Routing and Transmittal Slip Template Example

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Date

ROUTING AND TRANSMITTAL SLIP

TO: (Name, office symbol, room number, building, Agency/Post) Initials Date
1.

2.

3.

4.

5.
Action File Note and Return
Approval For Clearance Per Conversation
As Requested For Correction Prepare Reply
Circulate For Your Information See Me
Comment Investigate Signature
Coordination Justify
REMARKS

DO NOT use this form as a RECORD of approvals, concurrences, disposals,


clearances, and similar actions
FROM: (Name, organization symbol, Agency/Post) Room Number - Building

Phone Number

AUTHORIZED FOR LOCAL REPRODUCTION 7540-00-935-5862 OPTIONAL FORM 41 (REV. 3/2007)


Previous Edition is Usable

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