WA 'A 4~ k % --AbP-96.00788 ROO 190 3,000-4- roved For Release 2000/08/08 C 0`3 App lA- CLASSIM -D&~MENf -ACCOWNU Y- -RE-d-0-R-D- DME For us* cj4 this form, too Aft 3M5; fho prop"ent agency is the Office, Assittant Chief of Stuff for Antviligance. SECTION A - GENERAL To- ATF RECEIVED ACTION SUSPENSE DATE(s) REGISTER QFFICE(Si OR CONTROL NO. ] .. CONTPOL,CLASSfFI-NUMBEROF DESCRIPTION (Type. File Ref.DATE LOG (bichysstfred St, bjerf OF ORIGINATOR OR FILE CATION COPIES ot'Shwl Taleand Number of DOCUMENT NO. IndoosentertalInds) L-062-83S/NOF"OF?t I Cy of I cyt Report IIIJ-1040/8310/08................... -1, .. . ....... .. ........ ................... a I ....... NOTHINC FOLLOWS ....... SECTION 6 - ROLITING TO Y NO~ ATE I~i so TURE SECTION C - 0 ESTRUCTION CERTIFICATE (Check appropriate j~~iiiiiWL 66i~~16~6 nFSTHOVrED TORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER DATE PRINTED NAME OF CUSTODIAN OR REP SIGNATURE BA-TE" FRINT~6V~Ai;ii6r '~5GNAfL RE PAGE OR COPY NIJMB~R DATE PRINTED NAME OF WITNESSING OFFICIAL SIGNATURE TO BE REPRODUCED SECTION 0 -, REP*OUUCTION AUTHORITY TE PAGE OR COPY N SECTION E - ItECEIPT/TRACER ACTION (Check appropriale 61ock) [JRLCEIPT CF O.)CUMENT(S) ACKNOWLEDGED DOCUMENT(SO HAVE NOT BEEN RECEIVED EITRACER ACTION: SIGNED RECEIPT FOR MATERIAL DESCRIBED A13OVE HAS NOT BEEN RECEIVED, '-i ZNATU~E Approved For Release 2000108108 : CIA-RDP96-00788ROO1900330003-4 )A FOHM 3%4, 1 Jul 79 EDITION OF I NOV 72 IS OBSOLETE.