Originator: USA
Document date: 00/00/00
Document type: Paper, Textual Document

## Page 1

Date

::10/05/95

Page

1

JFK ASSASSINATION SYSTEM

IDENTIFICATION

FORM

AGENCY INFORMATION

AGENCY : INSCOM/CSF

RECORD NUMBER : 194-10001-10430

RECORDS SERIES

INTELLIGENCE/COUNTERINTELLIGENCE SOURCE

AGENCY FILE NUMBER

: AC555469W - PAGE

DOCUMENT INFORMATION

ORIGINATOR : USA

FROM

TO

TITLE :

DATE

: 00/00/00

PAGES

1

SUBJECTS : I RESTRICTED ]

DOCUMENT TYPE : PAPER, TEXTUAL DOCUMENT

CLASSIFICATION

: CONFIDENTIAL

RESTRICTIONS : 1B, 2, DONOR RESIRICTIOI

CURRENT STATUS

• POSTPONED IN FULI

DATE OF LAST REVIEW

: 03/07/95

OPENING CRITERIA :

COMMENTS :

Teleased under the John F. Kenned,

ssassination Records Collection Act ol

1992 (44 USC 2107 Note). Case#:NW

56754 Date: 09.22-2022

* **

***

***

*

*W*

* I*

* I*

*H*

*[*

*R*

*A*

*W*

*A*

*I*

* *

*C*

*A*

*R*

*D*

***

***

***

NW 66754 Docld:34431971 Page 1

---

## Page 2

"CONFIDENTIAL (when filled 1.

SOURCE

CONTROL

CHECKLIST

NAME: MEDINA Montes de Oca, Armando #

15832

DATE ISE -NITIATED: 13 Dec 65

AUTH: EPIDEMIC (C)

TRACE FOR-OST FILED:

INTEREM SEPLY:

FINAL FEFUX:

BSD ROCHIVEL:

PHOTO RECEIVED:

A.SG #:

DATE INSIGNED:

DATE TERMINATED:

REASON :

DASCO NOTIFIED:

2

CONFIDENTIAL (when filied

in)

NW 66754 Docld:34431971 Page 2

---