“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) (”
“(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)(”
“.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 ”
“K1 L SIGNATURE OF DO/IMS/FPLG REVIEWING OFFICER Exemptions and Provisions claimed to p rotect the f ollowing: Ε.Ο. 12356 1. Classification FOIA (b) (1) PA (k).(1) 2. Informat ion from lia ison with a Foreign Gove rnment (b) (3) (j)(1) 3. Information pertaining to a liaison (b) (3”
“14-00000 SECRET (When Filled In) 16-88- 46 PROCESS SHEET FOR DOMESTIC CONTACT SERVICE COLLECTIONS FOR FIELD USE ONLY FOR HEADQUARTERS USE ONLY A. ntose- 5. FIELD B.REQ. CODE FORWARDED1 th CASE e. OFFICE rr 12 13 14 ‘S NUMBER MO.POA.IYR J o 1H 9 4 16 17 8 1920 22 23/24 2”
“9 FOIA B1 B2 B3 B4 B5 B6 87C NEW CLASS PA BJ1 J1 ال K1 L SIGNATURE OF DO/IMS/FPLG REVIEWING OFFICER Exemptions and Provisions claimed to protect the following: Ε.Ο. 12356 1. Classification FOIA (b) (1) PA (k).(1) 2. Information from liaison with a Foreign Government (b) (3) (j)(1”
“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”
“SECRET (When Filled In) +4-20=50 PROCESS SHEET FOR DOMESTIC CONTACT SERVICE COLLECTIONS FOR FIELD USE ONLY FOR HEADQUARTERS USE ONLY F-15-45-31 A. FIELD 8. REPORT 3 REQ. CODE D. CASE RECEIVED Jotnan. A: OFFICE- S NUMBER no 12:• * s4!b NUMBER MO. ‘6a. ve. —2 X U 0 00”
“SECRET REQUEST FOR INVESTIGATION AND/OR NAME CHECK pacicor a ND ASIA of ASSIGNMENT TO : Deputy Director Security, 10S FROM: Chief, CI/Operational Approval and Support Division SUBJECT: 201 - TYPE of REQUEST os INDIES RESULTS sr 791 Hk aesults BY 904 04 SI (Date) (Date)”
“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”
“C/NE/ISR) should be indicated as the originating office with CI/SP always indicated as the secondary office of interest. b. Military attaches. C. Assistant military attaches. d. Identified intelligence officers. 26.15 SECRET A 0001.777 16 PAGE of 20”
“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”
“semi-annually to Headquarters and the field; based on a component’s interest as indicated in the “Action Desk,” “Country of Location,” and "Interest 26.7 SECRET 1 0001773 12 of 20 CO. % 0,”
“C/NE/ISR should be indicated as the originating . office with CI/SP always indicated as the secondary office of interest- . b. Military attaches. - -'-7 c. Assistant military attaches. d. Identified intelligence officers. IF Xoa 26,15 ■ : SECRET 0004176 6/174”
“identify the source )Information pertaining to a source. ) Information pertaining to intelligence methods - Location S —Location ) Name of CIA overseas installation of unacknowledged domestic installation of CIA employee )File number ) Pseudonym 1J Cryptonym® . Inter”
“) 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”
“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”
“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”
“pertaining to a source . . ()Information pertaining to intelligence methods ( ) Location of. CIA overseas installation ( ) Location of unacknowledged domestic installation [ ) Name of CIA employee . • . (>File number ( ) Pseudonym Mare 0) Cryptonym $ i ) Internal organizatio”
“would/could identify the source () 0) Information pertaining to a source... 00 Information pertaining to intelligence methods ) Location of CIA overseas installation 48 Location of unacknowledged domestic installation ) Name of CIA employee DJ File number/Ae- 1 Pseudonym ”
“ov isions c laimed to protect the following: Ε.Ο. 12356 1. C lassifi cation FOIA (b) (1) PA (k) .(1) 2 . Information from liaison with a Foreign Government (b) (3) (j)(1) 3. Information pertaining to a liaison (b ) (3) (j) ( 1) rel ationship with a Foreign Government 4. Informati”
“SECRET 11-20-50 (When Filled In) PROCESS SHEET FOR DOMESTIC CONTACT SERVICE COLLECTIONS - 15-45-3 • fon FIELD use oiLY FOR HEADQUARTERS USE ONLY A. FIELD OFFICE B: REPORT - NUMBER Lingg:cope 000 D. CASE - NUMBER 5. RECEIVED 97ldvn REPORT wo, RKI- OTHER MO - 0a5”
“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 ”
“/IMS/FPLG REVIEWING OFFICER Exemptions and Provisions cl aimed to protect the following: Ε.Ο. 123 56 1. Classification FOIA (b) (1) PA (k).(1) 2. Information from liaison with a Foreign Governmen t (b) (3) (j) (1) 3. Informati on perta ining to a liaison (b) (3) (j) (1) relations”
“originating office with CI/SP always indicated as the secondary office of interest. I;. Military attaches. C. Assistant military attaches. J. Identified intelligence officers. 26.15 SECRET”
“office with CI/SP always indicated as the secondary office of interest. b. Military attaches. c. Assistant military attaches. d. identified' intelligence officers. -- _ 26.15 SECRET”
“organizations to carry out the provisions of DCID 5, b) Chief of the main military cover unit, c) general supervision of the Central Registry consisting of 7 employees, d) general supervision of the Station name and source check unit consisting of 3 employees, e) general supe”
“OTHER/MISC 6 • GE 0 S. COMBINED wie ORGANIZATION NO. B.s o 6. ISUFFICIGT INTEREST 8 ♦t. METHOD OF COLLECTION wlt s EVALUATION USSR ONLY RESPONSIVE TO SPECIFIC EXCHANGES REQUIREMENTS REQUESTED FROM (CHECK ONE: LXIDTERviEw TRIP REPORT NO . 1 TO USSR yon OTHER DO”
“WHERE COULD CONTACT SO MAORI WHAT SON A FIDES COULO INDIVIDUAL MAKING CONTACT USE? If contact with Subject were to be made other than through the Case Officer, the newly-contacting Officer should exhibit documentary evidence of his Agonuy con- nection and a reasonable explan”
“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 ”
“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”
“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”
“( ) Information pertaining to intelligence methods ( ) Location of- CIA overseas installation ( ) Location of unacknowledged domestic installation ( ) Name of CIA employee ()File number () Pseudonym ( ) Cryptonym ( ) Internal organizational data ( ) Name of FBI agent ( )”
“foreign finds for the Intelligence Community, and performs such other services as may be directed by the DCI. L (3) ORGANIZATION. See organization chart, figure 7.. 10 February 1975 (871) E2 IMPDET 23 Cl BY: 059687 SECRET”
“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”
“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”
“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”
“should be indicated as the originating office with CI/SP always indicated as the secondary office of interest. h. Military attaches. C. Assistant military attaches. • . d- Identified intelligence officers. 26.15 ■ SECRET”
“ves w* 9. 2. 1 OCCUPATION/POSITION OCC/PCS. cone ■ 9. 1 SECTION II. CRYPTONYM PSEVLONM SECTION III COUNTRY or CISIDNC9 19. ACTION DESK - 11.5 ucond county wrasse 12. THIRD COUNTRY INTEREST 12e. COMMENTS PUNCHED COPY PERMANENT CHMOT RIGTRICTID PAS IONAfUAS 191098 201”
“which w/could identify the source Information pertaining to intelligence methods 12) Location Locat ion of CIA overseas installation of unacknowledged domestic installation Name of CIA employee. ) File number ° 2 Q Pseudonym® Cryptonyms XJ Internal organizational data ”
“intelligence methods $ I Locations of CIA overseas installation 3 Location - of unacknowledged domestic installation : . X noted ) Name 0 File 88 of CIA employee numberc Pseudonym Cryptonym3 Merer Internal organizational data Name of FBI agent 161167OR 2)_FBI f”
“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 ”
“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”
“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”
“intelligence methods Locations of CIA overseas installations )Location of unacknowledged domestic installation X 0 ■ Name of CIA employee File number Pseudonyms Cryptonym 3 . : ) Internal organizational data . ) Name 03 of FBI agent FBI file number 1 ( M0 4 0 P”
“identify the source ) Informat ion pertaining to a source - )Informat Lon pertaining to intelligence methods Locat IO8 of CIA overseas installation - Location of.unacknowledged domestic installation ) Name of CIA employee 2J File number - ZJ Pseudonym 75 Cryptonym Intern”
““th. SECRET hint PRO so. PERSONAL RECORD QUESTIONNAIRE PART II - OPERATIONAL INFORMATION akomgAr DISPATCH so. INSTRUCTIONS To CASE OFFICER /This tore use be filled-an by: the e officer of eppropreate eothority on the basis of the beef eveclable /n* ned to be ehewn-f”
“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”
“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 ”
“14-00000 SECRET DOI 50-10 DDO INSTRUCTION OPERATIONS-GENERAL NO. 50-10 4 September 1973 99 (c) Officials or employees of the International Association for Cultural Freedom; 99 (d) Officials, employees, or grantees of the Ford, Rockefeller and Carnegie Foundations; (”