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OMB Burden Disclosure Statement - hdbk1113cn10170


U.S. Department of Energy
DOE F 1300.3
OMB Control No.
DOCUM ENT IMPROV EMENT PR OPOSAL
(01-94)
1910-0900
OMB B urden D isclosure
(Instructions on Reverse)
Statement on Reverse
1. Doc um ent Num ber
2. Docum ent T itle
3a. Name of Submit ting Organization
4. Ty pe of Organization (M ark o ne)
G
Vendor
G
User
G
3b. Ad dress (St reet , Cit y, Zip Co de)
M anufac turer
G
Oth er (Specif y:
)
5 . Problem Areas (Attach extra sheets as needed.)
a. Paragraph Number and Wording
b. Recomm ended Wording
c. Reason/Rationale for Recommendation
6 . Remarks
7a. N ame of Submit ter (Last , First , M I)
7b . W ork Teleph one Nu mb er (Inc lude A rea
Code)
7c . M ailing Address (St reet , Cit y, St ate, Zip Co de)
8. Date of Submission
DOE F 1300.3
OM B Control No.


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