V U.S. GOVERNMENT PRINTING QVIFICE. 1974 - 5!i8 - 057 For use of th MOO&W"64*60%6-00788RO I f so* AN 380-5; the proponent agency is the Office, Aist lant Chief of Sfaff for Intelligence. SECTION A - GENERAL TO: ROM: ITAC DATE RECEIVED ACTION OFFICE(S) SUSPE N SE DAT E (S) IREGISTER OR CONTROL NO, CONTROL. LOG CLASSIFI- NUMBER OF DESCRIPTION I, 7'yl)c. P'ilc Rcl, Lhiclassifted Subji-et DATE OF OR FILE NO. CATION COPIES ot Shw-t 'Tillecirid Number of butorsemcnislIncls) DOCUMENT ORIGINATOR GF-010-82 S/NOF(RN I Cy 2 of 2 cys Session 855 on TGT 8123 ....................... ....... 0 .......... 0---NOTHING FOLLOWS.... .......... SECTION 6 - ROUTING TO COPY No, DATE PRINTED NAME SIGNATURE 2. SECTION C - DESTRUCTION CERTIFICATE (Check appropriate block) MATERIAL DESCRIBED HEREON HAS BEEN: El DESTROYED El TORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER (AR 380 .1) T)FFICE SYMBOL DATE PRINTED NAME OF CUSTODIAN OR REi3 SIGNATURE DESTRUCTION RECORD 0. DATE I NTEb NAM E OF C E PT I FY ING/D EST R. OFF. SIGNATURE PAGE OR COPY NUMBER DATE PRINTED NAME OF WITNESSING OFFICIAL SIGNATURE SECTION D - REPRODUCTION AUTHORITY NUMBER OF COPIES TO BE REPRODUCED ]AUTFIORIZCD 13Y SECTION E - RECEIPT/TRACER ACTION (Chcck (ilipr,q)) rale b(ock) [JRECEIPT OF DOCUMENT(S) ACKNO)WLEOGED DOCUMEN r(S HAVE NOT BEEN RECEIVED OTRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT OEEN RECEIVED. DATE PRINTED NAME. GRADE OR TITLE SIGNArURE MMENTS DA FORM 3964, 1 Nov 72 REPLACES VA FORMS 1203~ 1 SEP 50 1204. 1 JAN 60; 631. 1 MAR 62 AND Approved For Rblmd cg'(e' CIA-RDP96-00788ROO0700030002-1