SIGNATURE RECORD AND COVER SHEET

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP62S00231A000100220005-5
• Release Decision: RIFPUB
• Original Classification: T
• Document Page Count: 1
• Document Creation Date: November 9, 2016
• Document Release Date: January 11, 1999
• Sequence Number: 5
• Content Type: FORM

SIGNATURE RECORD AND COVER SHEET
DOCUMENT DESCRIPTION
Jr
REGISTRY
SOURCE
-
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- C I A CONTROL NO.
DOC. C.N.
DATE DOCUMENT RECEIVED
DOC. DATE
COPY
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It
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LOGGED BY
UMBER
OF PAGES
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NUMBER OF ATTACHMENTS
ATTENTION: This form will be placed on fop of and attached to each Top Secret document received by the Central Intel-
ligence Agency or classified Top Secret within the CIA and will remain attached to the document until si.ch time as it
is downgraded, destroyed, or transmitted outside of CIA. Access to Top Secret matter is limited to Tot) 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
5IGNATURt
DATE
TIME
DATE
TIME
SIGNATURE AND OFFICE
DATE
NOTICE OF DETACNMEN1: When
spaces below and transmitted
this form is detached from Top Secret material it shall be completed in the appropriate
to Central Top Secret Control for record.
DOWNGRADED
DESTROYED
DISPATCHED (OUTSIDE CIA)
TO ?..
I
BY (Signature)
TO
BY (Signature)
WITNESSED BY (Signature)
BY (Signature)
DATE
DATE.
OFFICE DATE