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HEARNAP — Part 3
Page 431
431 / 877
~ ©
Sertal Removal Charge Out : 4 -
4621 (Rev. 2-13-65) (EX ie) Gg |
INSTRUCTIONS: hia form is to be removed from file by a Filing Unit cmployee only upon the return of the item. :
Subject
Cc ihcoMng letter
oO Outgoing letter eee a
(~) Memorandum a ee
CO Airtel eee $e
C_] Teletype TT -
(7) Enctosure {describe} eee
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# Leboratory Work Sheet ° ~~~
| Para Personnel ‘Security Questionnaire {(PSsQ)
CI Lovalty Form >
.[_) Other fdescribe)
Date of Removal
Reason for Removal _ . ,
(2 For copying (if for another agency, list agency and date of request.)
CJ To send to
CO To attach to
(3 For office use
SID ener eres We
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([j For change to another file
- : - : . °
Complete File and Seriat Number
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