U. S. GOVERNMENT PRINTING OFFICE: 1974-531-n9l:l
CLASS"" FDOGWOMeA2=EM=tlalN-RM129R4DO788RO01 20023 027--8
For eftioF ih1n f*rn-q sea AR,3WS; the proponent agency IS the Office* Assistant chief of staff for Inteing.,.. 21 Ja-n 1980
SECTION A - GENERAL
F
TOt

T
o.	F ROMs
ATE RECEIVED	ACTION OFFICE(S)
I -.
i	SUSPENSE DATE(S)
I	REGISTER OR CONTROL No.
CONTROL,LOG
OR FILE NO.	CLASSIFI-
CATION	NUMBER OF
COPIES	-
DESCRIPTION (Type, File Ref., Unlassified Sub)ect
of Short Title @id Number of IndorsementslInclg)	DATE OF
DOCUMENT	ORIGINATOR
DAMA-ZD
1-80	S	1	R-epep4by-Thia-Z It I. Z-j=ANi-E-	Dec79	DAMA-ZD
			Qo-py 1 &i--3-&.-		
SECTION 8 - RIDUTIN-10
T 0	COPY NO.	DATE	PRINTED NAME	SIGNATURE


AS A(RDA)
Dr. Yore	
-T@
0			C/
				
				
				
SECT10M 'C - DESTRUCTION CERTIFICATE (check eppr@prlatc block)
-'
HEREON
@A@l iEEI@-
ERIAL DESCRIBED
E-IDESTROYED E73TORN INIMALF ANDIPLACEDIM A CLASSIFtEDWASTE CONTAINER (AR 38,0-5)
OFFICE SYMBOL	DATE	PRINTED NAME OF CUSTODIAN OR REP. --	St-G-N,A-TURE
DESTRUCTION RECORD No.	DATE	PRINTED NAME OF CERTIFYINGIDIEST-R. OFF.	SI GNAT
PAGE OR COPY NUMBER	DATE	PRINTED NAME OF WITNESSING OFFICIAL	SIGNATURE
SECTION D - REPRODUCTION AUTHORITY
NUI`45ER OF COPIES TO BE REPROD5	THORIXED BY	
SECTION E - RECEIPT/TRACER ACTION (Ch&ck appropriate block)
R

ECF
-IPT OF DOCUMENT(S) ACKNOWLEDGED F1 DOCUMENT(S) HAVE NOT BEEN RECEIVED
'
TRACER ACTION, SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RECEIVED.
TE
[A	PRINTED NAME, (iRADE OR TITLE @	SIGNATURE
OMMENTS
l
0
DA FORM 3964, 1 Nov 72 REPLACES DA FORMS 1203,.l SE P 58: 1204, 1 JAN 60: 631. 1 MAR 62 AND
546, 1 OCT 63, 'WHICH 4, RE BSOLETE.
Approved For Release 2003/09/10 : CIA-RDP96-00788ROO1200230025-8