SIGNATURE RECORD AND COVER SHEET

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP59-00882R000100070022-7
• Release Decision: RIPPUB
• Original Classification: T
• Document Page Count: 1
• Document Creation Date: December 14, 2016
• Document Release Date: February 19, 2002
• Sequence Number: 22
• Publication Date: November 4, 1953
• Content Type: FORM

SIGNATURE RECORD AND COVER SHEET
DOCUMENT DESCRIPTION
REGISTRY
SOURCE
CIA CONTROL NO. 1 ++''
DOC. No.
DATE DOC. RECD.
Date
DOC
.
Copy NO.
LOGGED BY
of Pages `
No
.
NO. OF ATTACHMENTS
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 DOCUMENT UNTIL SUCH TIME AS IT IS DOWNGRADED.
DESTROYED OR TRANSMITTED OUTSIDE OF CIA. ACCESS TO TOP SECRET MATERIAL IS LIMITED TO THOSE INDIVIDUALS WHOSE OF-
FICIAL DUTIES RELATE TO THE MATERIAL. EACH ALTERNATE OR ASSISTANT 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 COL-
UMNS PROVIDED. THE NAME OF EACH INDIVIDUAL WHO HAS SEEN THE TOP SECRET DOCUMENT AND THE DATE OF HANDLING SHOULD
INDICATED
REFERRED TO
RECEIVED
RELEASED
SEEN BY
OFFICE
SIGNATURE
DATE
TIME
DATE
TIME
NAME & OFFICE SYMBOL
DATE
S
25X1 A