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HEARNAP — Part 17
Page 649
649 / 901
SS INSTRUCTIONS: This form is to be ‘ote nnn from file” by a Filing Unit employee only upon 4q return of the Item. gm
= jSubject : ;
r
Type of Mal! Date of Mail
(J Report
(7) Incoming fetter
([) Outgoing letter
[2 Memorandum
C1) Airtel
{7} Teletype
(_} Enclosure ideecribe?
Laboratory Work Sheet
{7} Personnel Security Questionnaire (PSQ)
{[) Loysity Form —
(73 Other (describe)
Removed for Removed by Date of Removal
8.
tel Miss
Room
Reoson for Removal
{7} For copying (if for another agency, liet agency and date of request.)
cj To send to
[_} To attach to
{3 For office use
(C] For change to another file
a .
op Other (Specify) Zier ty
. a te a” : : tas Up Pv ea werek TROD
age 5 laa teeny ete Poona Sak ante. et Saar se yy
~- tine, venee s ae i Na ee Ce "op ”~
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