I PRc Serial # of Originating Document Date Received S From 3\ - (TA 0(0.2.--'74-/D47 (Name of Contributor/Interviewee) (Address) frity and Smtcl By C A To Be Returned 0 Yes Receipt Given 0 Yes C3~Io — Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) Federal Rules of Crimina