Ap q I>%;#* of thi At TO: ~TO NSA TE RECEIVED the propontnt og*ncy is the Offke, AssistiAnt SECTION A - GENERAL ACTION QFFICE(S' SUSPENSE DATE(S I DAT ROO *nce. TREGISTER OR CONTROL NO. CONTROL. LOG CLASSIFI- NUMBER OF DESCRIPTION (Type. Yile Ref. Unclassified Subject DATE OF ORIGINATOR OR FILE NO. CATION COPIES or Short Title and IVui?zbk,t of Indot semenislIncls) DOCUMENT CL-020-83 SMOFM 1 Cy I of 1 cy, Report CL-1001/8303/01 ...................... ........................................... NOTHING FOLLOWS ........................... SECTION B - ROUTING I ACKN TO DAT PRINTED NAME ~-F-C-Opl 1-0 T E 4. SECTION C - DESTRUCTION CERTIFICATE (Check appropriate block) WA-T~-RIZ-6-EEIiiii-F 6-~~ER EON 4Z - --- -- --------- ED DESTROYED El TORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER (AR 7TF-FICE SYMBOL DATE --6- REP SIGNATURE ___JPRINTED NAME OFCUST rTl,~W-05-ii- IDESTRUCTION RE-CORD 6 ]DATE PRINTED NAME OF CERTIFY ING/D EST R, OFF, SIGNATURE PAGE OR COPY NUMBER JDATE PRINTED NAME OF WITNESSING OFFICIAL ISIGNATURE SEC71ON D - *EPRODUCTION AUTHORITY fDAT-E- SIGNATURE PAGE OR COPY N SECTION E - RECEIPT/TRACER ACTION (Check appropriate block) [:]RECEIPT OF DOCUMENT(S) ACKNOWLEDGED DOCUMENT(S~ HAVE NOT BEEN RECEIVED 0TRACER ACTION: SIGNED RECEIPT FOR -MATERIAL DESCRIBED ABOVEHAS NOT BEEN RECEIVED. ---'[PRI~TE6 ~AME,'GRADE OR TITLE SIGNATURE D A FORM 3W, 1 Jul 79 EDITION OF 1 NOV 72 IS OBSOLETE. *U.S.GPO:198G-0-31%-M9 2-000[0910T."'C"T.K.R -T, r a ea(sd,' '7 - 7-*