CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001900140002-6
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: December 4, 1998
• Sequence Number: 2
• Publication Date: May 3, 1983
• Content Type: FORM

CLASSIFIED DOCUMEN CC N ABiL rV DEFRRD DA B"
For use of this form. see AR 3W5, the proponent agency is the Office, Assistant Chief of Staff for Intelligence. 1933
CONTROL. LOG
OR FILE NO.
~_ 11 DESTROYED
(OFFICE_SYMBOL
_ EJ TORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER (AR 380-ill
DATE - PRINTED NAME OF CUSTODIAN OR REP SIGNATURE
SECTION D - REPRODUCTION AUTHORITY
AUTHORIZED BY
SECTION E - RECEIPT/TRACER ACTION (Check appropriate block)
JEJRECEIPT OF DOCUMENT(S), ACKNOWLEDGED L~ DOCUMENTISI HAVE NOT BEEN RECEIVED
DTRACER ACTION. SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED.
GATE iPRINTED NAME, GRADE OR TITLE 1SIGNATURE
CLASSIFI-
CATION
/NOFDRN
SECTION A -GENERAL
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NUMBER OF
COPIES
DESCRIPTION (Type. File Ref., Unclassified Subject
or Short Title and Number of Indorsements/Incls)
Cy 1 of 1 cy Report CL-1006/8305/01...
.........NDTHINC FOLLOWS ..............
DATE OF
DOCUMENT
SIGNATURE