“crianchrrtatha TSus — - •——A 4 a-a —— n’g No7/wojfcGa thute Be ICovER. (* *40-72 9. Viv ; 010 gist SUDAtT FORM 1323450/ ASreediNccovrE 21 RESPONSIBILITY. Go 0... A 0.78 Ita EAA. careSORY 1j (CATEGORY IL. .J _- jsuoMir FORM 2588 FOR HOSPITALIZATION CARD REMARKS ANG/on R”
“0 0 0 3 20 i out forms, where were you born, this type of thing, biographic 21 type thing. These forms would be passed to our people who would 22 look at the forms and based on previous experience or what 23 they might have been doing, and they felt that perhaps they 24”
“(3) (j)(1) installation ☐ 9. Name of CIA employee (b) (3) ☐ 10. File number (b) (3) ☐ 11. Pseudonym (b) (3) ☐ 12. Cryptonym (b) (3) ☐ 13. Internal organizational data (b) (3) ☐ 14. Name of an FBI agent ☐ 15. FBI file number (b) (2) ☐ 16. Privacy of other individual (b) (6) H (j)(”
“200U 3 20. out forms, where were you born, this type of thing, biographic- 21 type thing. These forms would be passed to our people who would 22 look at the forms and based on previous experience or what 23 they might have been doing, and they felt that perhaps they 24 mi”
“1 4-00000 1 1 1 1 1 1 1 SECRET _FIELD REASSIGNWENT QUESTIONNAIRE TRANSMITTAL ISTRCCrtovs 47 -1 A Thie coestionnaire io Peeignod to previle ieferestion for eonsiderotion by Powquorters in plionene n, Isel supervisor in the ?iel4 will ensue ionnsire io co-pleted”
“1 Aljevwgn/asind‘7 SUB-SOURCE (Nome,‘T o. Organizer Addioss)< ", INDIVIDUAL NOR W‘*z *7*3 v* ‘ $ ele camsince •tri 0 mhauPrit a a Sts 09 OnGANIZATIONING. MA J. METHOD OF COLLECTION- EVALUATION. :“USSR ONLY: RIS-CHSIVE TO SPECIFIC ‘ EXCHANGES REQUESTED FROM \(CHECK ONE”
“J1 K1 Exemptions and Provisions claimed to protect the following: FOIA PA 1. Classification (b) (1) (k) (1) 2. Information from liaison with a Foreign Government (b) (3) (j) (1) 3. Information pertaining to a liaison,. (b)(3) (j) (1) ■ relationship with a Foreign Governmen”
“ument. 3. An asterisk in the column headed by (A) indicates that the lead originated in CIA, eith er in the field or headquarters.. 4. An abbreviation of a component of the U.S. Government in the column headed by (B) was othú than the : indicates that the originator of the lead w”
“DURING INVESTIGATION? / 8. CIA INTEREST May BE see* DURING INVESTIGATION? C. IS SUBJECT AWARE OF U.S. GOVERNMENT INTEREST IN wim? I X D. IS SUBJECT AWARE or CIA INTEREST IN Win? €. INDICATE ANY LIMITATIONS ON COVERAGE IN THE INVESTIGATION OF SUBJECT. F. SUGGEST "COVER ”
“operation, it is normally expected that a complete and realistic statement of specific duties may be reported in Section 8. However, the nature, source, purpose or dispo- sition of information or operations will not be included. On the other hand, the position titles ond descri”
“.1 4-00000 SECRET (When Filled In) 4-61-88 PROCESS SHEET FOR DOMESTIC CONTACT SERVICE COLLECTIONS FOR FIELD use ONLY FOR HEADOUARTEPS USE ONLY A. FIELD 81 REPORT C-REQ. CODE E. RECEIVED CASE OFFICE NUMBER — -- -- -- 19 12 13 14 19 NUMBER mo.i Da ve A fl 4 OTHER pi U ”
“Information pertaining to a source (b) (3) (j) (1) 6. Information pertaining to intelligence methods (b) (3) (j)(1) 7. Location of CIA overseas installation (b) (3) (j) (1) = 10 installation 9. Name: 10; File number 8. Location of unacknowledged domestic of CIA employee (b) (3) (”
“May BE SHORN DURING INVESTIGATION? c. 15 SUBJECT AsAnE or 0,5, GOVERNMENT urERFST IN HIMT X D, IS SUBJECT Amane or CIA UNTERPST IN HIM X €. INDICATE AN’S LIMITATIONS ON COVERAGE IN THE INVESTIGATION OF GUBJECT. F. SUGGEST "covrn PRETEXT co BE ueso IN CONDUCTING PERSONAL ”
“CONFIDENTAL (when filled in) Control PROCESS SHEET FOR DOMESTIC CONTACT SERVICE COLLECTIONS 15-45-31 RC o copr CASE ro wanDfoj PILO OFFICE NumnER o. *112 13 16 39. 0. in 2 4 i ad 26 • ze 30 V *4 ye ND ARE 0-31144 627.0-1 MO. 4 Possible Identification and Surveillanc”
“INDIVIDUAL NO. 9 S C 1. cowerwro wire 6 G € O 6. insurricirut ;ratr 7 e i o ORGANIZATION NO. 8 9 M I S J. METHOD OF COLLECTION USSR ONLY RESPONSIVE TO SPECIFIC EVALUATION EXCHANGES REQUESTED FROM REQUIREMENTS A interview (CHECK ONE) Trip Report NO TO USSR Other Docu”
“CEvALUASIONS. va USSR ONLY. RESPONSIVEMO SPECIFIC % EXCHANGES REQUESTED PROM CHECK ONE: REQUIREMENTS. IINTERVIEW Phir RERomr NO rorUSSe OTHER DOCUMENTS _EJOTHER (specify blow) PROMUSSR ALIEN: 055 sovd INF CASEFOPFICER MEADQUART ERS € OMMENTS DIRECTED TO FIELD COMMENTS ”
“SECRE I/xo FOREIGN DISSEM y INTERNAL USE ONLY Instructions for SWL Form Pari IV: Operational Data 1. This form will be used for maintaining a ready reference fist of sources with direct . or indirect access to subject and for recording operationally sensitive data on subject”
“means; CSCI dissemination through regular liaison channels, or memorandum). Following the subject o f the document there is an appropriate excerpt from the document. 3. An asterisk in the column headed by (A) indicates that the lead originated in CIA, either in the field or headq”
“ADMINISTRATIVE INFORMATION OF WHICH HE IS COGNIZANT. . " 65-2.* -4. SUBJECT WAS INSTRUCTED THAT INFORMATION PERTAINING TO INTELLIGENCE OPERATIONS. SOURCES‘AND METHODS PECULIAR TO THE AGENCY MAY NOT BE DIVULGED TO PERSONS IN OTHER GOVERNMENT AGENCIES. EVEN THOUGH SUCH PERSONS A”
“14-00000 SECRET (When Filled In) 4-61-88 PROCESS SHEET FOR DOMESTIC CONTACT SERVICE COLLECTIONS FOR FIELD USE ONLY Fon MEASGUARTERS USE owLr ‘FIELD B. REPORT "REO. CODE D. e. RECEIVED ALPORT *0. 1 NOMEER OFFICE NUMBER tt 12 saiain wo: DA. Ya. |A U 0_ 1 2 » 4 • 0 7 a C”
“al means; CSCI dissemination through regular liaison channels, or memorandum). Following the subject of the document there is an appropriate excerpt from the document. 3. An asterisk in the column headed by (A) indicates that the lead originated in CIA, either in the field or hea”
“PERSONNEL RECORDS AND REPORTS.. 155 Figure Title Page 1. DISTINGUISHED INTELLIGENCE CROSS............... .......... 94.1 2. DISTINGUISHED INTELLIGENCE MEDAL................................... 94.1 3. INTELLIGENCE STAR ........................................................”
“) Informat ion from a foreign liaison service 1 )Lnformat lon pertaining to a foreign liaison relationship ) Information which would/could identify the source go on ) Information pertaining to a source . J Information pertaining to intelligence methods. yolocation of CIA of”
“Escape _____ __ 27. Weapons 28. Demolitions drzestot raian- ours Per 29. Special Devices (R&D) .30. Air Reception - The L-official --- to whom inis ro::s€- try within sonalyIC-EChl —orortothent it Aitheena he n-esofbston 31. Sea Reception his discretion,s’. 32. Map ”
“!S J. METHOD CF COLLECTION USSR CNLY . EVALUATION EACHANGES RESPONSIVE TO SPECIFIC REQUESTED FROM REQUIREMENTS .X Interview Trip Repcin - - CHECK ONE) 190 TO USSR . Other Document FIELD COmmEnTs Other (specify below) HEADQUARTERS COMMENTS FROM USSR IRS f 1 P ”
“the source ( ) Informat ion pertaining to a source ( ) Informat Lon pertaining to intelligence methods I Location . of CIA overseas installation i Location of unacknowledged domestic installation ( ) Name 0% CIA employee. ) File number J Pseudonym O Cryptonyms ) Internal”
“SECRET (When Filled In) 4-61-88 PROCESS SHEET FOR DOMESTIC CONTACT SERVICE COLLECTIONS FOR FIELD USE ONLY •OR MEDOUARTE PI USA ONLY C-PEG.CODE D. CASE €. RECEIVED A. FIELD B. REPORT Iale,•".( OFFICE NUMBER 13 NUMBER MO. DA,e A 1 2 >14 s a 1o 00 FC 0 *6187112/10/20,129 22 ”
“0 •. ISUFFRizOT INTEREST 7 B tlo ORGANIZATION NO. & -1.I- Mi’s J. METHOD OF COLLECTION USSR ONLY I EVALUATION EXCHANGES RESPONSIVE TO SPECIFIC REQUESTED FROM REQUIREMENTS (CHECK ONE) Interview Trip Report I NO TO USSR Other Document a. Other (specify below) FROM USS”
“Initiate and develop contacts and operations in the Washington diplomatic and foreign press communities, encompassing all the major world geographical areas. Handle recruited agents resident in the Washington area. Establish and maintain self in commercial cover role, Perform”
“L ( @ CIA - State Dept. Utegration Fig Korf cover - »hu S.D. employees are avere that EIA amp. is in fact amplrjed de More integrated covie where a person would do a full-time S.A. job &, 0200 al"dLIeepA joffiob Wheel a c i a l un unbekrasownstwelltoasnesta ofdeepS. D.cov”
“14-00000 'SECRET ____PRQ hQ. PERSONAL RECORD QUESTIONNAIRE PART II - OPERATIONAL INFORMATION 01sPar;= vo INSTRUCTIONS ro CASE OFFICER I. This forw oust be filled in by the cvse officer or soptoprsate authority on the basis of the best available in for-ution It 43 not t”
“fills-eo CONFIDENTIAL (when filed in) : axgerogrisp-pargem-gwenwrois-ommake PROCESS SHEET FOR DOMESTIC CONTACT SERVICE COLLECTIONS F 9G t.0 Fet 1. corn •nnamrep : v. t,ICR o tax : 4 ,2 04 co 0-3-1-1-4. -6 27 o: 74 $* NO. t'1 Possible Identification and Surveillanc”
“SECRET. SECTjOm.vh: OPERATIOAL USE - CONTACT Of/um/ec was • 1 uSeotom CONTACTLDYBEFORT Abi Chid “Ac Tiv it• 46.0fcAznt-es ENGAGED AND fef -t O’ inten. NAT:***-***/*****--*--*-"----*.:- . N.A. " w e s - n il , »•. INDICATE: now AND ♦ a oe »<ow SUBJECT OBTAINS INFORMAtiOn. ”
“INTEREST max »c SHOWN DURING INVESTIGATION? ? ,C. is SUBJECT AwARt or U.S. GOVERNMENT INTEREST IM MINI ») X p. is SUBJECT AMARE er CIA INTEREST IM Hrut t. INDICATE ANY LIMITATIONS ON COVERAGE IM THE INVESTIGATION or SUBJECT. ale r. SUGGEST "covra ParText” TO st usto IM ”
“dma may be reported in Section B. However, the nature, source, purpose or dispo- sit-un of information or operations will not bo Included. On the other hand, the position titles and description of specific duties of certain other employees may jeopardize security and should not”
“service Information pertaining to a foreign liaison relationship • Information which would/esrt identify the source 9Informat ion pe retaining to a source 3 Information pertaining to intelligence methods ) Location of CIA overseas installation ) Location of unacknowledged domest”
“8 Fretar 201 Silject-countrier, projects exi s t for il involved in. all project That CIA MM PMMN amort GroeN espto. FinanceDERI nDi EDRect Rent El Blnthetey UN Il be a crypt file Logistic -sautomobiles, c bothing, supplies D0 ILAD11 Communication - able Eolta”
“agency to the USSR. The case officer told Subject that this information could be forwarded to the Station through the LNPURE officer and assured him that his cooperation in supplying such infor mation would not involve him in a series of escalating intelligence assignments. ”
“RIMARY DESK INTEREST 12. 2ND COUNTRY INTEREST 124. 3RD COUNTRY INTEREST 時100 702 COMMENTS FORM 12-10 RETURN TO CIA Background Use Only Do Not Reproduce 03 201-275416 PERMANENT CHARGE RESTRICTED FILE SIGNATURE NW 65987 Docld:32405814 Page 1 ☐ ☐ SECRET (38) CS COPY 90”
“8 9 M I S J. METHOD OF COLLECTION USSR ONLY EVALUATION RESPONSIVE TO SPECIFIC EXCHANGES REQUESTED FROM REQUIREMENTS (CHECK ONE) Laser. Interview Trip Report NO 1 TO US p Other Document Other (specify below) FROM USSR 1 FIELD COMMENTS HEADQUARTERS COMMENTS C0 Clon”
“msurvicitur HTEREST 7 B 1 O ORGANIZATION NO. e 9 M 9 J. METHOD OF COLLECTION USSR ONLY RESPONSIVE TO SPECIFIC ' EVALUATION EXCHANGES REQUESTED FROM REQUIREMENTS Interview JTeip Report (CHECK ONE) NO D/Cksi ■ RECAI TO USSR Other Document Other (specify below) FROM U”
“in any FI project. Subject subsequent to clearance and hire will be considered by the Project for possible re-assignment into more responsible work. Appropriate security clearance up-grading will be hen requested.---- ----------------------------------- 4. INVESTIGATION AND C”
“organization, or association they represent; D) Forged business documents; E) Accommodation addresses (“residences of record” for anyone working under alias). 3. (S) Many of the specific forms of alias documentation represented in this package are identical to those used ”
“Address) INDIVIDUAL NO. $ S |O C 4. OT E* miscm 6 € O s. COMBMED ettie 7 a 0 6. MSUFFic Eut INTEREST ORGANIZATION NO. M 1 S N. METHOD OF COLLECTION USSR ONLY EVALUATION RESPONSIVE TO spEclnC EXCHANGES REQUESTED snow CHECK ONE) REQUIREMENTS :INTERVIEW TRIP REPORT NO T”
“Subject is going to be assessed for use in future oporational needs of Station. INVESTIGATIVE COVER IS OR WILL SUBJECT BE AWARE OF U.S. GOVERNMENT INTEREST IN HIMT IS OR WILL SUBJECT BE AWARE OF CIA INTEREST IN HI INDICATE SPECIAL LIMITATIONS OR COVERAGE DESIRED IN THE SECURITY O”
“FALSE STATEMENT ON THIS FORM CAN BE PUNISHED BY FINE OR IMPRISONMENT OR BOTH (See U. S. Code, title 18, section 1001) 40115 Jan DATE Cyr K Hayashi 5 Oct 1966 21. THIS SECTION TO BE COMPLETED BY AUTHORITY REQUESTING INVESTIGATION BRIEF DESCRIPTION OF DUTY ASSIGNMENT AND”
“cessinconTOP SECRET (This form is to be used for material extracted from CIA—controlled documents.) - 303 - Pitched: Made an effort to recruit as an agent, asset or source. Production: Materials or information generated by an operation or project. Project: A group or se”
“SECRET PRO 60. PERSONAL RECORD OCESTIOSNAIRE PART 1I - OPERATIONAL INFORMATION DISPATCH mo. HMIA-33865 * INSTRUCTIONS 10 CASE OFFICER 1. This form suet he fitted in by the case officer or appropriate eetbority en the bosin of the best available san focoelien. I t is -of ”
“SECRET A / Fretar 201 Subject- Countries, projects Exist for all projects that CIA il involved th. DIN Support Lite JUN D1 espto FinancePEINE DLD30 B10120D762443115 AlLUAR 0 02111117/2014 Il be a copt file Logistic - 5100 Dtomobile.c Lothing, supplies D211170 C”
“with 6 G E 0. isurricizur GTEPEST 7 e 1 o ORGANIZATION NO. 8 -9 M 5 J. METHOD OF COLLECTION USSR ONLY EVALUATION EXCHANGES RESPONSIVE TO SPECIFIC REQUESTED FROM REQUIREMENTS 2x30 Interview Trip Report (CHECK CNE) NO Ala Et 1Other Document, Other (specify below) F”