SIGNATURE RECORD AND COVER SHEET

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP33-02415A000200350060-4
• Release Decision: RIPPUB
• Original Classification: T
• Document Page Count: 1
• Document Creation Date: December 12, 2016
• Document Release Date: October 7, 1998
• Sequence Number: 60
• Publication Date: January 13, 1956
• Content Type: FORM

~::e SIGNATURE CARD AND. CO R SHEET
"
DOCUMENT DESCRIPTION
RE
GISTRY
SOURCE
CIA CONTROL NO.
-I,?OC, NO. `S - 14 -f. ?5
DATE DOCUMENT RECEIVED
DOC. DATE I
COPY NO.
LOGGED BY
NUMBER OF PAGES
T
NUMBER F ATTACHMEN
S
ATTENTION: This form will be attached to each Top Secret document received by the Central Intelligence Agency or classified Top Secret
within the CIA and will remain attached to the docume until such time as it is downgraded, destroyed, or transmitted outside of
CIA. Access to Top-Secret material is limited to those in}viduals vLlLose oicial dyties relate to -theematerial Each alternate or assist-
tnt Top Secret Control Officer who receives and/or releases, the attached Top Secret material will sign this form and indicate period of
custody in the left-hand columns provided. The name of each individual who has seen the Top Secret document and the date of han-
clling should be indicated in the right-hand columns.
REFERRED TO
RECEIVED
RELEASED
SEEN BY
OFFICE
SIGNATURE
DATE
TIME
DATE
TIME
NAME AND OFFICE SYMBOL
DATE
I3 1
NOTICE OF DETACHME hen th oalt is detachp&frorn op Secret material it shall be completed in the appropriate spaces below and
transmitted to Central Top Secre Control for record.
THE TOP SECRET MATERIAL DETACHED FROM ~TFUS "R
IIOWNGRADED .
DESTROYED
DISPATCHED (OUTSIDE CIA)TO
A tovlect Fac Release 21/09 : CIA' ?P3 f-02 .
OFFICE
O00200350060-
DATE