FORM - REQUEST FOR DOMESTIC COVER LIST ENTRY OR CHANGE.
Originator: CIA
From: CHIEF, WH SECURITY
To: CCG/OCL
Document date: 07/31/1962
Document type: PAPER - TEXTUAL DOCUMENT

## Page 1

104-10110-10339|

2022 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992

SECRET

REQUEST FOR DOMESTIC COVER LIST ENTRY OR CHANGE

TO

THROUGH:

SUBJECT:

SUBMIT THIS FORM IN TRIPLICATE, ENCLOSED IN SEALED ENVELOPE

Edward Pitagerald

Hra Stula habaka = 009, 5o0a 47 211

DATE

ENTRY:

Il Saly 2962

CHANGE S

Inclusion of subject on the

Domestic Cover List is requested

for the reason

noted below.

When

notified that cover has been es-

tablished, subject will be specif-

ically authorized and instructed to

conceal his Agency affiliation.

Subject

18

currently included on

the Domestic

Cover kist." For ther

reason noted below, it is requestea i

that

thie

this employee be removed from

the Domestic Cover List.

the following change be made:

REASON

soo, Charlotto BUSTOS-VIDELA antsalpates vlasts to.

of Argentino national solatives of her burbend..

Montla

aba could be contanted during baniness hours

DUS TOS

TYPE AdDEd/ IOS

ASST/IOS

C/ID

COVER (Comp

andy

for

NOH®

TYPE SUGGESTED

(Specify

whether

official or non-

official

IF

MO COVER

IN -USE -

OFTICIAL

JUSTIFICATION.

IF

NON• OFFICIAL COVER

C/:3

SUGGESTED

€ APPROVED BY CENTRAL. COVER DIVISION

тре

nitro.

ATE

A&TS

Ts PS0tt 56840

- 58

1322 °

SIGNA

TITLE

SECRET

Security

---