k, 4
           Approved Forig6W*eA?,GCV"WrtCtl&fiiDP91?-tb7,pr*060250022-0
           yo.                                inltials@   Date
           guame,                                     
           office                                     
           symbol,                                     
           room                                     
           number,                                     
           ilding,                                     
           Agency/Post)                                     
                                                  

           2.                                     
                                                  

           3.                                     
                                                  

           4.                                     
                                                  

           IL                                     
                                                  

             tion         File             Note     
                                           and     
                                           Return     
                                                  

                                                  
             pproval      For clearance    per     
             p                             Conversation     
                                                  

             Requested     For Correction   Prepare     
           I                               Reply     
                                                  

             irculate     For Your Information  See     
             ft                            Me     
                                                  

             mment        investigate      Signature     
                                                  

           l Coordination                             
                                                  

           


REMARKS
           A*blk'L@
           G@sjtoo
           t@cs
           Do NOT use this form as a RECORD of approvals. concurrences, disposal$,
                          clearances, and similar actions
                 FROM: (Name. org. symbol, Agency/Post) Room No.-Bldg.
           @kc w 0@_ Phone No.
           Approved F
           022-0
           * GPO : 1977 0 - 241-530 (3450)