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_ mmm an a a a le mm a me ca A «I - Serial Removal Charge Out 4-2) (Rev. 2-11-65) C (. C) C) INSTRUCTIONS: This forint is to be removed from file by a Filing Unit employee only upon the return of the item. Dote of Mail 4 _) Report {_1 Incoming letter (_) Gutgoing letter a [-) Memorandum Se TEE U I UEIIIEttIIEIIAIISIESSESSaEEE SSSR {I Airtel oo (7) Teletype a ] [_-] Laboratory Work Sheet [4 Personnel Security Questionnaire (PSQ} (_} Loyalty Form OM Other (describe? [_] Enclosure (describe) Af Dote of Removal asin for foe f/ts/ Room Reoson for Removal ((] For copying (If for another agency, list agency and date of request.) y, ([] To send to (7 To attach to C} For change to another file [2f- 232708 - 68 Complete File and Serial Number