NAME CHECK REQUEST - LYALYA PETRUSEVICH
Agency: CIA
Originator: CIA
Document date: 01/01/0000
Document type: PAPER-TEXTUAL DOCUMENT

## Page 1

1104-1006-102787

FROM:

BRANCH

(Requesters name) O

.f"W. BRASKO

BADGE NO.

ROOM

EXTENSION

TO

TUBE

ROOM

DATE

INITIALS

RID/INDEX

DT - 5

REQUESTER

RID/FILES

DT - 6

REQUESTER

RID / ANALYSIS

GT. 7

RID/201

DW - 6

SECRET

DATE

NAME CHECK AND CONSOLIDATION REQUEST

RID CONTROL NO.

CHECKING INSTRUCTIONS

RID/MIS

GT - 6

AKA, ALIASES

0. 5P APENTEY IN DATA (Occupation, sex, CP membership,

bradl

in of Lubes Bolde it

Med, USSR

SEX

DATE OF BIRTH

PLACE OF BIRTH

• ITIZENSHIP

USSR

RESULTS OF RID/INDEX CHECK

COMMENTS

RESIDENCE

Meath

USSR

NO PERTINENT IDENTIFIABLE INFORMATION

"CARD REFERENCES ATTACHED

INSTRUCTIONS FOR REQUESTERS

IN ALL CASES

Use gummed label; type or print all

entries.

Upon receipt of index card reproductions

draw a green diagonal line across the

the tune et estate

items you do not want.

Edit (use green) the reproduced index

cards to indicate:

(a) cards to be destroyed (mark with

green D and note reason for destruction)

Examples: document destroyed; duplicate

or less informative than retained in-

formation; information of no CS value.

(b) corrections and additions, inclu-

ding infinity symbol oo when card in-

cludes all facts contained in the

document.

201 CONSOLIDATION

2. For each document to be included in the

consolidation (i.e., copy or cross reference

(a) I 201-o11date into

(b) = Open 201 file on subject.

RESTRICTION (IS any)

CRSSTENESM

I YES

NO

OTHER INTERESTED 'DESKS OR STATIONS

Note 1. Records of COI, SSU, OSS and CIG

BE REF?

TRID

are in RID/ARD, and those that meet

I DESK

indexing criteria in CSHB 70-1-1 are

carded in the CS Main Index. If you

believe there could be additional in-

formation of value in these records,

tary) may be available in BR/OCR

x7997.

you must request an Archives Index

search.

DATE

SIGNATURE OF RECORDS OFFICER

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