Agency: HSCA
Originator: HSCA
To: CIA
Document date: 11/2/64
Document type: FORM

## Page 1

JFK Assassination System

Identification Form

Agency Information

Date:

4/26/201

AGENCY:

RECORD NUMBER :

RECORD SERIES :

AGENCY FILE NUMBER:

HSCA

180-10146-10001

CIA SEGREGATED COLLECTION

56-05-2K

Document Information

ORIGINATOR: HSCA

FROM:

CIA

TO :

TITLE:

Released under the John

i Remation Records

Collection Act of 1992

144 USC 2107 Note).

Case#:NW 53090 Date:

06-07-2017

DATE :

11/02/1964

PAGES:

0

SUBJECTS :

CIA, FILES

DOCUMENT TYPE: FORM

CLASSIFICATION: Unclassified

RESTRICTIONS: Consulted

CURRENT STATUS:

Withhold

DATE OF LAST REVIEW: 08/31/1995

OPENING CRITERIA:

COMMENTS :

Box 32 Document Withdrawal Notice

v9.1

HH 53090

DooId: 32273285

Page

1

---

## Page 2

CIA -- JEK COLLECTION

Document Withdrawal Notice

THIRD AGENCY COORDINATION

Box/Reel #

Folder #

56

5

Documen't # HSCA

Date

2 Now 64

Agency

Army

Title / Description (U)

Pages

Item 2.k.

Release Delayed Pending Coordination

HW 53090

DocId: 32273285

Page 2

---