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

## Page 1

104-10120-10655

SPECIAL ACCESS AND/OR BILLET APPROVAL

(submit original"

and five copies

to CIB/SR&CD)

SUBJECT®S NAME (Lag

Sity

DATE OF

BIRTH DE MARO

ORGANIZATIOI

POSITION

Wentbet

SCODE

COMPONE!

CF2738

CODE

TO:

CHIEF SIR THRUSTHE APPROPRIATE APPROVING

AND

CONCURRING

OFFICERS

APPROVED

DATE?

ROVED

SATE

CONCUR

APPROVED

CONCUR

APPROVED

CONCUR

APPROVED

CONCURA

APPROVED

CONCUR

APPROVED

FILE WHEN INITIALED U

ATE OF REQUEST

trol forg

CODES

BELOW

FUSE BONA

COOL

QUESTED

AND

CABLE

GRANTED

FOLLOWING

REQUESTER'S MAIL

ADDRESS (Room and Building)

CIB

INDEX SEARCH

TO:

CHIEF, PSD/ID 2 For action indicated)

OTHER

(Specify)

TO:

CIB

CASE NO

SUBJECT

MEETS

ESTABLISHED

SECURITY CRITERIA

FOR SPECIAL

ACCESS(S) REQUESTED. S

TO:

REQUESTER

SIGNATURE

A CHIEE CIE

B 1

PATE Fallenge

PSD

1D/2:

DATE

SIGNATURE: '5

DATE

SUBJECT

HAS

BEEN

APPROVED

ADVISE

CIA DATE

BRIEFED

ARRANGE WITH CIB FOR BRIEFING

CHIEF. CIE SIGNATURE

FORM

8-72

2018a

• 10-381

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