REQUEST TO PROCUREMENT DIVISION FOR SERVICES

• Document Type: CREST
• Collection: NGA Records (Formerly NIMA)
• Document Number (FOIA) /ESDN (CREST): CIA-RDP78B04770A000700040017-4
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 1
• Document Creation Date: December 28, 2016
• Document Release Date: November 27, 2006
• Sequence Number: 17
• Publication Date: November 21, 1966
• Content Type: FORM

roved /11/27 C - 4770 40017lt I
pp
.~I, 19NCLASSIFIED
CO DENT-L =SECKET- (specify)
REQUEST TO PROCUREMENT DIVISION FOR SERVICES
(other than property or building maintenance and repairs)
INSTRUCTIONS: (1) As appropriate, refer to Contract, Task Order Proposal Numbers and attach any proposals, specifications or justification.
Obtain hereon or attach evidence of R & D approval as required by DDCI Memo of 23 Decembe
1963
ER 63
8811.
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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.
REQUEST NO.
DATE OF REQUEST PROCUREMENT DIV. ASSIGNMENT
DATE RECD IN PD.
.&~."?~
REQUESTING OFFICE APPROVING OFFICER
TYPE OF SERVICE REQUESTED
RESEARCH/DEV. (1) (2) (3) OTHER-SPECIFY (2) (3)
GRANT (1) (2) (3)
REPAIR (3)
MAINTENANCE (3)
MODIFICATION (1) (2) (3)
REPAIR OR MAINTENANCE SERVICE HAS SIGN
BEEN SATISFACTORILY COMPLETED
'ERIAL LOCATED OR SERVICES TO BE PERFORMED AT
-NOW
NARRATIVE DESCRIPTION OF SERVICES REQUESTED
.;~#:}.