[104-10227-10000.pdf — page 128]
TOP SECRETUNCLASSIFIED when blank—TOP SECRET when attached to Top Secret Document—Automatically downgraded to SECRET when filed in form is detached from controlled document.CONTROL AND COVER SHEET FOR TOP SECRET DOCUMENT| DOCUMENT DESCRIPTION  || --------------------- || Source SR/CI/K        || Doc. No. XAAZ-17241/2 || Doc. Date 19 MAY 1964 || Copy No. #Repro 2     || Number of Pages 22    || Number of Attachments || REGISTRY                           || ---------------------------------- || CIA Control No. TS# 191722B        || Date Document Received 15 JUN 1976 || Logged By                          |ATTENTION. This form will be placed on top of and attached to each Top Secret document received by the Central Intelligence Agency or classified Top Secret within the CIA and will remain attached to the document until such time as it is downgraded, destroyed, or transmitted outside of CIA Access to Top Secret matter is limited to Top Secret Control personnel and those individuals whose official Juties relate to the matier. Top Secret Control Officers who receive and/or release the attached Top Secret material will sign this form and indicate period of custody in the left-hand columns provided. Each individual who sees the Top Secret document will sign and indicate the date of handling in the right hand columns.| REFERRED TO |                            |                  |            |                  |         |           |             |      || ----------- | -------------------------- | ---------------- | ---------- | ---------------- | ------- | --------- | ----------- | ---- || Office      | RECEIVED                   | RELEASED         | SEEN BY    |                  |         |           |             |      || ----------- | -------------              | -------------    | -------    |                  |         |           |             |      || DDP(TSCO)   | Signature B. Lwigg         | Date 15 JUN 1976 | Time 11:14 | Date             | Time    | Signature | Office/Div. | Date ||             |                            |                  |            |                  |         |           |             |      ||             | DCI/IOC - Kaidersfune      |                  |            |                  |         |           |             |      ||             | Scott Breckinridge         |                  |            |                  |         |           |             |      ||             |                            |                  |            |                  |         |           |             |      ||             | DDO/TSCO B. Lwigg          | Date 19 JUN 1978 | Time 14:15 | Date 19 JUN 1978 | Time 15 |           |             |      ||             | Sheppeck                   | Date 19 Jun 78   | Time       | Date 19 Jun 78   | Time 15 |           |             |      ||             | ACI/C(w)                   |                  |            |                  |         |           |             |      ||             | DDO/TSCO B. Lwigg          | Date 20 JUN 1978 | Time       | Date 21 JUN 1978 | Time    |           |             |      ||             | DCI/OCC                    |                  |            |                  |         |           |             |      ||             | Breckinridge or Gabrielson |                  |            |                  |         |           |             |      ||             | DDO/FIDO                   |                  |            |                  |         |           |             |      |NOTICE OF DETACHMENT: When this form is detached from Top Secret material it shall be completed in the appropriate spaces below and trans-mitted to Central Top Secret Control for record.| DOWNGRADED     | DESTROYED                | DISPATCHED (OUTSIDE CIA) || -------------- | ------------------------ | ------------------------ || TO             | TO                       | TO                       || By (Signature) | By (Signature)           | By (Signature)           || OFFICE         | WITNESSED BY (Signature) | OFFICE                   || DATE           | OFFICE                   | DATE                     |FORM 26 USE PREVIOUS EDITIONS.6-64 (OF 1)TOP SECRETGROUP 1EXCLUDED FROM AUTOMATIC DOWNGRADINGAND DE CLASSIFICATION(40)TOPSECRET