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422) fio, leP LBS) INSTRUCTIONS: This form is to be removed from file by a Filing Unit employee only upon the cetum of the item Subject “Serial Renova! Chorge Out o~ rs : ~, —, “ASCO Rel Type of Maik ba Y Date af Haile ([] Incoming letter a ee a (-} Outgoing letter (C) Memorandum (_} Teletype . eee . ([) Enctosure (describe? Gk _¢ ol tebe Work Sheet ee _ 820-7 C} Personnel Security Questionnaire (PSQ) (_] Loyalty Form’ (C) Other (describe) . nn eee Removed for Removed by Dete of Removol “Mr. {3 . ; () Mrs. Ni x aw af , Qyyp7 Reason for Removal Cc} For copying (If for another agency, list agency and date of request.) [J To sénd to ) To attach to ) For office use (C] For change t6 another file {7] Other (Specify) MASA