ROUTING AND RECORD SHEET

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP83-01022R000100100019-3
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: December 9, 2016
• Document Release Date: April 11, 2001
• Sequence Number: 19
• Content Type: FORM

~. * Approved For Releas&.A11/05/02: CIA-RDP83- R000100100019-3
^ UN'CLASSFFIED 11 "'USE ONLY 022 COL )ENTIAL
^ SECRET
ROUTING AND RECORD SHEET
SUBJECT: (Optional)
25X1A9a Request for 'IQ" Clearance
FROM: C
EXTENSION
NO.
Chie , Executive ammF ivisio
4-E-42
5961
DATE
TO: (Officer designation, room number, and
building)
DATE
OFFICER'S
COMMENTS (Number each comment to show from whom
25X1A9a
RECEIVED
FORWARDED
INITIALS
to whom. Draw a line across column after each comment.)
1. C / S P & E S
3-E-54
A9
7.
'+?--
8.
9.
10.
11.
12.
13.
14.
15.
FOR
3-62M 610 AppTp ed~r t 200'~ u f95/ ft-010 tlUSE~IQ8 b01Y10ONLY0019- ^ UNCLASSIFIED