NAME CHECK REQUEST - CHACKIWITCH
Agency: CIA
Originator: CIA
From: WITHHELD
Document date: 09/21/1964
Document type: PAPER-TEXTUAL DOCUMENT

## Page 1

1104-1006-102451

FROM!"

(Reguisters nano) O

TA.W. BRASKO

BRANCH

TO

REQUESTER

RID/FILES

REQUESTER

RID / ANALYSIS

A1D/20g

RID/MIS

RID/INDEX

TUBE

ROOM

DATE

DT - 6

GT -7

GT - 6

DT - 5

SKIWITCH

SECRET

BADGE NO.

EXTENSION

NAME CHECK AND CONSOLIDATION REQUEST

DATE

RID CONTROL NO.

INITIALS

2158864

CHECKING INSTRUCTIONS

SUBJECT TO BE CHECKED

(fuu)

AKA, ALIASES

OTHER IDENTLEYING DATA cupation, sex, CP membership,

Former

Vlassorite

SEX

DATE OF BIRT

PLACE OF

LIRTI

1S50

RESIDENCE

BRUSSELS, BELG.

PERTINENT IDENTIFIABLE INFORMATION

RESULTS OF RID/INDEX/ CHECK

COMMENTS

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

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

(a) • Consolidate into

201-

(b) [ Open 201 file on subject.

RESTRICTION (I1 any)

OTHER INTERESTED DESKS OR STATIONS

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

are in RID/ARD, and those that meet

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 recoras,

you must request an Archives Index

search.

ASSIGNEEM

T YES

I NO

БЕ КEFЯ

TRID

I DESK

Note 2.

Information concerning foreig

ublic personalities (except mili

tary) may be available in BR/OCR

x7997.

DATE

SIGNATURE OF RECORDS OFFICER

---

## Page 2

13-00000

CHA

CKIENIEZ, Juao

4431-12

CESSA RRE

26UUN:

THIS

CAPD

HIED IN

MAIN

0198631

crlAck IEns N102, 442160

EDE ASUA

116

60 - 2-6-031

EGQA SS8T

THS

CARD

FILED IN

MAJN

20630

---