Agency: FBI
Originator: FBI
From: MM
Document date: 10/25/1963
Document type: PAPER-TEXTUAL DOCUMENT

## Page 1

JFK Assassination System

Identification Form

Date:

4/14/201

Agency Information

AGENCY :

RECORD NUMBER :

FBI

124-10325-10019

RECORD SERIES:

MM

AGENCY FILE NUMBER:

105-4769-78

Document Information

ORIGINATOR:

FROM:

TO :

TITLE:

FBI

MM

DATE:

10/25/1963

'PAGES:

2

SUBJECTS :

DRE

DOCUMENT TYPE: PAPER, TEXTUAL DOCUMENT

CLASSIFICATION: Unclassified

RESTRICTIONS :

CURRENT STATUS: Redact

DATE OF LAST REVIEW: 06/04/1998

OPENING CRITERIA: INDEFINITE

COMMENTS:

v9.1

DocId: 32312770

Page 1

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## Page 2

FD - 306

(3/21/58)

Date Rec'd

Rec'd from (name or symbol #)

10/25/63

JESUS. RAFAEL FRANCO CAMEDO

Method of Delivery (check appropriate blocks)

Rec'd by

SA WELTON F. MERRY

In person

By telephone

/ By mail

Orally

Recording device

Written by informant

If orally furnished and reduced to writing

by Agent:

Date of Report

Date

10/25/63

10/25/63

Dictated to

Transcribed

typed

3W8/6R

by Steno NANCY E. BROOKS

Date(s) of Activity

current

Authenticated by informant

Brief description of activity or material

LORENZO HAuL back in tow.

LUIS BALBUENA

In Jackson Memorial Hospital.

Remarks:

cc:

105-4769

134-903

(L. BALBUENA)

WEll/neb

(3)

File where original is

located if not attached

134-911-Sub A-29

ALL INFORMATION CONTAINED

DATE 2/24/4335668 Suo/sce

JFK)

105-4769-78

--

DocId: 32312770

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