CONTROL AND COVER SHEET FOR TOP SECRET DOCUMENT

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP70-00241R000200090068-2
• Release Decision: RIFPUB
• Original Classification: T
• Document Page Count: 1
• Document Creation Date: November 17, 2016
• Document Release Date: June 20, 2000
• Sequence Number: 68
• Publication Date: April 12, 1956
• Content Type: FORM

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UNCLASSIFIED when blank ~'1OP SECRET when attached to Top Secret Document - Auromatically downgraded or
declassified when filled in form is detached from the controlled document.
CONTROL AND COVER SHEET FOR TOP SECRET DOCUMENT (COLLATERAL)
CIA T.S. CONTROL NUMBER __jCIA COPY NUMBER DOCUMENT DATE DATE RECEIVED
as
NO. PAGES NO. O ATTACHMENTS (CIA T.S. # of Attachment) BRANCH, BADGE #, LOCATION LOGGED BY
SUBJECT:
CIA SOURCE INFORMATION
ORIGINATOR
EXTERNAL SOURCE INFORMATION
ORIGINATOR
DIRECTORATE
OFFICE/BRANCH
AGENCY
CONTROL NUMBER COPY NO.
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
When this form is detached from Top Secret material it shall be completed in the appropriate spaces below and forwarded to the Agency Top
Secret Control Office.
DOWNGRADED
DESTROYED
DISPATCHED (Outside CIA)
TO
BY (Signature)
TO
BY (Signature)
WITNESSED BY (Signature)
BY (Signature)
DIRECTORATE & AREA OFFICE
DIRECTORATE & AREA OFFICE
DIRECTORATE & AREA OFFICE
DATE
DATE
DATE
FORM OBSOLETE PREVIOUS (40)
8-82 26 EDITIONSApproved For Release -RDP70-00241 R000200090068-2