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Date <br /> ROUTING AND TRANSMITTAL SLIP /o/v/dr/ <br /> TO: (Name,office symbol,room number, Initials Date <br /> building Agency/Post) <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> Action File Note and Return <br /> Approval For Clearance Per Conversation <br /> As Requested For Correction Prepare Reply <br /> Circulate For Your Information See Me <br /> Comment Investigate Signature <br /> Coordination Justify <br /> REMARKS <br /> RECEIVED <br /> OCT 0 9 1991 <br /> Mined Land <br /> Reclamation Division <br /> DO NOT use this form as a RECORD of approvals, concurrences, disposals, <br /> clearances, and similar actions <br /> FROM: (Name,org.symbol,Agency/Post) Room No.—Bldg. <br /> Pp,-MU4 P Phone No. <br /> 5041-102 *U.S.GP0:1985 0 491 247/20038 OPTIONAL FORM 41 (Rev.7-76) <br /> !Prescribed by GSA <br /> FPMR(41 CFR)101-11.206 <br />