Doc 0000184384

r CONTROL NUMBER ,f(o .r 21 ... : Central Att'n: DATE: I FOR USE O~IA ONLY Cb!er, In~ct.1on and Secur1 t7 starr (; ~e~o~N~o~·------------------~ , I SUBJECT: Request for IntelllQence Mat,rial 1. Request t.hls ornce be turnlahed the lntdllcence 11aterlal described b.elow, whlch does not nlst ln the tlUs or tb1s orrtce and ls not readllY procurable rrom sources to whtch· ·t.hls orrtce ha:s direct ac cess. A descrtptlon or thi! specUlc Items or tnrormatlon deslrec, filth rererence numbers where appropriate, ls 1te111zed below b ettered lte111s or ara ra hs. On any· documents dulred, thls orHee has 1nc11eated whether loan or retent on ·cop es are es re \' uslng one or the rouowlng appropriate stateaenta: •LOAN•: •RETENTION 1t poss1ble, otherwise LOAN•: or •RET~N.TION ONLY, LOAN NOT ACCEPTABLE•. lt is reQuestt-d that the !oUGWinC t,os. ot 1ntormatloa be collected on iatorrogation (or 1nt.errlsw) techniques used by Hcur1ty l'Ql1co or can1sat.1one, l'()llce .Jenart.ente, COUrt r'OOIIS and intelligence RI"Ylcea arrr throughout the world, wi. tb epbuta on Sorlet Russtan acti 'ri. ty, or ..t ellite aoti~tr• Gftllt!tral Interro:ra tiont llouttne 1nt.eJTOgatlon •thode, both lomal. anti ln tol"'lal, util1a1n~ nnn-technl.cal l'rooedures to obtaln the desired 1nforaat1oa. Techn\.cal Ai•ia to lntarrn~attont Php.lcal: Various maihOda or l'h11lcai persuasion ut111M~ u, el1ctt 1n!onD&tton Cram the uncooTMtrati"Ya wbjeat. · Psyehol"fteai' Threats, interttnces, ,.,matMts and ~stended procedure• atll1 zed in anecial interrog11ti.on &l"l'roachtts, aoftoning-u" l)rocedurea and 1nducemnnte. .. .. Mechnntcnl: Various mdes or 11e detection &f."''ArRt.ui utilised as an ald anct voriticaU.on tn interrogation rl"':)cerfura. Uedlcal: Various drugs, such as the so-clll.led "truth ~ru,..s,• I utll1zed to brP.ak down 1nhibi tions and reaiot.anca• and tf) l"rorluce short or prolonged control or 1nnuance owr the subjnct.. Also ndlcnl technique• .,rodtice ua.td as a torw ot •d1c1nal. durress t.o pain or d1aoomtort to the nbject. · . ;-..' .. ~­ I f 2. Suggested sources or this inrorMation are: ......................................................................- -- ~ 3. a. Degree or need: b.· Tlme or need 0 Urgent, required by ___________________ __ Hlghest otberwtse cannot be uaed. D Oreat, but not Juatl rJing extreae aeasurea I a a t ron U.Y des 1 r e d ff contt nuoualy ~~l~R~XRXHJJ.HW Standard (noraal collection aetton) As early as practicable bJ routine aethods. No J•~ ... 4 • Questions regarding thls request should be r.ererred ~"~_::...a:;:.....:.=-.......;.;...;.;.;....-.·. .._ ....._ . P.b one __.. ;:C;.::IA:::.;_ ___. .;_._ Ext ens 1 on ___ .;:;6L9.::.2 _____ ~ddressedo: ··c· 6. This The image is a digitally rendered graphic with a dark background. On the left side, there's a detailed illustration of a vault door with various mechanical components, suggesting security and access to stored information. Dominating the right side is the title "THE BLACK VAULT" in a stylized, bold font. Beneath the title, white text provides information about the document's origin, noting it was obtained from The Black Vault, an online database of declassified government documents, specifically mentioning the MKULTRA/Mind Control Collection and its housing by the Central Intelligence Agency (CIA). A yellow hyperlink, "http://mkultra.theblackvault.com," is prominently displayed at the bottom. e d ff contt nuoualy ~~l~R~XRXHJJ.HW Standard (noraal collection aetton) As early as practicable bJ routine aethods. No J•~ ... 4 • Questions regarding thls request should be r.ererred ~"~_::...a:;:.....:.=-.......;.;...;.;.;....-.·. .._ ....._ . P.b one __.. ;:C;.::IA:::.;_ ___. .;_._ Ext ens 1 on ___ .;:;6L9.::.2 _____ ~ddressedo: ··c· 6. This lnroraatlon, when procured, should be ......... ss Roo11 208 - 2210 "E" St., N.W. ttr ' . lDCla\ SIGNATUit[ OF AI'PitOYING OFFiC£1t ~ FOitM NO. IO I - ~ • -4•. • ·. ' .. • -: ... .. CY .. A l'lt 11•1 • P lt£VIOUS £OI \ TIONS \ NOT TO 1£ .. . . ' . -- - ·- ... " The document is a declassified CIA form requesting intelligence material related to interrogation techniques. It features several checkboxes that have been marked with an "X" or appear to have been selected. There are handwritten annotations, including a signature, a control number, and a designation of "ISS Copy." Additionally, there are redactions, indicated by blacked-out sections, particularly in the upper right corner and in the "FOR USE OF" field. The form itself is titled "REQUEST FOR INTELLIGENCE MATERIAL" and includes fields for "TO," "FROM," "SUBJECT," and various numbered questions and sections, some of which are filled in with typed text.