(UNTITLED)

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP82-00490R000100020042-9
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: December 12, 2016
• Document Release Date: May 28, 2002
• Sequence Number: 42
• Content Type: MISC

Approved For Relea~2002/06/14: CIA-RDP82-004908000-020042-9
rT I am still available /~ I am no longer available
~?
(Note: If you are available for an occasional odd ,job but not for fu11
time duty ir. a national emergency so states or vice versa),
A'Iy current address is;
Telephone TTumber;
T~?y current employment affiliation is;
t~ duties consist of:
Z~fiy ctsrent military reserve affilie ion is; Service
Unit
Location
I }lave attained the following additional skills;
Signature;
Hate;
Txhibit B (Neck)
Approved For Release 2002/06/14: CIA-RDP82-004908000100020042-9