14-00000
104-10110-10307
ACADET
6
2025 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992
NOTIFICATION OF ESTABLISHMENT OR CANCELLATION
DATE
10 JULY 1974
3190
TO:
(Check)
OF OFFICIAL COVER BACKSTOP
☑
CHIEF, CONTROL DIVISION, OP
CHIEF CONTRACT PERSONNEL DIVISION,
OP
CHIEF. OPERATING COMPONENT (For action) WM
SS NUMBER
069-24-3138 RETURN TO CLA
EMPLOYEE NUMBERS
007667
ID CARD NUMBER
Background Use Only
Do Not Reproducă
ATTN:
EN SIFFORT STAFF
REF:
FORK 2458, DATED 19 JURIE 1974
OFFICIAL
COVER
ESTABLISHED
DISCONTINUED.
SUBJECT
CHARLOTTE BUSTOS-VIDELA
UNIT
99
DEPARTMENT OF STATE
KEEP ON TOP OF FILE WHILE COVER IN EFFECT
✗ ESTABLISHMENT OF OFFICIAL COVER BLOCK RECORDS
☑☑ BASIC COVER PROVIDED
EOD
EFFECTIVE DATE
OPERATIONAL COVER PROVIDED
FOR
.TDY _ OTHER (Specify)
SUBMIT FORM 642 IMMEDIATELY TO
ILIMITATION CATEGORY TO CATEGORY
X |(HHB 20-7)
CANCELLATION OF OFFICIAL COVER UNBLOCK RECORDS-
EFFECTIVE DATE:
SUBMIT FORM 3254_
TO BE ISSUED. (HHB 20-11)
SUBMIT FORM 642 IMMEDIATELY TO CHANGE TELEPHONE
LIMITATION CATEGORY TO CATEGORY
(HHB 20-7)
CHANGE
TELEPHONE
EAA: CATEGORY 1
CATEGORY 11
x
SUBMIT FORM 3254
(HHB 20-11)
STATE
99
W-2 TO BE ISSUED.
X
SUBMIT FORM 1322 FOR ANY CHANGE AFFECTING THIS
COVER. (HR 240-2e)
SUBMIT FORM 1323 FOR TRANSFERRING COVER
RESPONSIBILITY. (HR 240-2e)
RETURN ALL OFFICIAL DOCUMENTATION TO CCS
SUBMIT FORM 2688 FOR
HOSPITALIZATION CARD.
DO NOT WRITE IN THIS BLOCK
-
X
EAA. CATEGORY 1
CATEGORY 11
X
X
AGE
SUBMIT FORM 2688 FOR
HOSPITALIZATION CARD
REMARKS AND/OR COVER HISTORY
27 AUG 51-AUG 62-BUS-OVERT
AUG 62-JULY 67-50-DAG 99
JULY 67-10 AUG 72-MEXICO-STATE-NOVINC
1 SEPT 72-27 JUNE 74-BS-AC) 99
28 JUNE 74 TRINIDAD-STAT
99
27 1631
DISTRIBUTION:
COPY 1 -
CD
COPY 2
COPY 3
COPY 4
COPY 5
FORM
1974-1551
OR CPD
OPERATING COMPONENT
OS/SR&CD
OC DO/TFB
CCS-FILE
ED
KP:Mlr
James S. Franklin
CHIEF. OFFICIAL COVER BRANCH, COVER AND COMMERCIAL STAFF.
SECRET
E-2, IMPDET CL BY: 007622
61BR