Appilrv'eq For-ft-gie-asli ___ )8 : QIA-RQP96-~ Date ROUTING AND TRANSMITTAL, SLIP 0370003-2 70.e m number, InitialsDate =nj.0AffigCeenScyy"j'PM)roo 2. 4. ion File Note and Return provel For Clearance Per Conversation s Requested For Correction Prepare s Reply I irculate For Your Infomation See ir Me mment Investigate Signature : - l -- "Justify Coordination REMARKS F IM-1 FwL C1w WICKAAH (%JCSA) to t DO NOT use this form as a RECORD of approvals, concurrences, disposals, clearances, and similar actions symb~, Age~ 10ost) Room No--Bift. FROM: (Name, oig. CY Phone No. WI-102 Approved For Rqjqq.5q,?QQQjQP/08 : C1 41 (Rev. 7-76) MR001700370003-2