FORM 2214: NON-OFFICIAL COVER CONCURRENCE
Agency: CIA
Originator: CIA
Document date: 1/1/64
Document type: PAPER-TEXTUAL DOCUMENT

## Page 1

104-10220-10269

SECRET

NON-OFFICIAL COVER

CONCURRENCE

DATA

TO BL COSPLETEO BY CHICA UNLY

BUBJECT ' Y MANE

DATE OF DIATH

* On 701 H0.

PLACE OF DIRTH

СІТАЯВАВ#»

Es 155)

OVINDEAD ARBIDENCE

EMPLOYER

iss,

V.S.

MERIDENCE.

"l.

CAD€

PHOJICT

17481-

•ROOM NO.

PROPOSED WIE

CORING CASE OFFICIA (REPASION JIAN)

SOUL COMPLIED BY ECS ONLY

TeeS PILe NO.

Central Cover Staff concurs in your proponnl to une subject for the purpose

In keeping with the reguirement placed upon COs to maintain an

occurate regioter

current nonofftell cover netivity, you are specifically

requented to advice CCS/NO promptly by memorandum when subject har been

The pseudonym anslened auljeet chould be provided CCS/riC At

time notifiention of netivation la iorwarded.

notiflention of arrivation

1o not roceived in Cos/NC one yonr trum ubove dute lt will be noduned propored

check mark appears herd,

Information of Intcreat, concerning rubject

lor his employer in in Ces/NC files.

Artor operational approval le reccived,

and prior to unking arrangementa for initint contaet thoreunder, you are

mpecipically requester to conter with CCS/NC concerning other Agency Interento

posalbly affected and the ndvianbility of additionil coordination.

Il check mark appears here the proposed

use of subject requires DDP

approval under CaR 240-6, porn, 5.

Please roster CSI 210-6 an

initiate

actiun as appropriate.

201-274330

HISTRIBUTION

DHY 2214

I.88

POSIOTS SIA OPIST

SECRFT

7. 4.

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