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File: 970101_sep96_decls1_0061.txt
Subject: MEDICAL BIO WARFARE DEFENSE PLAN 8 APR 91
Unit: OTSG
Parent Organization: HSC
Box ID: BX003202
Folder Title: MEDICAL BIOLOGICAL WARFARE - BW- DEFENSE PLAN
Document Number: 2
Folder Seq #: 25
SHIPPER'S CONTROLI@% PRIVACY ACT STATEMENT
MATERIEL COURIER RECEIPT AUTHOPilfy SU.@.C.,Socb52.iPL93579)
PRINCIPLE PURPOSES: To p,o@.de a ece.pt for transfer of controlled material. TI,6 .,a of the SSAN
SHIPPER SUPPLY ACCOUNT NUMBER ,Gould and s necessary to P,O.id. positive id..t.ficat.on of the individuals ec,.pzi.g far h. @ai,,i.1
ROUTINE USES: To doc,,@.nt transfer of ate,,ai from a sh.ppol to a to no!
0, ecei@a,.
DESTINATION SUPPLY ACCOUNT NUMBER DISCLOSUFIE IS VOLUNTAFIY: Since the SSAN usi be used, efusal to P10.1do SSAN May be grounds
for action to emovo the individual concerned from duties involving the material transferred by use of this
form.
I certify by y signature that I have received the material listed on this form and am @a,o of the SHIPMENT DESCRIPTION
applicable safety and security requirements.
LINE NUMBER CUANTITY SERIAL NUMBEFIS REFAARKS
SHIPMENT TRANSFERS
FIRST I LOCATION OF TRANSFER IDATEtYR/MDIDAY)
RECIPIENT'S PRINTED NAME (LAST, FIRST, M.I.) ORGAN. OR ACCOUNT NO.
SIGNATURE SOCIAL SECURITY NUMBER
LOCATION OF TRANSFER DATE(YR/tAO/DAY)
SECOND
I I
RgCiPiENT'S PRINTED NAME TLAST, FIFIST, M.I.) ORGAN. 09 ACCOUNT NO.
SIGNATURE CIAL SECURITY NUMBER
r
THIRD ILOCATION OF TRANSFER IDATE(YR/K40/DAY)
RECIPIENT'S PFlit4TED NAME ILAST. FIRST, M.I.) ORGAN. OR ACCOUNT NO.
SIGNATURE SOCIAL SECURITY NUMBER
LOCATION OF TRANSFER DATE(YFI/MO/DAY)
FOURTH I I
RECIPIENT'S PRINTED NAME (LAST, FIRST, tA.I.) ORGAN. OR ACCOUNT NO.
SIGNATURE SOCIAL SECURITY NUMBER
LOCATION OF TRANSFER DATE(Yf4/MOIDAY)
FIFTH I
F.CIPIENT'S PRINTED NAME (LAST, FIRST. M.1.1 OFTGAN. OR ACCOUNT NO.
SIGNATURE SOCIAL SECURITY NUMBER
DD FORM 1911 PREVIOUS EDITION MAY BE USED Uf4'f%L 31 DEC 82.
I INI(IL
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Document 194 f:/Week-36/BX003202/MEDICAL BIOLOGICAL WARFARE - BW- DEFENSE PLAN/medical bio warfare defense plan 8 apr 91:1224960931152
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003202
Unit = OTSG
Parent Organization = HSC
Folder Title = MEDICAL BIOLOGICAL WARFARE - BW- DEFENSE PLAN
Folder Seq # = 25
Subject = MEDICAL BIO WARFARE DEFENSE PLAN 8 APR 91
Document Seq # = 2
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 24-DEC-1996