410150

ROUTING AND TRANSM~AL

767FGne,
OfiCOSmbofo
building,

12/17/80
Initials

room number!

Date

Agency/post)

I

Bair

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1.

SLIP

2

1

59
File

Approval
As Requestad

For Clearance
For Correction

$3rculate

For Your Information

See Me

Investigate

Signature

mment

!

II Note and Return
Conversation

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I@Prepare Reply

Justify

lCoordination

REMARKS

FYI

00

NOT

use

this form as a RECORD of approvals, concurrences, disposals,
clearances, and similar actions

FROM: (Name,

Bruce Wachholz

Phone No.

I
OPTIONAL FORM 41 (Rev. 7-75J

W41-102

*U.S.

Room No.—Bldg.

org. symbol, AgencY/Post)

G. P.O.

1980-311-156/4

Pnscribed b GSA
FPMR (41 Cd& 101-11.206

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