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![handle is hein.jfk/jfkarch71954 and id is 1 raw text is: 104-101
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UNCLASSfFIED when blank-TOP S .iET when attached to Top Secret Document-- omatically downgraded or declassi-
fied when filled in form is detached from controlled document.
CONTROL AND COVER SHEET FOR TOP SECRET DOCUMENT
DOCUMENT DESCRIPTION REGISTRY
SOURCE : -.- CIA CONTROL NO.
DOC. NO. z.s.. A-40ei*,' - DATE DOCUMENT RECEIVED
DOC. DATE $ *I@7
COPY NO. LOGGED BY -
NUMBER OF PAGES -
NUMBER OF ATTACH NTS
_ i85U (/ 4c- s _
ATTENTION: This for will be placed on top of and attached to each Top Secret document received by the Central Intelligence Agency
or classified Top Secre within the CIA and will remain attached to the document until such time as it is downgraded, destroyed, or
transmitted outside of CIA. Access to Top Secret matter is limited to Top Secret Control personnel and those individuals whose official
duties relate to the matter. Top Secret Control Officers who receive and/or release the attached Top Secret material will sign this form
and indicate period of custody in the left-hand columns provided. Each individual who sees the Top Secret document will sign and
indicate the date of handling in the right-hand columns.
REFERRED TO RECEIVED RELEASED SEEN BY
OFFICE SIGNATURE DATE TIME DATE TIME SIGNATURE OFFICE/DIV. DATE
B_ _ rtReproduce
NOTICE OF: DETACHMENT When this form is detached from Top Secret material it shall be completed in the appropriate spaces below
and transmitted to Central Top Secret Control for record.
DOWNGRADED DESTROYED DISPATCHED (OUTSIDE CIA
TO BY (Signature) T0
BY (Signature) WITNESSED BY (Signature). . BY (Signature)
OFFICE DATE OFFICE DATE OFFI DATE
26tG RVOSEIIN.TPSCE
03-10096]
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TOP SECRET
2022 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992
(40)2.
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