## Page 1

JFK Assassination System

Identification Form

Agency Information

Date:

12/6/201

AGENCY: FBI

RECORD NUMBER:

124-10273-10258

RECORD SERIES :

SU

AGENCY FILE NUMBER :

100-11666-16

Released under the John

ussassination Records

Collection Act of 1992

li44 USC 2107 Notel.

Case#:NU 55509 Date:

Document Information

ORIGINATOR:

FROM:

TO:

TITLE :

DATE:

PAGES:

SUBJECTS :

00/00/0000

0

NAR

DOCUMENT TYPE :

CLASSIFICATION :

Unclassified

RESTRICTIONS:

CURRENT STATUS : Withhold

DATE OF LAST REVIEW: 08/02/1994

OPENING CRITERIA: INDEFINITE

COMMENTS :

v9.1

H₩ 55509 DocId: 32199523

Page 1

1

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## Page 2

File-Serial Charge Out

FD-5 (Rev. 6-17-70)

# U.S. G.P. 0. 1974-533-456

File -

Serial No.

100-1i464

Class.

Case No.

Last Serial

Perding

_Closed

Description of Serial

Date

DIte

Charged

te

Transfereed

44-253

Employee

RECHARGE

Dote

TO —

-

From

Initials of

Clerk

Date Charged

Employee

Location

Hit 5ag09 DocId: 32199523 Page 2-

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