[104-10227-10000.pdf — page 126]
# TOP SECRETUNCLASSIFIED when blank - TOP SECRET when attached to Top Secret Document - Automatically downgraded to SECRET when filled 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  || Doc. Date             | 20 APR 1964 || Copy No.              | # Repro 2   || Number of Pages       | 38          || Number of Attachments |             |**REGISTRY**| CIA Control No.        | TS# 191722   || ---------------------- | ------------ || Date Document Received | 15 June 1979 || Logged By              | ![signature] |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 duties relate to the matter. 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                                     | RECEIVED             | RELEASED     | SEEN BY |              |       |           |             |      || ----------------------------------------------- | -------------------- | ------------ | ------- | ------------ | ----- | --------- | ----------- | ---- || Office                                          | Signature            | Date         | Time    | Date         | Time  | Signature | Office/Div. | Date || DDP(TSCO)                                       | ![signature] B. Bigg | 15 June 1979 | 11:19   | 15 June 1979 | 12:14 |           |             |      || PCI/OLC Scott/Breckinridge                      | ![signature]         |              |         |              |       |           |             |      || DDO/TSCO                                        | ![signature] B. Bigg | 19 June 1979 | 12:15   | 19 June 1979 | 14:15 |           |             |      || SA/DDO/IS M. Hezekick (HAROY)                   | ![signature]         | 19 June 79   |         | 19 June 79   |       |           |             |      || DDO/TSCO                                        | ![signature] B. Bigg | 20 June 1979 |         | 20 June 1979 |       |           |             |      || DCI/0/CC fwerder agent Breckinridge or Hadilson | ![signature]         |              |         |              |       |           |             |      || DDO/TSCO                                        |                      |              |         |              |       |           |             |      |NOTICE OF DETACHMENT: When this form is detached it must be transmitted to Central Top Secret Control for record purposes.| TO             | DOWNGRADED || -------------- | ---------- || By (Signature) |            || OFFICE         | DATE       |FORM 6-64 26 USE PREVIOUS EDITIONS (OP 1)When finished with these documents return them to DDO/TSCO as we are the control Office for these documents,TS# 191722TS# 191722ATS# 191722BTS# 191722C(40)| LATEST VERSION | Lived in Nikol | Entered "zero" | Moved to Lening and then direct successively on 1:1 Pr. Maxima Gor (different ones) | Father appointed missar of Shipt Commissar. Fam at Ul. Serafinc Year school No. Polyanka. | Completed 6th with parents whe || -------------- | -------------- | -------------- | ----------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------- | ------------------------------ || 1927 to 1934   | Fall 1934      | 1935 to 1938   | 1938                                                                                | June 24:                                                                                  |                                |TOP SECRETEYES ONLYTOP SECRET