14-00000
104-10110-10298
2025 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992
SECRET
REQUEST PUR OFFICIAL COVER ACTION
+
f
25
1. WHEN REQUESTING INITIAL COVER OR 2. WHEN CHANGE OR REMOVAL IS RE-
QUESTED ROUTING SHOULD BE:
(COMPLETE SECTION 2)
ON RETURN FROM OVERSEAS ROUTING
► SHOULD BE COMPLETE SECTION 1) 7
TO
CC OFFICIAL COVER BRANCH TO : CCS/OFFICIAL COVER BRANCH
Form 610 Routing & Record Sheet
FROM: Security
THRU OS/SSD
FROM:
FILE NO.:
EMPLOYEE TELEPHONE NO.
(Use Form 610 Routing & Record Sheet
URN TO CIA
na Use Onl
TH AGENCY
JECT'S TRUE NAME (
iddle).
Bustos Videla, Charlotte.
TOF OFFICIAL COVER FOR SUBJECT IS REQUESTED.
COVER
S
E
USE OF COVER
MILITARY
STATE
DOMESTIC ALL PURPOSE
OTHER GOVT AGENCY:
DOMESTIC OPERATIONAL
EMPL
EEK SERIAL NUMBER
007667
SOCIAL SECUR
EGRATED
NOMINAL
SUBJECTS CI
GNCOVERI
COMPROMISE WH
sepa
FFILATION
HAS.
HAS
HAS NOT BEEN VOLUNTARILY DECLARED OR INVO
NTSOR FOREIGN INTELLIGENCE SERVICE. THERE T
HAS NOT
SHOULD BE CONSIDERED IN THIS REQUEST. (If an affirmative.
JUSTIFICATION FOR REQUESTED ACTION:
Ms
Bustos-Videla is currently assigned to the in
lon under Integrated State cover It is request
be placed under Nominal State cover for her future
Headquarters assignment.
QUESTE
OFFICIAL COVER STATUS FOR SUBJECT IS REQUESTED.
E JUSTIFICATION FOR REQUESTED ACTION:
SIGNATURE AND TITLE OF REQUESTING OFFICER
nathan S. Ha
Jonathan G. Hanke. C/LA/PEMS
FOR OFFICE OF SECURITY
DATE:
DO YOUR RECORDS REFLECT ANY EXPOSURE. COMPROMISE. SECURITY OR OTHER FACTORS WHICH SHOULD BE CONSIDERED
IN MAKING A COVER DETERMINATION. IN RESPONSE TO THE ABOVE REQUEST? (If the answer is affirmitiv
provide details on separate attachment.)
OFFICE A
OF SECURITY,
NO PERTINE
✓ NFORMATION
ATTACHED.
SIGNATURE L
APPROVAL
SIGNATUR
RAND COMMER
STAFF
1322
DATE
E-2, IMPDET CL BY: 006687,
SECRET
OSCOPY
31BK