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Seriat Removal Charge Out 4-21 (Reg. 2-11-65) ae (3) INSTRUCTIONS: This form is to be removed from file by a Filing Unit cnployee only upon the return of the item. Subject on, TYO_ DMV AL Con Type of Maik [_) Repo Date of Mail (] inconting letter {_] Outgoing letter ([] Memorandum (C} Airtel ; : S CJ Teletype {3 Enclosure (describe) oO Personnel Security Questionnaire (PSQ) [J Loyalty Form CC) Other (describe) ead Removed for Date of Removal }~W-Th Reason for Removal ([} For copying {f for another agency, list agency and date of request.) (Lj To send to (7 To-attach to - + (I For office use a ooo ([) For change to ano hyr file | id . » | Complete File and Seria! Number ~ \S HO ~ ‘ {< = 2 Los