(UNTITLED)

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP81B00879R001100030126-2
• Release Decision: RIFPUB
• Original Classification: S
• Document Page Count: 2
• Document Creation Date: December 9, 2016
• Document Release Date: July 25, 2000
• Sequence Number: 126
• Content Type: FORM

THIS DOCUMENT REQUIRES SPECIAL HANDLING
THIS DOCUMENT CONTAINS INFORMATION REGARDING A HIGHLY CLASSIFIED
ACTIVITY. PERMISSION TO TRANSFER CUSTODY,, OR PERMIT ACCESS TO
THIS DOCUMENT MUST BE OBTAINED FROM THE ORIGINATOR. HAND CARRY
PROCEDURES WILL BE APPLIED TO ANY INTER-OFFICE OR INTRA-AGENCY
MOVEMENT OF THIS DOCUMENT.
REFERRED TO
RECEIVED
RELEASED
SEEN BY
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SIGNATURE
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TIME
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TIME
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 THIS DOCUMENT CONTAINS INFORMATION REGARDING A HIGHLY CLASSIFIED
ACTIVITY. PERMISSION TO TRANSFER CUSTODY, OR PERMIT ACCESS TO
THIS DOCUMENT MUST BE OBTAINED FROM THE ORIGINATOR. HAND CARRY
PROCEDURES WILL BE APPLIED TO ANY INTER-OFFICE OR INTRA-AGENCY
MOVEMENT OF THIS DOCUMENT.
REFERRED YO
RECEIVED
RELEASED
SEEN;BY
OFFICE
SIGNATURE
DATE
TIME
DATE
TIME
NAME AND OFFICE SYMBOL
DATE
FIN/DPD