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FORM NV-164
2/78)

U.S, DEPARTMENT OF ENERGY
NEVADA OPERATIONS OFFICE

Dom O278

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OUTGOING FACSIMILE TRANSMITTAL
Yerificatian Telephones No, 598-3159
(See reverse side for trintructinns,)

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1.

CLASSIFICATION:

Indicate above whether message to be trans-

mitted is Unelassificd, Privacy Act of 1974°, Official Use Only
*

:

.

.

,

Proprietary, Confidential, or Secret. ("This message (does

(does not

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If it does, dissemination to the receiving
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) contain information under the purviaw of the

Privacy Act of 1974,
party is allowed by

FROM:

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A. . Tiime

FOR NV MAIL ROOM USE”

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NV Document Contral Number

"FOR COMMUNICATIONS CENTERUSE”

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8

pages, no.

4-2DD
9.

TO:

DOCUMENTATION:

Message transmitted consists of __ .|
of

copies, Seriés

eee

SERIES DISTRIBUTION: This constitutes authority to reproduce
the required number of copies necassary tu equul the total nymher authorized far each series.

TO:

10,

lst aoddreszaea, copy

of

2nd addressee, copy__

uf

Grd addressee, copy

of

, oeries

_, S@ries

, Series

AUTHORITY TO REPRODUCE: bcerttfy thot the autherity of
the originator has been received tu repraduce this Secret documents
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. NUMBER OF PAGES, EXCLUDING THIS FORM, TO BE TRANSMITTED
ad

- MESSAGE RETRIEVAL: Excluding Secret messages, indicata+—_
_

722 SEE
ett get x ee Litin on

whether the sendor will retrieve eriginal message.

ves [4

No |]

(OK

Tl,

OFFICIAL BUSINESS;

(Fegrestire}

FORM CLASSIFICATION:
When seporoted
handle this farm as UNCLASSIFIED.

Co2PEO
(Date)

from

mensoge ,

12. EXTRA MARKING: Indicate briow if message to be transmitted
contains:

(Signature of 4uthorizing Official)

(Date)

indicate clagsification of cetegary.

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Restricied Daia

{| Formerly Restricted Data

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7, CLASSIFICATION:

Select target paragraph3