Form 135-F1 - Records Transmittal And Receipt
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1Page
of
Pages
Complete and send original and two copies of this form to the appropriate Federal Records Center
Records Transmittal and Receipt
for approval prior to shipment of records.
5. From (Enter the name of complete mailing address of the office retiring the records. This signed
1. To (Complete the address for the appropriate records center serving your area)
receipt of this form will be sent to this address.)
As shown in
FPMR 101-11.410-1
2. Agency
Transferring Agency Official (Signature and title)
Date (mm/dd/yyyy)
(RMLO)
Transfer
Author-
ization
3. Agency
Transferring Agency Liaison Official (Name, office, and phone number)
Contact
Records Received by (Signature and title)
Date (mm/dd/yyyy)
4. Records
Center
Receipt
Fold line
6.
Records Data
Accession Number
Volume
Agency
Series Description
Rest-
Disposal Authority
Disposal
Completed by Records Center
RG
FY
Number
(cu. ft.)
Box
(with inclusive dates(mm/dd/yyyy) of records)
riction
(Schedule and
Date
Location
Shelf Cont- Auto-
Numbers
item number)
(mm/dd/yyyy)
Plan Type Disp
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
(k)
(l)
(m)
Note: Access to these Records is Restricted to persons approved by HUD officials.
StandardForm 135-F1 (Rev. 6/76)
Prescribed by GSA
135-106
FPMR (41CFR) 101-11.4
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