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HEARNAP — Part 20
Page 697
697 / 889
Serial Removal Cherge Out JP ‘ :
4.2} {Rev, 2 65) ie 0 . Ah
INSTRUCTIONS: This form is to be removed from file by a Filing Unit employee only upon the return of the Item.
Subject
OOS FZ OH
Type of Mall U : Date of Matt
"#5 Report :
(C1 Incoming feteal
(]} Outgoing letter
£7} Memorandum
(2) Teletype
{~] Airtel et
(I Enclosure {describe}
Latent
(orLaboratory Work Sheet - Y -
{[} Personnel Security Queationnaire (PSQ)
{7] Loyalty Ferm
(_} Other (describe?
Removed tor Removed by Date of Remora!
‘(3 Mre. Cc . u ; a
Sue Bode | 343 j-G Tl
Reason for Removal
([] For copying (if for another agency, list agency and date of request.}
C7] To send to
(77 To attach te
(7) For office ure
[7} For change to another file
~
([} Other (Specify)
_ we
-_ q
Complete File and Serial Number ~ 5 pe 00 ~ J
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