CONTROL AND COVER SHEET FOR TOP SECRET DOCUMENT

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP33-02415A000300110017-7
• Release Decision: RIPPUB
• Original Classification: T
• Document Page Count: 1
• Document Creation Date: November 17, 2016
• Document Release Date: January 5, 1999
• Sequence Number: 17
• Publication Date: April 17, 1964
• Content Type: FORM

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CONTROL AND COVER SHEET FOR TOP SECRET DOCUMENT
DOCUMENT DESCRIPTION
REGISTRY
SOURCE 25X1
6b
CIA CONTROL NO.
DOC. NO.
DATE DOCUMENT RCEIVED
DOC. DATE
30 A= 64
37
COPY NO.
LOGGED BY
NUMBER OF PAGES
NUMBER OF ATTACHMENTS
.- _ tv? J
ATTENTION: This form will be placed on top of and 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 document until such time as it is downgraded, destroyed, or
transmitted outside of CIA. Access to Top Secret matter is limited to Top Secret Control personnel and those individuals whose official
duties relate to the matter. Top Secret Control Officers who receive and/or release the attached Top Secret material will sign this form
and indicate period of custody in the left-hand columns provided. Each individual who sees the Top Secret document will sign and
indicate the date of handling in the right-hand columns.
REFERRED TO
RECEIVED
RELEASED
SEEN BY
OFFICE.
SIGNATURE
DATE
TIME
DATE
TIME
SIGNATURE
OFFICE/DIV.
DATE
30 A
PR 191
34
. DM
25X1A9a
NOTICE OF DETACHMENT: When this form is detached from Top Secret material it shall be completed in the appropriate spaces below
and transmitted to Central Top Secret Control for record.
DOWNGRADED
DESTROYED
DISPATCHED (OUTSIDE CIA)
TO
BY (Signature)
TO
BY (Signature)
WITNESSED BY (Signature)
BY (Signature)
4
OFFICE Approved F
Welease
r
d~ rd1(8/21 : CIA-R033 -02415
000300110017-7
DATE
FORM
A C USE PREVIOUS EDITIONS.
9-60 LV