SPECIAL ACCESS AND/OR BILLET APPROVAL
Agency: CIA
Originator: CIA
Document date: 07/13/1973
Document type: PAPER-TEXTUAL DOCUMENT

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104-10120-10662

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0.. 5.

ME AN ERO TRIA

SPECIAL ACCESS AND/OR BILLET APPROVAL

• (Submit original

and five copies to CIB/SR&CD)

DO A

DATE OF REQUEST

SUBJECT'S NAME (Last, First, Middle)

iNCE

SSN

ROB: Dos juan mili

DATE OF BIRTH (DA MO YS)

POSITION

Member * Prl12

ORGANIZATION

CODE

COMPONENT

CODE

SUB- DIVISION

i sendin's foreign Intelligence Advisory Eoszc

TO: CHIEF, CIB THRUSTHE APPROPRIATE APPROVING AND CONCURRING OFFICERS

CODES BELOW ARE

FOR

CIB

USE ONLY

CODE

APPROVED

TCO/CIA

DATE

APPROVED

CODE

APPROVED

DD/SaT

DATE

CONCUR

APPROVED

C/SS/OSA

DATE

APPROVED

DATE

DATE

APPROVED

IT IS REQUESTED THAT

PROJECTS) AND PHASE WHERE APPLICABLE, JUSTIFICATION:

TO SPECIAL ACCESS APPROVAL LO BILLET APPROVAL

DEPUTY:

DIFECTOR

GRANTED FOR THE SUBJECT IN THE FOLLOWING

FENNIFE:

and will need the above nicarancee

as a resuer of the Provident's Foreign li!

•inlis once Advisory Boaze.

REQUESTER'S MAIL ADDRESS (Room and Buildind)

3F22

CIB INDEX SEARCH

TO:

CHIEF, PSD/ID 2 (For action indicated)

SI

OTHER

(Specify)

T0:

CIB

CASE NO.

/ l

1C.

SUBJECT

MEETS ESTABLISHED SECURITY CRITERIA

FOR

SPECIAL ACCESS(S) REQUESTED

TO:

REQUESTER

SUBJECT HAS BEEN APPROVED

ADVISE CIO DATE. BRIEFED

ARRANGE WITH CID FOR

BRIEFING

SIGNATURE.

Robert 5. Leidenheimer

CHIEF. CIB

BI DATE (Julian)

PSD

DATE

731(2

SIGNATURE

DATE

I/ih3

DATE

CHIEF. CIB SIGNATURE

FORM

8-72

2018a

USE

PREVIOUS

EDITIONS

89-10-388

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