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104-10117-10111 JFK Assassination Records Archives 1 (2/20/1963)

handle is hein.jfk/jfkarch38973 and id is 1 raw text is: 04-10117-10111


CIA  INTERNAL  USE ONLY
  (Classify When Filled In)


                               OUTSIDE ACTIVITY  APPROVAL  REQUEST
                 SEE ER 10-7 BEPORE SUPMZTTING TO EAB AN ORIGINAL AND 3 COPZES OF THIS FORM
                                                                         DATE
10      DIRECTOR  OF SECURITY;  ATTN:       EMPLOYEE ACTIVITY BRANCH
       (0 erating official, adedni atrative. and/or security officer)             I MAR 1963

                       LiI                      EmployOe  has been  briefed oonoejn     lis
                                                resPoncibilities   and conduct in  this matter,

        ME AND GRADE     LOYEE (Print Or typO) COMPONENT        ROOM NO. AND BLDS.    PHONE
FRM   :
1. DES IPTION OF OUTSIDE TIVITY FOR WHICH APPROVAL IS. REQUE TED:


         Ien  v.anaes . Ansters  MU' CT s
         gam    . ags. .. . - Gou rsnem






2. FULL NAMES OF ORGANIZATION AND/OR PERSONS INVOLVED

         Me  Ame     e    n     i

3. DATE(S) OF PARTICIPATION AND LOCALE OF ACTIVITY
             ~g   m*t2ple                                      & Mass. Asi,
             9   .        .(4I. V                    uJeDm    m      4* *
 4. REMARKS.
         In  engaging  in the requested   activity I will  mak          no reference     o  or discuss
   my CIA  assignments  or duties  nor will  I make  referen     o or d   cu      CIA  employ-
   ment except  as authorized  by  Headquarters  Regulati        7
                                                           SIGNATURE OF REQUESTING EMPLOYEE
 5. CONCURRENCES AND/OR APPROVAL WITHIN OPERATING OFFICE



                 FOR COMPLETZON BY EMPLOYEE ACTIVITY BRANCH AND RETURN OF ORIGINAL TO EMPLOYEE


Date


-  Wlsl


Security Approval  has  been gr   ted  ot
the use contemplated  by           est

Chie  Personnel  Security Di


RN
   879 UE  P   *REVIOUS
       EDITIOM.


CIA  INTERNAL USE  ONLY


(9-8)


. _ ..                                                                                                         - I _

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