SIGNATURE RECORD AND COVER SHEET

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP83-00764R000100080008-6
• Release Decision: RIPPUB
• Original Classification: T
• Document Page Count: 1
• Document Creation Date: December 9, 2016
• Document Release Date: September 27, 2000
• Sequence Number: 8
• Publication Date: December 17, 1948
• Content Type: FORM

Approved For Rejoase 20 764RQD.0100080008-6
SIGNATURE RECORD AND COVER SHEET
DOCUMENT DESCRIPTION
REGISTRY
SOURCE: d7voc'_~
DATE OF DOCUMENT: / Ste: I
COPY NUMBER (S): r .S
NUMBER OF PAGES: / DOCUMENT NO.
NUMBER OF ATTACHMENTS:
CIA CONTROL NUMBER: a37?'
DATE DOCUMENT RECEIVED:
LOGGED BY:
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 OFFICIAL DUTIES 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 INDI-
CATE PERIOD OF CUSTODY IN THE LEFT-HAND COLUMNS PROVIDED. THE NAME OF EACH INDIVIDUAL WHO HAS SEEN THE TOP
SECRET DOCUMENT AND THE DATE OF HANDLING SHOULD BE INDICATED IN THE RIGHT-HAND COLUMNS.
REFERRED TO
RECEIVED
RELEASED
SEEN 13Y
OFFICE
SIGNATURE
DATE
TIME
DATE
TIME
NAME & OFFICE SYMBOL
DATE
25X1A9a
WNW
NOTIC
E OF DETACH
MENT
WHEN THIS FORM IS DETACHED FROM TOP SECRET MATERIAL IT WILL BE COMPLETED III THE APPROPRI-
ATE SPACES BELOW AND TRANSMITTED TO CENTRAL TOP SECRET CONTROL FOR RECORD.
The Top Secret material detached from this form was:
DOWNGRADED BY:
DESTROYED (SIGNATURE)
DISPATCHED (OUTSIDE CIA) TO:
(OFFICEI (DATE)
Approved For Release - 00764R000100080008-6
FORM NO.
APR 1948 38 13 PREVIOUS EDITIONS NOT TO BE USED