[1]“\104-10121-10149 | 2025 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992 |
[3]esi se
[4]SECRET
[6]~ NOTIFICATION OF ESTABE SHNENT OR CANCELLATION
[8]OF OFFICEAL COVER BACKSTOP . : Te Se5 75 2043
[9]i; i : SS NUMBER ;
[10]| CHIEF, CONTROL DIVISION, OP . EOE OT Z586 -
[12]EMPLOYEE NUMBER :
[14]063365 -
[16]CHIEF, CONTRACT PERSONNEL DIVISION, _OP
[18]OFFICIAL
[19]COVER
[21]SUBJECT
[23]STATUS He STAFF: | | conreact ,
[25]ES" LYSHMENT “OF OFFICIAL COVER”
[26]SBR GA
[28]BASIC COVER PROVIDED ran
[30]EFFECTIVE DATE LOG
[33]OPERATIONAL COVER PROVIDED
[35]FOR Toy: JOTHER jf SPect ty) .
[37]SUBMIT FORM 3254 -+ W-2 TO BE ISSUED
[38](HHB 20-7) ;
[40]SUBMIT FORM 642 !MMEDIATELY To CHANGE | TELEPHONE
[42]LIMITATION. EATEGORY To CATEGORY .
[43](HAB 20-7) . wine
[45]SUBMIT. FORM” ‘ad IMMEDIATELY TO. CHANGE. ‘TELEPHONE
[46]LIMITATION CATEGORY To. carl ORY,
[47](HUB 20-7) : n.
[49]ie _ CATEGORY 1:
[50]| RETURN ALL OFFICIAL DOCUMENTATION TO CCS
[52]SUBMIT FORM 2688. FoR °
[53]HOSPITALIZATION “CARD.
[55]SUBMIT FORM 3254: Army W-2.TO BE ISSUED.
[56]CHHB 20- 31) i .
[58]DO NOT WRITE IN THIS BLOCK - 1
[60]SUBMIT FORM 1322 FOR ANY CHANGE, “AFFECTING THIS
[61]COVER. (HR 240-2e) .
[63]SUBMIT FORM 1323 FOR TRANSFERRING COVER
[64]RESPONSIBILITY. CHR 240- -2e)
[66]EAA. CATEGORY |
[70]cD of CPD so
[71]GPERATING COMPONENT fi} , 5R
[72].. “s "=RD os _ {/ 2
[73]+ O0-OfU/TEB prose Les
[74]fe
[75]nese FILE 4 _— :
[76]CHSEF. OFFIC!st CoveR BRANCY. ZPVER AND COMMENT IAL STAFF
[77]ee See en
[79]zt 155 csc reevrous ‘ecrtion SECRET