[104-10176-10010.pdf — page 37]
UNCLASSIFIED CONFIDENTIAL SECRET TOP SECRETINITIAL REVIEW FORMDocument Description: *inimes*Document Located By : *DCD*Document referred to DDO for review by:RECOMMEND:Release in full-textRelease in sanitized formDeny in totoDefer decision to *WH Derin*Coordination with _______ prior to above denial/releaseEXEMPTIONS ARE BEING CLAIMED TO PROTECT THE FOLLOWING:|                                                             | FOLA    | PRIVACY                                               || ----------------------------------------------------------- | ------- | ----------------------------------------------------- || () Classification                                           | (b) (1) | (k) (1)                                               || () Information from a foreign liaison service               | (b) (3) | (j) (1)(b)(c)                                         || () Information pertaining to a foreign liaison relationship | (b) (3) | (j) (1)(b)(c)                                         || () Information which would/could identify the source        | (b) (3) | (j) (1) (b)                                           || () Information pertaining to a source                       | (b) (3) | (j) (1) (b)                                           || () Information pertaining to intelligence methods           | (b) (3) | (j) (1) (b)                                           || () Location of CIA overseas installation                    | (b) (3) | (j) (1) (b)                                           || () Location of unacknowledged domestic installation         | (b) (3) | (j) (1) (b)                                           || () Name of CIA employee                                     | (b) (3) | (j) (1) (e)                                           || () File number                                              | (b) (2) | (j) (1) (b)                                           || () Pseudonym                                                | (b) (3) | (j) (1) (b)                                           || () Cryptonym                                                | (b) (3) | (j) (1) (b)                                           || () Internal organizational data                             | (b) (3) | (j) (1) (e)                                           || () Name of an FBI agent                                     | (b) (7) | (j) (1) (b)                                           || () FBI file number                                          | (b) (2) | (j) (1) (b)                                           || () Privacy of other individual                              | (b) (6) | (j) (1) (f)                                           || () Does not pertain to request                              | N/A     | "Exempted portions are not relevant to the requester" || () Information from another Government agency               | (b) (1) | (j) (1) (c)                                           || *() Other, specify:                                         |         |                                                       |*For further guidance regarding exemptions, please see DDA-75-5343,16 December 1975 (Privacy Act) and HN-70-21, 14 February 1975 (FOIA).COMMENTS AND/OR SPECIAL INSTRUCTIONS:![signature of refixing officer & office]UNCLASSIFIED CONFIDENTIAL SECRET TOP SECRETFORM 39668-77FOIA/PA Request No. F77-260Dated: 12 June 19727 July 1972 (2)6 July 1972Document No.(To be completed by ISS/PICG)E 2 IMPDET CL BY: