(Sanitized)

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP83-00036R000500080034-1
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 4
• Document Creation Date: December 12, 2016
• Document Release Date: September 2, 2000
• Sequence Number: 34
• Publication Date: September 7, 1969
• Content Type: FORM

Approved For Release 2001/07/27 : CIA-RDP83-00036R000500080034-1
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