CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD

CIA-STARGATE

PDF Scan: PDF

Open AI Summary

This document is a classified record pertaining to the accountability of a document received by the Office of the Assistant Chief of Staff for Intelligence. The form includes information about the originator, date of the document, routing information, destruction certificate, and reproduction authority. The document is described as unclassified and the number of copies is not specified. The form also includes a section for receipt/tracer action, indicating whether the document has been received or not. The document bears the approval for release by the CIA on August 8, 2000.

Text

Body:  CLASSIFIED DOCUMENT ACCOUNTABILITY RECORD
 DATE
 For use of this form, see AR 3180-5., %e prop .anent agency it the Office, Assistant Chief of Staff for Intelligence.
 SECTION A - GENERAL
 TO:
 `
 FROM
 l
 f
 /
 "
 ~rb'/ +  j? i,~       /
 (Y
 .~
 f  WI
 >
 a
 / Iv
 Gf
 C.
 DATE RECEIVED
 ACTION OFFICE(S)
 SUSPENSE DATE(
 REGISTER OR CONTROL  NO.
 CONTROL. LOG
 OR FILE NO.
 CLASSIFI-
 CATION
 NUMBER OF
 COPIES
 DESCRIPTION I Type. File Ref. Unclassified Subject
 or Short Title and Number of Indorsements/fncls)
 DATE OF
 DOCUMENT
 ORIGINATOR
 SWF f n -
 17r                                                        r:77mi
 r                                                                 ~
 f'
 a o ta.L-*
 /
 v~E~'  mar  C~i
 /
 111114
 wsfl v47)vat           /L/>ff ~/   w  ~J
 / f
 -
 'l~llq~Gt1S
 SECTION 8 B. ROUTING
 1 ACKNOWLEDGE RECEIPT OF TH MATERIAL OESCRISED HEREON
 TO
 COPY NO.
 DATE
 PRINTED NAME
 SIGNATURE
 I.
 2.
 3.
 4.
 S.
 SECTION C C. DESTRUCTION CERTIFICATE  (Check appropriate block)
 MATERIAL DESCRIBED HEREON HAS BEEN:
 1
 PAGE OR COPY NO
 0 DESTROYED                                  0 TORN IN HALF AND PLACED IN A CLASSIFIED WASTE CONTAINER (AR 380-5)
 OFFICE SYMBOL
 DATE
 PRINTED NAME OF CUSTODIAN OR REP
 SIGNATURE
 DESTRUCTION RECORD NO.
 DATE
 PRINTED NAME OF CERTIFYING/DESTR. OFF.
 SIGNATURE
 PAGE OR COPY NUMBER
 DATE
 PRINTED NAME OF WITNESSING OFFICIAL
 SIGNATURE
 SECTION D - REPRODUCTION AUTHORITY
 NUMBER OF COPIES TO BE REPRODUCED;
 AUTHORIZED BY
 DATE            SG 1 J
 SECTION E - RECEIPT/TRACER ACTION (Check appropriate block)
 RECEIPT OF DOCUMENT(S) ACKNOWLEDGED                                       Q DOCUMENT(S) HAVE NOT BEEN RECEIVED
 [!)TRACER ACTION: SIGNED RE
 COMMENTS
 Approved For Release 2000/08/08 : CIA-RDP96-00789R002100270007-3
 DA FORM r?Y    or  a ease            ,zI              0?400270007-3  U.S. G.P.O.  1986-162-374