SECRET

PERSONALITY FILE ACTION REQUEST

TO: RID/201 Section

FROM: TUBE STATION: DM6

ACTION: BRANCH: CODE NO.: FILE NO.: FILE NAME:

CHECK: ( ) 201 ( ) 120 ( ) EXCLUDE TRUE NAME FROM MACHINE LIST ( ) RESTRICTED ( ) PERMANENT CHARGE

NAME: (Last) (First) (Middle) SEX: PHOTO:

NAME VARIATIONS:

NAME: (Last) (First) (Middle)

NAME: