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U.S. Department of Energy
DOE F 1300.3
OMB Control No.
(01-94)
1910-0900
OMB Burden Disclosure
(Instructions on Reverse)
Statement on Reverse
1. Document Number
2. Document Title
3a. Name of Submitting Organization
4. Type of Organization (Mark one)
G
Vendor
G
User
3b. Address (Street, City, Zip Code)
G
Manufacturer
G
Other (Specify:
)
5. Problem Areas (Attach extra sheets as needed.)
a. Paragraph Number and Wording
b. Recommended Wording
c. Reason/Rationale for Recommendation
6. Remarks
7a. Name of Submitter (Last, First, MI)
7b. Work Telephone Number (Include Area Code)
7c. Mailing Address (Street, City, State, Zip Code)
8. Date of Submission


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