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THIS AGREEMENT Made in Duplicate as of the Day of ,  Form

THIS AGREEMENT Made in Duplicate as of the Day of , Form

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SIGNATURE GENERAL SERVICES ADMINISTRATION GSA 1500 7/1960. 4. Use reverse or additional sheets to continue explanations if necessary. SECTION I - VIOLATION NAME OF VIOLATOR TITLE AND DUTY STATION OF VIOLATOR NATURE OF VIOLATION State circumstances and facts relative to violation including time date and place describe classified documents compromised or mishandled and indicate agency of origin describe actions or negligence of person involved or responsible state what action has been taken to...
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