◆ SpookStack

Serial Removal Charge Ouse NN Pa. , oN —_ 4-21 {Rev. s- 11-65) . INSTRUCTIONS: This form is to be remaued from file by a Filing Unit employee only upon the return of the item. Type of Mail Report cT> incoming letter {_} Outgoing letter (-) Memorandum } Airtel C7} Teletype. (_} Enclosure (describe). {—} Laboratory Work Sheet {_} Personnel Security Questionnaire (PSQ> (CI Loyalty Form ter Other {deacribe? Removed fee ' i . Dote of Removal as . she . p-6-7C (_} Room ; : Reoson for Removal {—} For copying (If for another agency, list agency and date of request.) {(] To send to {7 To attach to {7} For office use (Cj For change té another file Cj Other (Specify?