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HEARNAP — Part 5
Page 633
633 / 905
4+21 (Rev. 2-13-65)
. Serial Removal Charge Out Es @ n®
(<< * <3 Cy hes <2.
Type of Mail . Date of Mail
(_j Report
CJ Incoming letter
(} Outgoing letter
(_) Memorandum
C) Airte}
(_) Teletype
{_} Enclosure (describe? .
beter OE ol pa 7? - f + LLL PYM LS 2
() Personnel Security Questionnaire (PSQ)
Cj Loyalty Form
CC Other (describe)
Removed for Removed by . . Date of Removal
ALSO SLIDE
Reason for Removal 7
(C} For copying (If for another agency, list agency and date of request.}
C) To send to
a (C} To attach to
(CZ For office use
C) For change to another file
Complete File ond Serial Number Ao ee
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