◆ SpookStack

Serial Remeval Charge Our .~ {6 4021 {htee. - 1 b-& 5) INSTRUCTIONS: his form is to be removed from file by a Filing Unit employee only vpon the return of the item. Subject ~~ t SOE ce HE OO Type of Mail Dote of Mail i ((} Report ) ([} Incoming letter (_) Outgoing letter {71 Memorandum a. ij (_} Airtet g t {_) Teletype , 4 TC] Enclosure (describe) ch email iS Ug, Lb bb 212 BLL : {[} Personnel Security Questionnaire (PSQ) De ie 2 [_} Loyalty Form (_] Other (describe) SSS Removed for Removed by Dote of Removet Mr. Mrs, wo reaeeir Miss EL Reason for Removal ((} For copying (if for another agency, list agency aud dale of request.) Ww yee ((] To send to ([} To attach to a (_] For office use (7) For change to another fe C23 th Other (Specify) we We we Complete File and Sericl Number - fi rte YO 2?