CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001900130002-7
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: April 11, 2000
• Sequence Number: 2
• Publication Date: May 3, 1983
• Content Type: FORM

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For eve of this fort , see AR 3 0 S; the proponent agency is the Office, Assistant Chief of Staff for Intelligence.
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SECTION A - GENERAL
TO..-.--_
ACSI
FROM:
DATE RECEIVED
ACTION OFFICE(S1
SUSPENSE DATE(SI -- -
REGISTER OR CONTROL NO.
CONTROL. LOG
OR FILE NO.
CLASSIFI-
CATION
NUMBER OF
COPIES
DESCRIPTION (Type. File Ref. Unclassified Subject
or Short Title and Number of Indorsements/Incls)
DATE OF
DOCUMENT
ORIGINATOR
CL-024-83
..........
5/NOFOR
......
1
......
Cy 1 of 1 cy Report C1-1005/8305/01 ....
............NOTHING FOLLOWS...........
........
........
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...........
SECTION B - ROUTING
ACKNOWLEDGE RECEIPT OF TML
MAT ER ITC E9-ZFIBED HEFTt EZ1W
TO
COPY NO.
DATE
PRINTED NAME
SIGNATURE
2.
3.
,A.
SECTION C - DESTRUCTION CERTIFICATE (Check appropoate block)
MATERIAL DESCRIBED HEREON HAS BEEN: PAGE OR COPY NO
U DESTROYED O 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
tM
SIGNATURE
SECTION 0-- REPRODUCTION AUTHORITY
e CO TO BE REPRODUCED
NUMBER OF COP RES ~_._~.~~
AUTHORIZED BY DATE
,u,_. .A. _ .,.~. _ r_,.._._....... -o
SECTION E - RECEIPT/TRACER ACTION (Check appropriate block)
a RECEIPT OF DOCUMENT(SI ACKNOWLEDGED DOCUMENT(S) HAVE NOT BEEN RECEIVED
OTRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED.
D ATE PRINTED NAME, GRADE OR TITLE SIGNATURE
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