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              D
              ASSIFIED DOCUMENT ACCOUNTABILITY RECORD ATE
              nr
              

              12 May 83
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    Staff for 
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    For uso   
    of 6is    
    form,     
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    380.5-,   
    the proponent
    agency    
    is tho    
    Off;ce,   
    Assistant 
    Chio      
    o         
    V         
              

              SECTION A - GENERAL
              

              FROM:
    To.       
    T         
              

    NSA       
              

    ATE RECEIVEDACTION OFFICE(S~ SUSPENSE DATEIS) REGISTER OR. CONTROL NO.
              

    CONTROL,  CLASSIFI- NUMBER OF DESCRIPTION (rype. Fitt, Ref. (Inclussified
    LOG       Subject DATE OF
              

    OR FILE   CATION COPWS Or Shoyl 7ille and Num6ve (if Indwseinewsl1rids)
    NO.       DOCUMENT ORIGINATOR
              

    CL-038-83 S/NOFOR~ 1 Cy I of 1 cy -Report Cl-1012/8304/08 .....................
    ................. ................. NOTHING FOLLWS ....................................
              

              SECTION 8 - ROUTING
              I ACKN0WL,FL)rlE:
    O         COPY NO. DATE PRINTED NAME ~Tl~A TL~R E
              

              
              

              
              

              
              

              
              

              SECTION C - DESTRUCTION CERTIFICATE (Check appropri(ife block)
    J~1'4 _E'R-1-A6 -ED- -HE' -RF 0'-N -HAS B, E -EN:'
    5--Cp     AGE OR COPY NO
    1-        
              

    DE        STROYFI-) TORN IN HALF AND PLACED IN A CLASSIFIEDWASTE CONTAINER
    '         (AR 380-
              

    6FTZi TyW6&.DATE PRINTED NAME OF CUSTODIAN OR RLP SIGNATURE
              

              --6- ---- -~R~NHD N,~WEi5F"CEHfIFYING/DESrR. OFF SIGNATURE
    R E       C61~ D N6 Aii
              

              ---'FlRli~TED NANiE
    7~4,~~E   jM"B[j EATE OF WITNESSING OFFICIAL. SIGNATURE
    C&;~7'N(  
              

              SECTION D - REPRODUCTION AUTHORITY
    I -EZjFI  C!'7 -f'-jg-f-F~C p p -0D U C CD XUTHORIII ED BY
    jWl~iBbi  
    6F        
              

              SECTION E - RECEIPT/TRACtIlt ACTION (Check appropriate block)
    C']RLfCEIPY-OCUMENT(S) ACKNOWLEDGED DOCUMENT(Sl HAVE NOT BEEN RECEIVED
    Of D      
              

    [._-]TRACERON. SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN
    ACTI      RECEIVED.
              

              F
              FW4~WE6 AME, GRADE OR TfrLE E
    ATi       
              

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