Source of document: OSD/JS FOIA Requester Service Center · 2018-03-23 · Officer assigned to your...
Transcript of Source of document: OSD/JS FOIA Requester Service Center · 2018-03-23 · Officer assigned to your...
Description of document: Eleven (11) Secretary of Defense Forms, 1963-2011 Requested date: 19-July-2017 Released date: 12-January-2018 Posted date: 26-March-2018 Source of document: OSD/JS FOIA Requester Service Center
Office of Freedom of Information 1155 Defense Pentagon Washington, DC 20301-1155 Fax: (571) 372-0500
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DEPARTMENT OF DEFENSE OFFICE OF FREEDOM OF INFORMATION
1155 DEFENSE PENTAGON WASHINGTON, DC 20301-1155
JAN 1 2 2018
Ref: 17-F-1351
This responds to your July 19, 2017 Freedom oflnformation Act (FOIA) request, which is attached for your convenience. We received your request on July 26, 2017 and assigned it case number l 7-F-1351.
The Washington Headquarters Services, Directives Division conducted a search of their records systems and located the enclosed 13 pages determined to be responsive to your request.
This constitutes a full grant of your request, and closes your case file in this office. There are no assessable fees associated with this response.
I trust that this information fully satisfies your request. If you need further assistance or would like to discuss any aspect of your request, please do not hesitate to contact the Action Officer assigned to your request, Cheryl Jenkins, at [email protected] or 571-372-0445. Our FOIA Public Liaison, Jim Hogan, is also available to assist you and may be reached at 571-372-0462.
Enclosures: As stated.
RECORD Of LEGISLATIVE BILLS AND RESOLUTIONS i
REQUEST FOR REQUEST FOR REQUEST FOR
ACTION FILE REPORT FROM ACTION FILE REPORT FROM ACTION FILE REPORT FROM
BILL NUMBER AGENCY CLASSIFICATION (A6eltC1 and BILL NUMBER AGENCY CLASSIFICATION (A6e,w:y and BILL NUMBER AGENCY CLASSIFICATION (A6fflC1 a'8d ASGMT Daw) ASGMT Daw) ASGMT Dot.)
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2. SUBJECT
OfFICE OF THE GENERAL COUNSEL, DEPARTMENT OF DEFENSE LEGISLATIVE ROUTING SLIP
ROUTING TO
11. DATE
ROUTING
Secret.ry of the Army Director, Defense Logistia Agency
TO
ATTN: O,lefofLeglslatlveLlalson r ~ ATTN: Counsel '"·------+--+------------------4--....... Secretary of the N•~ . ,1, Director, Defense Mapping Agency ATTN: O,lef of Leglilatlv• ~ffairs \1 ATTN: Counsel
1, ·---------+----+----------------------+--......, StcrmryoftheAir Force ATTN: Director, Legislative• ·•Ison
\ Director, Defense Nuclear Agency ATTN: Counsel ----------- -
Under Secrmry of Defense ~- Director, Defense Security for Research arid Engineering ~ I_ Assistance Agency --------------- ---+----+----------------------.1----1
Under Secrmry of Defense ' 1/ Director, National Security Agency for Policy H ATTN: Counsel to------ - --+----+--------+----II Chairman, Joint Chiefs of Staff AGC (Fiscal Matters) ATTN: Administrative Assistant AGC (International and Intelligence)
Executive Secretary :..:r AGC (Legal Counsel) ASD (Command, Control and Communications Intelligence' __ : ---+-.-~""'. ·; (-L-'-oa,._i;...st....;;ics-'-).......;;--=----------------+----1
ASD (Comptroller) · f ~GC (Personnel and Health Policy) ATTN: AGC (Fiscal Matters) I _ OTHER ("--ecify)
ASD (Acquisition and Logistia) _____ ;..... ___________ .....,..=--__ =----------+ -1-AS_D_<,..For.....,ce_M_a.,.na....;;g;..e.,...m_e_n_t_an_d_P_•_rso_n_n_e_l) ________ ---t-__ ---t /_,
ASD (Health Affairs)
ASD (Legislative Affairs) ., 1----,....;;.,,..--. ..... -----------------1-----1i---- -ASD (Public Affairs) TYPE OF"'-••-',. REQUIRED ______________ _
ASD (Reserve Affairs) Preparation of DoD Rel)'_, ____________ -+-_1_ ...
Inspector General, Advise If AnyObjecti -'-'-'-------------1---'-2;....-1 .,0t.....;.pa_rt_m_e_nt_o_f_Def_e_nse _______________ +----t-C;..;;;o:-m_m_e.;..n_ts_a;...n ___ d Rr_j.;..m_m ___ e_nd_a_t_io_ns __________ ,._ __ 3__.
Director, Operational Test Information 4 .. •_nd_E_va_t_ua_t_lo_n _________________ -+----t Information, -..nding Submission of
5 Director, Program Analysis Proposed Repo.' ______ _
and Evaluation Implementation 6
Deputy Assistant Secretary of Defense Appropriate Action #' _ i,\~ 7 (Administration), OASD (Comptroller) OTHER (Specify) 8 t----------------------+----t DlrKtor, Defense Advanced Research Projects Agency
Director, Defense Audiovisual Agency
Director, Defense Communications Agency ATTN: Counsel
Director, Defense Contract Audit Agency ATTN: Coun1el
Director, Defenle Intelligence Agency ATTN: Counsel
Dnctor, Defense Investigative Service
3. REMARKS
4. A1;;T1ON AGENCY
SD Form 311, FEB 86
ADDRESS REPl Y TO: GENERAL COUNSEL, DEPARTMENT OF DEFENSE ATTN: Director, Legislative Reference Service Telephone Number: (202) 697-1305
Previous ~tlons are ob!olete.
DIRECTORATE FOR FREEDOM OF INFORMATION AND SECURtTY REVIEW fDfOISRI COORDINA TIONRECORD
2.. CASEMO.
3_ DATE
4, DIICNf'TION a. TYft Of DOCIJaNT • aAISIRCATION
•• UQl,IQTCNI
• · f\11 .. T DATl
I. THl ATIACHE'D MATERIM.11 FORWARDt. . f R IIIEVEW ,-,·.,COMMENT• ACCORDANCEWmt THIE ll'OLlQwtNQ GUIDIEUMl!S. QUEITIONI C08CIEJINING THIii CASIE IHOL' DIE mi.u·· c' TO:
A flElt.Y IS .iEO:UESTEDIY;
I. KCUIIITY MV1!W COOIIDINATIONOFAaACTION TO: Oncilo,arte for frNdom ot lnfOffll.uoA and Securt1v ..,. ;,w l~OISP' >Aoom 2C7. 1
Reviaw Ir/ 1h11 affiaa ill •ccarunai With,._ guidellnn btlr;iw l'NIMtl ' ,,,._ •0tlowlng r-..: •mfTlllndatloneti~ dei,ranc• for pub.-c~- fXOM:}
NO OIJECTION AS RECEIVED.
NO OIJECTIOflll IUIJIECT TO AMENDMfHTI MADE IY THII OfFICE. Amendmtl"ICI lrll" Aionele l .. cunt\' 111d Polley) _,. ar,notated on page nu~ll&ted below.
OBJECTIOW. A1Nndll'wn11101M1rmitpubic~11te lmei,IM:ticable. Re--~ ,1edbalow. iAtadlcan~tianpaps if lllft'ftSaty.J
1 . TVIIID_.,. 11 fflll
d s.GINATUM
INSTRUCTtONS
The policy of the Department of DefenN i1 to authorize and encoLM"age the public rele•H of lnfcwm•uon ccnce,nlng lhe Department of Oefense COMl•tenl with NC\.lrit't' requtr.ments, Ind othtJr ~ptior,s to diwclosu~ under th• Freedom of lnfOffflation Act.
SECURITY Rievi9wing lltil9"Citll5 •hould id9ntify infarmat,on known to be clauifiad within the meaning of Executive Order 129H (DoD Aagul• tion 5200. 1 R~ or inforrNtlon wnich in the judgment of tt-.e revtewlno agency w•nant& ehi .. rfleatlon. In the l1tt1r c.Ne, ii II requesc.ct that l"Hlons for thil judgmeml b9 giqn and ,• cornrnenc.tianamade for ,appropriate daaaification
l'OUCY - MahWJal o,lganattng within the D•pawimen1 of Ottt.nH tor public ,..,._. •houfd, in addition, b9 1'11\llew•d for conflict wrth •mblilh•d polic• •nd prog,.m• of ttMt De~mant of Oefenae or thou of the F9deral government. If change i• neceuary, rav.Mng • ,g• nctN • re requested to recommend acceptable aubltltute language where c:,raetlclble. or apedfy Med•d dlang,N In sufficient detail to permit acc~•blt ,. ... 1.ion.
EDITORW. • Editort.l re\llew ia not • f88POnllibi1ity of the Directorate for Freedom of Information and Security Review end ,...wlnQ-oenoet ahould not make editorial c~na. However, ob\lioUI en'0l"II of ftct "1ould ti. ind~ed.
SD FORM 37~, DEC 1999 PREVIOUS EDITION MAY BE lJSED
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1 , _..., AME (Last • . • ,. /I ,ddle lnlt,.I) GRADE AGENCY I CERTIFY - - . , 1 I~ (read}(bffnbrlefed) AND FULLY UNDERSTAND THE STA~ .u 01'>, ~TIN< PROCEDURES FOR HANDLING (Cosmic) (NATO Oassin.d) MATERIAL ' ND ~M AWARE OF MY RESPONSIBILITY FOR SAFEGUARDING SUCH INFORMATI\. , . AND THAT ' M LIABLE TO PROSECUTION UNDER SECTIONS 793 ANO /94 OF TIT' .. d, U.S.C., IF EITHER BY INTENT OR NEGLIGENCE I ALLOW I" TO PASS . -cfC" UNAUTHORIZED HANDS.
DA TE SIGN' 'uRE
ROOM NUMBER TELEPHC" Jr- BUILDING
DATE VERIFIED BY (r· ,,vture of r .1trol O: 'icer)
SD Form 401, JAN 63 COSMI\. QQlr' . ING CE:RTIFICATE
+
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. . DIRECTORATE FOR FREEDOM OF INFORMATION AND SECURITY REVIEW (DFOISR)
RMEWER'SWORKSHEET
1. ACTION DMIION i0\\ 2. CASENO. 3 . DATE RECEIVED
4. DIICIIIPTION _ ti 1. TYPI OF DOCUM lff
~\ II. NUMIEROF PAGES c. CLAalFICATION
d, IUIJICT (I • • REOUEITOR
~ f. IOURCI ·
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- -I . ACTION OFFICER
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I. DPOIIIIACTION 1. IIICOIIMINDIDACTION ()( • _,,,.,., 11. FINALACTION ()(a~
CLIAIIID Cl!ARl!!D - -CLIAIIIDAI AMENDED CLEARED Al AMENDED
- -NOTCUAIIID NOT CU!ARl!D
- -• 11a.c>AnACHl!D I& MEMO ATTACH&>
Ct) INITIALS WDATE ,, , INIT1AL8 (2)DATE
I . CAii lHOULD IE INDEXED UND!II THI FOLLOWING KEYWORDS
8D FORM 403, DEC 1999 PREVIOUS EDITION MAY BE USED.
NAME DATE ADDRESS TELNO.
008 HEIGHT WEIGHT
POB I EYES I HAIR
SEX I NATIONALITY I OTHER--
REMARKS • INTERVIEW 0 LETTER '..J PHONlf D JTHER
0 OVER
SDPORM415, AUG81 THREAT AND CRANK DATA
REMARKS (Continued)
REFERENCES
ACTION TAKEN
*THESl DATA ELEMENTS MUST BE FILLED IN 328*
CLASSIFICATION __________ Ou
(CHECK BOX IF UNCLASSIFIED)
REPORT OF EXCEPTION TO NOP
335•
355•
328*
Cl.ASSIFICA TION (CHECK BOX I~ UNClASSIFIED)
Du SD Form 456, SEP 73
(I- .
DEPARTMENT OF-DEFENSE Control Number and Date: OFFICE OF FREEDOM OF INFORMATION AND SECURITY REVIEW
Action Assigned to:
Under Provl~lons of ffi'~jF~E[)~_~,:01:.::~NFOR.A,Ti,~-:~ _: c~· l'.., ~~-~ ~~).:~n,d:.Dc)D Regulation 5400.7-lt 1"9SDOnd··no:1._ than:'\ . ·: , .
, . • • I ,.• •·· . ' • ' -------READ AND FOLLOW THESE SPEC,:1L INSTR1 .C11,~NS
1. Handle this material as a package. Do not section or ~llow the pr ,«age tC# '1ecome separated from this cover.
. . . • • • • t<\'f •• t ,'4 • .. •• •,1, r •,•• • •- • .::-., • •1 1•" • • • ""ii' .... · :• :- ~• ••, : -- •• • -,• o,#• , ~ •:•• : , •1•w::-•· ·H•·••• ~, ... ,, , .. O ~-. ·••••-· • •••• - - , •• ·• .... ,, .. O
3. When this action Is completed, place In distribution or deliver to the Pentagon OSD Mallroom (Room 3A948). For further assistance, call (703) 696-4689.
SD FORM 488, JUL 2005 . . PREVIOUS EDITION IS OBSOLETE.
DEPARTMENT OF DEFENSE Control Number and Date:
DiRECTORA TE FOR FREEDOM OF INFORMATION AND SECURITY REVIEW
Action Assigned to:
MANDATORY DEC' .. Ass•:,.1\? ATION 1REVIEW
ACT10N Under Provisions l>f
· Executive Order 129F~ and DoD Directive 5200. 1 ,. , 1d 5200. 1-R
-
Respond no later than: _
,READ AND FOLLOW SPECIAL INSTRUCTIONS OF DOD REGO .. I. TION 5200. 1 R
1. Handle this material as a package. Do not break it up or allow it to be" ::,me separated from this cover. ·
- ------------------------------------------------3. When complete, do not place in Distribution Courier Service. Call for pickup or deliver
directly to Room 2C757.
SD FORM, 483. SEP 1888 PREVIOUS EOmON TS OBSOLETE,
•
,.r.. ~'lATORY DECLASSIFICATION REVIEW GUIDELINES
1. b this docc tient is under your classification jurisdiction and can be declassified, declas. ;fy in a, ordance witt, "")oD 5200.1-R.
2. If the doc -,as orir /lated by another agency and you do not object to its declassification, mark "lo ' 1bjection" on SD Form 472, Request Information Sheet (Item 9a) .
3. If this document is, 1der yr- .r cir ;sification jurisdiction and cannot be declassified, or if you object to its declas' .1catic- , when undflr the jurisdiction of another office:
a. State reasons why docum ,. .. .»1tould .. 1.ain classification and which of the classification criteria contained in r JD 5200."' ,. or EO 12958 apply (SD Form 472, Item 11 ).
b. Determinations to retain classificatior .,nail . 'e approv d by the appropriate classification authority.
4. If the document can be declassified, but information shoul oe withheld under one or more of the nonsecurity exemptions to mandatory disclr .Jre under the Freedom of Information Act, i.e., FOIA exemptions 2-9, coordinate •· :.1'.h the General Counsel. NOTE: FO IA exemptions should be invoked only on ra1 occasions. Cont? ~ , .,e action officer.
5. Complete Request Information Sheet, SD Form 472.
6. Return completed action to DFOISR (Room 2C757), Pentagon.
PLEASE NOTE: Suspense dates are assigned to permit 45 working days for total processing of MOR requests. Your response earlier than assigned suspense date is desired, especially when classification/declassification issues are clear and . uncomplicated.
SD FORM 483 (BACK), SEP 1998
_c_1-ASS ___ : _____ N~~tc. DA,.-. __ i _______ s_u-r-~-:-:-:-,~-:-:-AL_T~-~----------r-CO_N_T-RO_L_N_O _______ ___:,
FILE NO. .'I.. CASE SUSPEMSE ----------'39k------.l,I -----SUMMARY WHHSE
000 t __________________ ---1.._H..,A.._ ___________ ~, ~
--....---R_O_UT_I_N ... G_:_IN_F_O_R_MA __ r ... 1o_N_A_G_EN_c_,_e_s,------~---..i.il'"' l't " '
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ROUTING: ACTION AGENCIES
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A<" ON f ~
PREPARE
PREPARE
01 RECT REPLY TO
COORDINATE WITH
APPROPRIATE ACTION
REMARKS
TASKING OFFICIAL
SD FORM 511 83JUL
MEMO FOR WITH COPY TO .M!.
REPLY FOR SIGN.Ar jRE OF . WITH COPY TO
I I ADVANCE COP\ 7 I HAS ACTION
REPLACES DAS FORM 77, 1 OCT 79, WHICH MAY BE USED UNT&
- ~ St.TELEPHONE NO.
·cxHf lSTED.
Control No. must be shown on copy of reply furnished tasking official SUSPENSE SLIP WILL REMAIN \\ :'fH CORRESPONDENCE
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GIFT AGREEMENT
PRIVACY ACT STATEMENT
10 U.S.C. 113; DoD Directive 5110.4; and OSDAdministrative Instruction 103.
(S): To provide a record of donations and contributions of historical properties to DoD/OSD/Historical enable DoD to establish title to the property. To provide the donor or the donor's heirs information
ocation of the donation.
E(S): Information may be disclosed to a municipal corporation, a soldiers' monument association, a state museum, an museum or exhibition operated and maintained for educational purposes only; a post of the Veterans of Foreign Wars
erican Legion; other r veterans' groups; or other Federal museums upon donation or transfer of the historical property to one of thosa , • nformation may also be disclosed to Federal , State, or local taxing authorities.
, , ailure to provide complete information may result in the refusal of your gift or donation.
CRETARY OF DEFENSE (OSD) UNCONDITIONAL GIFT DONATION
I, (Print Name) _____ -"-_____ _.., __ _.__ __ , (Street Address) _________________ _
(City) __________ .;;,.:...__.___:....__,.._....,__ , (State) ____________________ _
own the item(s) described below and
I understand that
located at
ear of all encumbrances, to the
ip, title, interest, and possession
therein to the donee absolutely.
The herein described gift and transfer of said property does not enntail the granting of special conces ·
executors, administrators, heirs and assigns. The herein described gift and transfer of said prope is made for the benefit or use in
connection with the establishment, operation, or maintenance of an OSD or other institution 01F"tllilllflll>a
the Department of Defense, in conformance with Section 2601 of Title 10, United Statwe&ie.
I also understand that museum record-keeping procedures require that my name and addrese
acknowledge that I do not consider this to be an invasion of my privacy.
I understand it is my responsibility to have an appraisal of the donated property made for tax purposes. performed by the _______________________________ c,;...,.....,_ __ __,..,,,,,_ __
as a facility or members of the staff as individuals.
DESCRIPTION OF PROPERTY (Continue on separate sheet if necessary):
DONOR SIGNATURE DATE
RECEIVED BY (OSD Representative Name, Title, and Signature)
SD FORM 825, AUG 2011 Adobe Professional 8.0