CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001600330004-6
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: June 19, 1998
• Sequence Number: 4
• Publication Date: May 27, 1983
• Content Type: FORM

ove FZS'r release 2000/08/08: CIA-RbP96-00788R001600330004-6
PP-
CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD
DA
M~1y X983
For vs* of this forr-, sos AR 380-3; tha propommntt agency is the Offk? Assisioot r.Iisl of Staff for Intelligence.
SECTION A - GENERAL
TO: FROM:
NSA
DATE RECEIVED
ACTION OFFICE(S)
SUSPENSE DATE(S)
REGISTER OR CONTROL NO
CONTROL, LOG
CLASSIFI?
NUMBER OF
DESCRIPTION (Type. File Re/I. Unclassified Suirlect
DATE OF
ORIGINATOR
OR FILE NO.
CATION
COPIES
or Short Title and Number of Indorsements/lads)
DOCUMENT
CL-040--83
/NOFORN
1
Cyl of 1 cy, Report 1017/8303/08 ......
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FOLLOWS...........
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a SECTION 8- ROUTING
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I A C!C N 6 W L ED G E RECEIPT G F 7 H
- hA A T E fi I~ L.TD E 5 ~R 1 B E D H-- E !~i
TO
COPY NO.
DATE
PRINTED NAME
SIGNATURE
2.
3.
A.
SECTION C - DESTRUCTION CERTIFICATE (Check appropriate Klock)
PAGE. OR COPY No
MATERIAL DESCRIBED HEREON HAS BEEN
~- 1
CJ DESTROYED TORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER (AR 380-5)~
- - _ ,
OFFICE SYMBOL DATE PRINTED NAME OF CUSTODIAN OR REP SIGNATURE
DESTRUCTION RECORD NO. DATE PRINTED NAME OF CERTIFYING/DESTR OFF. SIGNATURE
PAGE OR COPY NUMBER DATE PRINTED NAME OF WITNESSING OFFICIAL SIGNATURE
SECTION f) ? REPRODUCTION AUTHOWITY
mER_?.o_.____ -B E R__. __ _._ E __..__
NUMEi OF COPIES TO EPRODUCD AUTHORIZED BY DATE
SECTION E - RECEIPT/TRACER ACTION (Check appropriate blocks
oRECEIPT OF DOCUMENTISI ACKNOWLEDGED [ DOCUMENT(S) HAVE NOT' BEEN RECEIVED
?TRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED.
DATE PRINTED NAME. GRADE OR TITLE SIGNATURE
1111T' roved For Release 2000/08/08 : CIA-RDP96-00788R001600330004-6