ADDITIONAL FUNDING REQUIRED FOR FINAL SETTLEMENT

• Document Type: CREST
• Collection: NGA Records (Formerly NIMA)
• Document Number (FOIA) /ESDN (CREST): CIA-RDP78B04747A002600010011-1
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: December 28, 2016
• Document Release Date: November 30, 2001
• Sequence Number: 11
• Publication Date: November 15, 1966
• Content Type: FORM

1 UNCLASSIFIED rove ONFI _ ECRET
REQUEST TO PROCUREMENT DIVISION FOR SERVICES
(other than property or building maintenance and repairs)
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INSTRUCTIONS: (1) As appropriate, refer to Contract, Task Order, Proposal Numbers and attach any proposals, speciii
vidence of R & D approval as required by DDCI Memo of 23 December 1963, ER 63-8811.
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Obt
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or Justifications.
Obtain Technical
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ereon or a
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Officer approval or concurrence as appropriate. (3) Include in the narrative portion amplification of particular security requirements and any
delivery or consignee instructions.
ATE OF REQUEST PROCUREMENT DIV. ASSIGNMENT
DATE RECD IN PD.
25X1A
TYPE OF SERVICE REQUESTED
S RESEARCH/DEV. (1) (2) (3) OTHER-SPECIFY (2) (3)
GRANT (1) (2) (3)
REPAIR (3)
MAINTENANCE (3)
MODIFICATION (1) (2) (3)
pp
STERILITY CODE I 10 p'* I 1 I 12 APPLIES
REPAIR OR MAINTENANCE SERVICE HAS Now+ SIGNATURE
DATE
-- -
'.EN SATISFACTORILY COMPLETED
M1t_}tIAL LOCATED OR SERVICES TO BE PERFORMED AT
25X1A
NARRATIVE DESCRIPTION OF SERVICES REQUESTED
M 4ti "k. 1
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25X1 A
N ~4shw is"4i Ys . or
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25X1 A
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Declass Review by NIMA / DoD
ILLEGIB
FORM 2420 UNCLASSIFIED CONFIDENTIAL SECRET
3.66
(specify) (5.12.38)