◆ SpookStack

~ ; : . 4-21 {Rev. 2-11-65) oN G . c~ oO INSTRUCTIONS: Thie form is to be removed from file by a Filing Unit employee onty upon the return of the item. Subject : Type of Mail (2) Report [_} Incoming letter Date of Mail C_) Outgoing letter (I Memorandum CO Airtel C] Teletype CJ Enclosure (describe) eet KD I pone A -D-1Y'- (2 Personnel Security Questionnaire (PSQ) () Leyalty Form () Other (describe) Date of Romeval L7G | 37 (() For copying (If for another agency, list agency and date of request.} (J To send to (CJ To attach to Cj For office use CZ) For change to another file 1 a ys) Other (Specify) A it 7-5200-G5U Complete File and Serial Number