SIGNATURE RECORD AND COVER SHEET

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP79B00970A000100010045-3
• Release Decision: RIPPUB
• Original Classification: T
• Document Page Count: 1
• Document Creation Date: December 12, 2016
• Document Release Date: July 31, 1998
• Sequence Number: 45
• Publication Date: October 20, 1953
• Content Type: FORM

SIGNATURE RECORD AND COVER SHEET
DOCUMENT DESCRIPTION
REGISTRY
SOURCE
25X1A9a
CIA CONTROL NO.
? 77, '
DOC. No.
DATE DOC. RE:C'D.
Doc. Date
Copy No.
LOGGED BY
NO. of Pages
25X1A9a
NO. OF ATTACHMENTS
ATTENTION: THIS FORM WILL BE 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 MATERIAL IS LIMITED TO THOSE INDIVIDUALS WHOSE OF-
FICIAL DIRTIES RELATE TO THE MATERIAL. EACH ALTERNATE OR ASSISTANT TOP SECRET CONTROL OFFICER WHO RECEIVES AND/OR
RELEASES THE ATTACHED TOP SECRET MATERIAL WILL SIGN THIS FORM AND INDICATE PERIOD OF CUSTODY IN THE LEFT-HAND COL-
UMNS PROVIDED. THE NAME OF EACH INDIVIDUAL WHO HAS SEEN THE TOP SECRET DOCUMENT AND THE DATE OF HANDLING SHOULD
REFERRED TO
RECEIVED
REL
EASED
SEEN 01'
OFFICE
SIGNATURE
DATE
TIME
DATE
TIME
NAME & OFFICE SYMBOL.
DATE
20
Got
=0
25X1A9a
NOTICE OF DETACHMENT: WHEN THIS FORM IS DETACHED FROM TOP SECRET MATERIAL IT SHALL BE COMPLETED IN THE APPROPRIATE
SPACES BELOW AND TRANSMITTED TO CENTRAL TOP SECRET CONTROL FOR
THE TOP SECRET 14ATERIAL DETACHED FROM THIS FORM WASo
BY (SIGNATURE)
DOWNGRADED
DESTROYED
DISPATCHED (OUTSIDE CIA) TO
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OFFICE
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DATE
- _ ___j
Approved For Release 2001/08/0$Ti QT9B00970A000100010045-3
FORM NO.
JAN 1950 98-19 T