PERSONNEL ACTION REQUEST

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP57-00384R001300140001-4
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: December 22, 2016
• Document Release Date: March 24, 2010
• Sequence Number: 1
• Publication Date: December 11, 1951
• Content Type: FORM

Sanitized Copy Approved for Release 2010/03/24: CIA-RDP57-00384R001300140001-4
REGISTER NO.
PERSONNEL ACTION REQUEST
STATOTHR
NAME REQUESTED EFFECTIVE DATE
NATURE WHEN LEAVING (VOUCH RED)
25 YEAR RE-REVIEW
LAST WORKING DAY:
EMPLOYEE'S SIGNATURE:
FROM
TO
TITLE
y t {a atLc~.
GRADE AND SALARY
tgyyyy~~,,~.y,
OFFICE
-~ --- -_-_-
y,yYa gray
jFYAillri~i
DIVISION --
BRANCH AND SECTION
OFFICIAL STATION
DEPARTMENTAL ^ FIELD El
DEPARTMENTAL
^
FIELD
REMARKS:
bo d t O
RECOMMENDED:
~: R! 1
(DATE) (SIGNATURE OF OFFICE CHIEF, DIVISION CHIEF OR ADM. OFFICER)
FOR USE OF PERSONNEL ONLY
PLACEMENT
TRANSACTIONS AND RECORDS
DATE QUALIFICATIONS APPROVED
APPROPRIATION:
ALLOTMENT:
CLEARANCE REQUESTED
CLEARANCE APPROVED
C. S. C. AUTHORITY:
DATE
TYPE
DATE
TYPE
DATE SIGNATURE
SIGNATURE
DATE
SIGNATURE
PERSONNEL RELATIONS
CLASSIFICATION
DATE
SIGNATURE
BUREAU NO. C. S. C. NO. DATE APPROVED
APPROVALS
^ SUBJECT TO SECURITY CLEARANCE
NEW
VICE
I. A.
REAL
DATE
SIGNATURE OF EXECUTIVE
DATE
SIGNATURE
DATE
SIGNATURE OF DIVISION CHIEF
EFFECTIVE DATE
JULN195No' 0 37-3
Sanitized Copy Approved for Release 2010/03/24: CIA-RDP57-00384R001300140001-4