For vr* of th;s form, see At 380.5; the proponent agency is the Office, Assistant Chief of Staff for
    SECTION A - GENERAL
    01
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    CONTROL. LOG CLASSIFF NUMBER OF DESCRIPTION f Type. File Ret. Unclassified Subject DATE OF
    OR FILE NO, CATION COPIES Or Shm-( Tale and Number of IndorsementslInds) DOCUMENT ORIGINATOR
    CL-060-83 S/NOFORq 1 y 1 of 1 cy, Report IIIJ-1035/8306/0_1 .......................
    ........... ........ ........ ............ NOTHING FOLLOWS ...........
                            SECTION 8 - ROUTING
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    TO COPY NO DAT E
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    4. --------
    SECTION C - DESTRUCTION CERTIF ICATE
       MA'fERIAL DESCRIBED HEREON HAS BEEN GE OR COPY N
    DESTROYED I OIRN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER 3,90
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    SYMBOL DATE TOD~AN OR REP
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    '-',,'GL OPq COPY NUMBER DATE PRINTED NAME OF WITNESSING Of FICIAL
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    SECTION D - REPRODUCTION AUTHORITY
                    I J M' ' 'H-r- ' R- -ii-F, -C -0-P -1E 5-F- -R- -E-P -R-C) 676-6 i -15 Ti U~ H 6~ JD -'AT'E--'-
    SECTION E - REMPT/TRACER ACTION (Cheek appropriate Work)
         ["]RECEIPT Ot- L)OCUMENT(S) ACKNOWLEDGED GOCUMFNT(S) HAVE NOT DLEN RECEIVED
    VRACFR ACTION. SIGNED RECEIPT FOR MATERIAL DESCRIBED ABOVE HAS NOT BEEN RE-CEIVED.
    DATE I
    TED NAME, GRADE OR TITLE SIGNATURE
    D A FORM 3%4, 1 Jul 79 EDITION OF 1 NOV 72 IS OBSOLETE. U. S.GPOA 900-0-3194M 7-7
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