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fit ULURfc lif NT S
(CITI
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(IT R/CIR/DJRM
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B.
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W
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VALUE
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12 .
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11 .
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10 BENEFIT
(ROM USE
OF
REPORT t()
INFORMATION
a
a.
BASIC
INTELLIGENCE
0 .
CURRENT
INTELLIGENCE
&
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ESTIMATIVE
INTELLIGENCE
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A. EVALUATORS RECOMMENDATION
(select one only)
D
RELEASABLE EVALUATION NOT REQUESTED
Jjf EVALUATION
IS NOT
RELEASABLE
n
PARA(S)
,
ABOVE,
I 5/ ART
RELEASASLE
'fb' THE GOVT(S)
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18.
EVALUATOR'S NAME
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YEAR
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MONTH
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TORFIGN DISCLOSURE AUTHORITY DECISION
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I VALUATION
IS NOT
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j-j
NON -CAVE A I El) PORTIONS
OE
THIS EVAL,
A
INI) I CAT I D,
MAY
BE
REL
TO THE
AUTH REP
nr
THE GOVT(S)
OF
.
_ _
A I
TIC DISCRETION OF
THE ORIGINATOR.
19.
EVALUATOR'S OITIC
SYMBOL
20.
SECURITY
INSTRUCTIONS
(DOWNGRADING ,
DECL ASSIE I CAT ION
,
AND SPECIAL
MARKINGS)
2FTTTr!c iWfoTFTirTill Ji irsTTTffT I1¥TjlMTlW'
23.
(S ujnature of evaluator)
Approved For Release 2000/08/07
: CIA-RDP96-0q788R000^OTS8Bro5^^^
'il
(
ili
'
I
I Y
C! ASST!
'
1 CA riON
u*.*
j'Mrt- t-&w
checked for each question asked.
If
you
huvfj any
cofnjficnts which you would
like
to _ make emphasizing the accuracy
of
the information
or with reference
to any information not generally covered
in
this
format,
please write them
on
the reverse of this page.
Response
to Tasking
Responses *
Does information provided satisfy
your intelligence collection require-
ment?
Accuracy
Geographical location
(terrain,
water,
river,
etc.)
Large scale man-mado objects
(docks,
silos,
buildings,
etc.)
Small scale man-made objects
(tanks,
computers,
antennas,
etc.)
Target ambience
(research,
production,
administration,
troop movement ,
etc.)
Activity
(nuclear
testing,
CBR,
SIGINT
monitoring,
etc.)
Personality
(Physical,
plans,
actions,
traits,
etc.
)
Utility
Please check which best describes
the
utility of
the information provided
(in
view of what is known
at this time,
un-
derstanding
that additional information
could raise
or lower such an interim ass-
essment at
a
later date)
YES
IN PART W
NO P
p
YES
IN PART m
NO a
D
YES
IN PART m,
NO
P
YES
IN PART m
NO a
O
YES
IN PART o
NO p
P
YES
IN PART V
NO O
a
YES
IN PART 0
NO Q
tJ
VERY USEFUL
M
USEFUL
O
MARGINAL
D
NONE
CANNOT
BE DETERMINED AT
THIS TIME
*YES - indicates
a full agreement with what
is known
to be
fact about
the
target.
NO
- indicates
a total
lack of agreement with what
is known
to be
fact about
the target.
Approved For Rejease 2000/08/07
: CIA-RDP96-00788R000500660003-3
Approved For Release 2000/08/07
: CIA-RDP96-00788R000500660003-3
Additiona l
tasking
Is additional tasking required?
O
yf q
g}
NO
(If yes,
please write what that
tasking
is
on
the back
of
the
form)
Did the attached information add
to
YES
Q
NO
information derived from other intell-
igence sources?
Did the attached information aid
in tasking
other intelligence resources by providing
targeting information?
Q
Yts 0
No
,
(Signed)
SIGNATURE
/?£&£&.T
sj
.
/
(Printed)
NAME,
GRADE
~
*
-pj/-
-
(Printed)
1 1 TIE,
or OFFICE
Approved For Release 2000/08/07
: CIA-RDP96-00788R000500660003-3