[104-10219-10153.pdf — page 118]
UNCLASSIFIED CIA INTERNAL--USE ONLY CONFIDENTIAL SECRET# KOUTING AND RECORD SHEETFROM:Contract Personnel DivisionRoom 301 1016 16th St.TO: (Officer designation, room number, and building)|                  | DATE        | OFFICERS INITIALS | COMMENTS (Number each comment to those from whom. Draw a line across columns after each comment)                                                                                                                                                                                                                       || ---------------- | ----------- | ----------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- || 1.               | DATE        |                   |                                                                                                                                                                                                                                                                                                                        || FI/OPS/Projects  |             |                   | The original of this contract was prepared in headquarters and forwarded to the field for their execution and retention. This amendment should follow the same procedure. Please let-CPD know when subject has signed his extension so a copy of this document can be forwarded to Finance Division for their records. || 1709 L Bldg.     |             |                   |                                                                                                                                                                                                                                                                                                                        || 2.               | 15 DEC 1957 | P                 |                                                                                                                                                                                                                                                                                                                        || WH Division      |             |                   |                                                                                                                                                                                                                                                                                                                        || 1405 Barton Hall |             |                   |                                                                                                                                                                                                                                                                                                                        || 3.               |             |                   |                                                                                                                                                                                                                                                                                                                        || 4.               |             |                   |                                                                                                                                                                                                                                                                                                                        || 5.               |             |                   |                                                                                                                                                                                                                                                                                                                        || 6.               |             |                   |                                                                                                                                                                                                                                                                                                                        || 7.               |             |                   |                                                                                                                                                                                                                                                                                                                        || 8.               |             |                   |                                                                                                                                                                                                                                                                                                                        || 9.               |             |                   |                                                                                                                                                                                                                                                                                                                        || 10.              |             |                   |                                                                                                                                                                                                                                                                                                                        || 11.              |             |                   |                                                                                                                                                                                                                                                                                                                        || 12.              |             |                   |                                                                                                                                                                                                                                                                                                                        || 13.              |             |                   |                                                                                                                                                                                                                                                                                                                        || 14.              |             |                   |                                                                                                                                                                                                                                                                                                                        || 15.              |             |                   |                                                                                                                                                                                                                                                                                                                        |Raw H. HartakeContact to fill, H.Arw-5760FORM1 DEC 55 610 USE PREVIOUS EDITIONS SECRET CONFIDENTIAL CIA INTERNAL USE ONLY UNCLASSIFIED