SIGNATURE RECORD AND COVER SHEET

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP59-00882R000100280029-7
• Release Decision: RIPPUB
• Original Classification: T
• Document Page Count: 1
• Document Creation Date: December 12, 2016
• Document Release Date: February 19, 2002
• Sequence Number: 29
• Publication Date: July 22, 1955
• Content Type: FORM

SIGNATURE RECORD AND COVER SHEET
DATE DOC EN RECEIVED
22
ATTENTION: This form will be att Fhed to each Top Secret document received by the Central Intelligence Agency or classified Top Secret
wFim the CIA and will remain attached to the document until such time as it is downgraded, destroyed, or transmitted outside of
CIA Access t4_,Top Secret material is limited to those individuals whose official duties relate to the material. Each alternate or assist-
ant g ecret_Con_trglOffi _w axeceives and/or releases the attached Top Secret material will sign this form and indicate period of
y ill the left-hand columns nrovided_ The name of , a t, i di
id
____
i ...~ h
v
e
as
SEEN BY
NAME AND OFFICE SYMBOL
KOIlcE-OF DETACHMENT When his form is_deta_ched from Top Secret material it shall be completed in the appropriate spaces below and
_ EFEAi TO
THE TOP SECRET MATERIAL DETACHED FROM THIS FORA~_b1AS; BY (Signature
Approved For Release 2002/05/06 : CIA-RDP59-00882R000100280029-7