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Serial Removol Chotge Out 402) (Rev. 2220-64) | Gy FN INSTRUCTIONS: This form is to be removed from file by a Filing Unit employee only upon the return of the item. Subject oY _ | Type of Mail | Incoming letter {_] Outgoing letter ((} Memorandum C Airtel TC) Teletype | (J Enclosura (describe) ([) Lahoeatory Work Sheet {C) Personnel Security Questionnaire (PSQ) CL) Loyalty Form (~j Other (deacribe) Removed for. ; Removed by ij Date of Removal S Mrs. Mise . —_ [J Room 3443 }-C-7G Reason for Removal (C) For copying (if for another agency, list agency and date of request.) © (_} To send to [J To attach to (_) For office use ) For change to another file {_] Other (Specify) Camplete File and Seziol somber . a A C j)-3 @ Q 5 _