[104-10194-10015.pdf — page 27]
SECRETFIELD TRANSMITTAL - FITNESS REPORTINSTRUCTIONSThe following items of the Fimess Report will NOT be completed by field personnel preparing the report for transmitted to Headquarters:SECTION A, Items 1, 6, and 7SECTION D, toms 1, 2, and 3 (Only in respect to "Typed or Printed Nano and Signature")|                                                                                                                                                                                                          |                                                                                          || -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------- || 1. I CERTIFY THAT HAVE SEEN THIS FITNESS REPORT                                                                                                                                                          | DATE 29 January 1969                                                                     ||                                                                                                                                                                                                          | TYPED OR PRINTED NAME AND SIGNATURE OF EMPLOYEE (in peruchmy) Sandra B. CAZAZZus         || 2. I CERTIFY THAT, EXCEPT FOR ITEMS OMITTED UNDER INE ABOVE INSTRUCTIONS, ALL ITEMS APPEARING ON THE ATTACHED FITNESS REPORT HAVE BEEN COMPLETED UNDER PROVISIONS OF CURRENT INSTRUCTIONS OR REGULATIONS |                                                                                          || DATE 28 January 1969                                                                                                                                                                                     | TYPED OR PRINTED NAME AND SIGNATURE OF SUPERVISOR (In proudanym) Francis J. COIGNE       || DATE 28 January 1969                                                                                                                                                                                     | TYPED OR PRINTED NAME AND SIGNATURE OF REVIEWING OFFICIAL ( pesudonya) Willard C. CURTIS |SPECIAL NOTEFitness Reports must be prepared with due regard for security considerations. For example, in the case of administrative and support personnel and athers whose duties do not in themselves reveal sources of information and methods of operation, it is normally expected that a complete and realistic statement of specific duties may be reported in Section 8. However, the nature, source, purpose ce dispo sition of information or operations will not be included in the other hand, the position titles and description of specific duties of certain other employees may jeopardize security anc should not be fully reported on this form. In these cases, general statements of specific duties will be included in Section B'indicating the level of responsibility.FORM 4-83 450 OBSOLETE PREVIOUS EDITIONS.SECRET