a.
ROUTING AND TRANSMITTAL SLIP
“WE
thitials
TO: (Name;office symbol, room number,
uilding, Agency /Post)
Date
1.
2.
_
A
ue
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ction
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'Note and Return
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DO NOT use this form as a RECORD of approvals, concurrences, disposals
clearances, and similar actions
FROM: (Name, org. symbol, Agency/Post)
5041-102
0g
WU. 5. Government Printing Office: 1979—-281-184/4
Room No.—Blidg.
Phone No.
OPTIONAL
FORM 41 (Rev. 7-76)
Prescribed by GSA
FPMR (41 Crk) 101-11.206