secret material it shall be completed in the appropristr Space,
transmitted to Central Top Secret-Control for record.
OFFICE
SIGNATURE RECORD AND COVER SHEET
oRM NO,
enr_ . 5 . 2i Sanitized Copy Approved for Release 2010/07/21 : CIA-RDP80BO1676RO01000140010-7
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