REQUEST TO PROCUREMENT DIVISION FOR SERVICES

• Document Type: CREST
• Collection: NGA Records (Formerly NIMA)
• Document Number (FOIA) /ESDN (CREST): CIA-RDP78B04747A000400040026-6
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 4
• Document Creation Date: December 28, 2016
• Document Release Date: February 6, 2001
• Sequence Number: 26
• Publication Date: February 16, 1967
• Content Type: FORM

CONFIDENTIAL C7 SECRET
UNCLASSIFIED
I ~
TYPE OF SERVICE REQUESTED
RESEARCH/DEV.(1) (2) (3)I OTHER-SPECIFY (2) (3)
GRANT (1) (2) (3) 1
proposals, specifications or gud~zJ-
k Order Proposal Numbers and attach b any u ?~??
Obtain
3
ID6
s
b
(
a
er
roval as required by DDCI Memo of 23 Decem
particular security
INS T RUCTIONS: (1) As appropriate, refer to Contract, a
i
re
and any D Obtain hereon or attach evidcnceQoanarov ate p (3) Include in the narrative portion amplification of p
-1-11-11 1
C icer approaal v. ~., - s
delivery or consignee Instructions. DATE RECD IN PD.
I DATE OF REQUE8T I PROCUREMENT DIV. ASSIGNMENT
^rvwn
_-
16 Feb 67 65-20364 - -_
55-8512-65 (A-2) OFFICE I
G
I
REPAIR (3)
(other than property or building main ena
7 r f T' ~~~c~~~r/
t nee and repairs)
I MAINTENANCE (3)
MODIFICATION (1 )
REPAIR OR MAINTENANCE SERVICE HAS
BEEN SATISFACTORILY COMPLETED
2 APPLIES
REQUESTIN
NPIC
TELEPHONE
25X1 A 2623
I CERTIFY THAT FUNDS, ESTIMATED AMOUNT 0155-4100
ARE AVAILABLE. CHARGE TO FAN DATE '~FY1 A
SIGNATURE OF BUDGET OFFICER
DATE,
AERIAL LOCATED OR SERVICES TO BE PERFORMED A.
,TT
NARRATIVE DESCRIPTION OF SERVICES REQUESTED
25X1A 25X1A
Amend for one s ecific Format Chip
as follows:
Printer to cover an overrun of 64 F nds (55-2778-64 (A-1)
25X1A
25X1 A.
Fiscal Year 19 Fiscal Year 1965 Funds
Declass Review by
izy0 Approved by DD/I on 16 February 1967 NIMA/DOD
FORM 7420 r] UNCLASSIFIED
CONFIDE
 Approved For Release 2001/03/06 : CIA-RDP78BO4747A00040004Q
55-2778-64 (A-1) 16 Feb 67 64-6152 25X1A
25X1A
25X1A
25X1A
Amend r a specific Format Chip Printer
to cover overrun of for
as follows:
cal Year 1964 Funds
Fiscal Year 1965 Funds (55-8512-65 A-1)
25X1A
R&D Approved by DD/I on 16 February 1967
Approved For Releass2001/03/06 : CIA-RDP78BO4747A000400040026-6
 Approved For Release 2001/03/06 : CIA-RDP78B04l47A00040004a2
11
55-8512-65 (A-2) 16 Feb 67 65-20364 25X1A 13 July 1964
25X1A
25X1A
Amend for one s.ecific Format Chip
Printer to cover an overrun of as follows:
25X1A Fiscal Year 1964 Funds (55-2778-64 (A-1)
Fiscal Year 1965 Funds
25X1A
R*D Approved by DD/I on 16 February 1967
Approved For Releasxe 2001/03/06 : CIA-RDP78BO4747A000400040026-6
 25X1A
Approved For Release 2001/03/06 : CIA-RDP78BO4747A000400040026-6
Approved For Release 2001/03/06 : CIA-RDP78BO4747A000400040026-6