◆ SpookStack

40 ah 421 (Rev. 2116s) FQ FN 7 ae ar . - = . 7 pe or ; INSTRUCTIONS: This farm is to be removed from file by a Filing Unit employee only vpon the return of the item, Onte of Mail £2} Incorfing Netter {_] Outgoing tettes (-} Memorandum } Airtel £7) Teletype . cad (J Enclosure (describe) srt -_ "(Co Personne? Security Questionnaire (PSQ) [7] Loyalty Form (2) Other (describe) Removed for ; Date of Removal = energy ein ieee a ees eo \~le~The Reason for Removal _ () For copying {lf for another agency, list agency and date of request.) (J To send to [7] Te attach to. a tee (7) For office use {[) For change to anot er file EY Other (Specify? —