# **APPENDIX C. EXTERNAL AND INTERNAL FORMS OF ADDRESS**

1\. **External forms of address**

> a\. The standard addresses are the conventional forms of address in
> general use. Use them as patterns for other addresses. They may be
> varied under certain circumstances.

\(1\) The Honorable may be replaced by a title such as General, Dr., or
His Excellency, as appropriate.

(2) Use of The Honorable

\(a\) All Presidential appointees and Federal and State elected
officials are addressed as The Honorable.

\(b\) All Mayors are addressed as The Honorable. However, as a general
rule, county and city officials are not addressed as The Honorable.

\(c\) A person once entitled as Governor, Senator, Judge, General, The
Honorable, His Excellency, or similar distinctive title may retain the
title throughout his/her lifetime.

> \(3\) The title Madam is used before such formal terms as President,
> Vice President, Chairman, Secretary, Ambassador, and Minister when the
> position is occupied by a woman.

(4) Use the title Senator for a female member of the Senate, and use the
    title of Congresswoman for a female member of the U. S. House of
    Representatives, Senator-elect, or Congresswoman-elect.

(5) If correspondence is received from a foreign government official and
    it is uncertain how the person should be addressed (as The Honorable
    or His Excellency), contact the FHWA Executive Secretariat for
    assistance. Another source of information is the Department of
    State, Executive Secretariat**,** which may be able to answer the
    inquiry.

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b.  General rules to observe when addressing communications to
    individuals by name and/or title are as follows.

    1.  Spell out all titles in the address except Dr., Mr., and Mrs. Do
        not use two titles with the same meaning. For example:

> Do not use Mr. John Doe, Civil Engineer, or Dr. Paula While, M.D., on
> the same line.
>
> Use: JOHN DOE CIVIL ENGINEER P E
>
> DR PAULA WHITE OR
>
> PAULA WHITE, MD

2.  If it is not known whether the addressee is a man or woman, use Mr.
    with the name.

3.  Use Ms. when uncertain whether to use Mrs. or Miss.

4.  Address a person holding a Ph.D. degree as Dr. (Full Name) rather
    than as The Reverend, Dean, Professor, etc.

5.  Rules for Addressing Children

> When responding to correspondence obviously from a child, use the
> following forms:
>
> Female -- Always use Miss
>
> Male
>
> Ages 1 -- 12 Master John Doe
>
> Dear John:
>
> Ages 12 -- 18 John Doe
>
> Dear John:
>
> Ages 18 + Mr. John Doe
>
> Dear Mr. Doe:

6.  When any official has military rank or a doctoral degree, use the
    proper title instead of Mr., Mrs., Miss, or Ms.

2\. **Internal forms of address**

> a\. The following addresses are to be used for correspondence to
> organizations within DOT.
>
> \(1\) Standard Addresses for Internal DOT Correspondence.
>
> \(2\) Standard Addresses for Internal FHWA Correspondence.

a.  The names of Secretarial Officers, Assistant Secretaries, heads of
    operating administrations, and heads of lower organizational
    elements may be obtained from the DOT Telephone Directory at
    <http://hqdirectory.dot.gov/>.

> c\. Names and addresses of FHWA Key Field Personnel (Directors of
> Field Services, Resource Centers and Division Administrators) may be
> obtained from the FHWA Key Field Personnel Directory at
> <http://www.fhwa.dot.gov/keyfield/index.htm>.
>
> d\. Names and addresses of Governors may be obtained from
> <http://www.nga.org/governors/1,1169,C_GOV_ADDRESS,00.html>.
>
> e\. Names and addresses of State departments of transportation may be
> obtained from
> <http://www.transportation.org/community/committees.nsf/allpages/directorsmembership?opendocument>.

+-----------------+-------------------------+-------------------------+
| ## ADDRESSEE    | **ADDRESS ON LETTER**   | **SALUTATION AND**      |
|                 |                         |                         |
|                 |                         | **COMPLIMENTARY CLOSE** |
+-----------------+-------------------------+-------------------------+
| **THE WHITE     |                         |                         |
| HOUSE**         |                         |                         |
+-----------------+-------------------------+-------------------------+
| # The President | The President           | Dear Mr./Madam          |
|                 |                         | President:              |
|                 | The White House         |                         |
|                 |                         | Respectfully,           |
|                 | Washington, DC 20500    |                         |
|                 |                         | or                      |
|                 |                         |                         |
|                 |                         | The President:          |
|                 |                         |                         |
|                 |                         | Respectfully submitted, |
+-----------------+-------------------------+-------------------------+
| # Spouse of the | Mrs. (Full Name) or Mr. | Dear Mrs./Mr.           |
|                 | (Full Name)             | (Surname):              |
| President       |                         |                         |
|                 | The White House         | Sincerely,              |
|                 |                         |                         |
|                 | Washington, DC 20500    |                         |
+-----------------+-------------------------+-------------------------+
| # A             | The Honorable (Full     | Dear Mr./Mrs./Miss/Ms.  |
| ssistant to the | Name)                   | (Surname):              |
|                 |                         |                         |
| President       | Assistant to the        | Sincerely,              |
|                 | President               |                         |
|                 |                         |                         |
|                 | The White House         |                         |
|                 |                         |                         |
|                 | Washington, DC 20500    |                         |
+-----------------+-------------------------+-------------------------+
| # F             | The Honorable (Full     | Dear President          |
| ormer President | Name)                   | (Surname):              |
|                 |                         |                         |
|                 | (Local Address) (ZIP    | Sincerely,              |
|                 | Code)                   |                         |
+-----------------+-------------------------+-------------------------+
| # The           | Formal: The Vice        | Dear Mr./Madam Vice     |
|  Vice President | President               | President:              |
|                 |                         |                         |
|                 | United States Senate    | Sincerely,              |
|                 |                         |                         |
|                 | Washington, DC 20510    | Dear Mr./Madam Vice     |
|                 |                         | President:              |
|                 | Informal: The Honorable |                         |
|                 | (Full Name)             | Sincerely,              |
|                 |                         |                         |
|                 | The Vice President of   |                         |
|                 | the                     |                         |
|                 |                         |                         |
|                 | United States           |                         |
|                 |                         |                         |
|                 | Washington, DC 20501    |                         |
+-----------------+-------------------------+-------------------------+
| # Former Vice   | The Honorable (Full     | Dear Mr./Mrs./Miss/Ms.  |
|                 | Name)                   | (Surname):              |
| President       |                         |                         |
|                 | (no title)              | Sincerely,              |
|                 |                         |                         |
|                 | (Local Address) (ZIP    |                         |
|                 | Code)                   |                         |
+-----------------+-------------------------+-------------------------+
| # Dire          | The Honorable (Full     | Dear Mr./Mrs./Miss/Ms.  |
| ctor, Office of | Name)                   | (Surname):              |
|                 |                         |                         |
| Management and  | Director, Office of     | Sincerely,              |
|                 | Management              |                         |
| Budget          |                         |                         |
|                 | and Budget              |                         |
|                 |                         |                         |
|                 | Washington, DC 20503    |                         |
+-----------------+-------------------------+-------------------------+
| **THE           |                         |                         |
| JUDICIARY**     |                         |                         |
+-----------------+-------------------------+-------------------------+
| # Th            | The Chief Justice       | Dear Chief Justice:     |
| e Chief Justice |                         |                         |
|                 | The Supreme Court       | Sincerely,              |
|                 |                         |                         |
|                 | Washington, DC 20543    |                         |
+-----------------+-------------------------+-------------------------+
| # As            | Justice (Surname)       | Dear Justice (Surname): |
| sociate Justice |                         |                         |
|                 | The Supreme Court       | Sincerely,              |
|                 |                         |                         |
|                 | Washington, DC 20543    |                         |
+-----------------+-------------------------+-------------------------+
| #               | The Honorable (Full     | Dear Mr./Mrs./Miss/Ms.  |
| Retired Justice | Name)                   | Justice:                |
|                 |                         |                         |
|                 | (Local Address) 00000   | Sincerely,              |
+-----------------+-------------------------+-------------------------+
| # Pr            | The Honorable (Full     | Dear Mr./Mrs./Miss/Ms.  |
| esiding Justice | Name)                   | Justice:                |
|                 |                         |                         |
|                 | President Justice       | Sincerely,              |
|                 |                         |                         |
|                 | (Name of Court)         |                         |
|                 |                         |                         |
|                 | (Local Address) 00000   |                         |
+-----------------+-------------------------+-------------------------+
| # J             | The Honorable           | Dear Judge (Surname):   |
| udge of a Court |                         |                         |
|                 | Judge of the (Name of   | Sincerely,              |
|                 | Court; if a U.S.        |                         |
|                 |                         |                         |
|                 | District Court, Give    |                         |
|                 | District)               |                         |
|                 |                         |                         |
|                 | (Local Address) 00000   |                         |
+-----------------+-------------------------+-------------------------+

+-----------------+---------------------+---+---+-----------------------+
| # T             | The Clerk of the    |   | D |                       |
| he Clerk of the | Supreme Court       |   | e |                       |
|                 |                     |   | a |                       |
| Supreme Court   | The Supreme Court   |   | r |                       |
|                 |                     |   | M |                       |
|                 | Washington, DC      |   | r |                       |
|                 | 20543               |   | . |                       |
|                 |                     |   | / |                       |
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|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
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|                 |                     |   | s |                       |
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|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Justi         | The Honorable (Full |   | D |                       |
| ce of the Peace | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Justice of the      |   | r |                       |
|                 | Peace               |   | J |                       |
|                 |                     |   | u |                       |
|                 | (Local Address)     |   | d |                       |
|                 | 00000               |   | g |                       |
|                 |                     |   | e |                       |
|                 | or                  |   | ( |                       |
|                 |                     |   | M |                       |
|                 | Justice of the      |   | r |                       |
|                 | Peace               |   | . |                       |
|                 |                     |   | / |                       |
|                 | (Name) District     |   | M |                       |
|                 |                     |   | r |                       |
|                 | (Local Address)     |   | s |                       |
|                 | 00000               |   | . |                       |
|                 |                     |   | / |                       |
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|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Constab       | Mr. (Full Name),    |   | D |                       |
| le (or Sheriff) | Constable           |   | e |                       |
|                 |                     |   | a |                       |
|                 | or                  |   | r |                       |
|                 |                     |   | M |                       |
|                 | The Constable of    |   | r |                       |
|                 | (District)          |   | . |                       |
|                 |                     |   | / |                       |
|                 | (Local Address)     |   | M |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
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|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Lawyer        | Mr. (Full Name)     |   | D |                       |
|                 |                     |   | e |                       |
|                 | Attorney at Law     |   | a |                       |
|                 |                     |   | r |                       |
|                 | (Local Address)     |   | M |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | . |                       |
|                 | or                  |   | / |                       |
|                 |                     |   | M |                       |
|                 | (Full Name), Esq.   |   | r |                       |
|                 |                     |   | s |                       |
|                 | (Local Address)     |   | . |                       |
|                 | 00000               |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
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|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # *             |                     |   |   |                       |
| *THE CONGRESS** |                     |   |   |                       |
|                 |                     |   |   |                       |
| **Senate**      |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Pr            | The Honorable (Full |   | D |                       |
| esident of the  | Name)               |   | e |                       |
|                 |                     |   | a |                       |
| Senate (See     | President of the    |   | r |                       |
| Vice President) | Senate              |   | M |                       |
|                 |                     |   | r |                       |
|                 | Washington, DC      |   | . |                       |
|                 | 20510               |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
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|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| President pro   | The Honorable (Full |   | D |                       |
| tempore         | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | President pro       |   | r |                       |
|                 | tempore of the      |   | M |                       |
|                 | Senate              |   | r |                       |
|                 |                     |   | . |                       |
|                 | United States       |   | / |                       |
|                 | Senate              |   | M |                       |
|                 |                     |   | a |                       |
|                 | Washington, DC      |   | d |                       |
|                 | 20510               |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | P |                       |
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|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Unite         | The Honorable (Full |   | D |                       |
| d States Senate | Name)               |   | e |                       |
|                 |                     |   | a |                       |
| (in Washington, | United States       |   | r |                       |
| DC)             | Senate              |   | S |                       |
|                 |                     |   | e |                       |
| (away from      | Washington, DC      |   | n |                       |
| Washington, DC) | 20510               |   | a |                       |
|                 |                     |   | t |                       |
|                 | or                  |   | o |                       |
|                 |                     |   | r |                       |
|                 | The Honorable (Full |   | ( |                       |
|                 | Name)               |   | S |                       |
|                 |                     |   | u |                       |
|                 | United States       |   | r |                       |
|                 | Senator             |   | n |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | m |                       |
|                 | 00000               |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
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|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Senator-elect | The Honorable (Full |   | D |                       |
|                 | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | United States       |   | r |                       |
|                 | Senator-elect       |   | S |                       |
|                 |                     |   | e |                       |
|                 | (Local Address, If  |   | n |                       |
|                 | given) 00000        |   | a |                       |
|                 |                     |   | t |                       |
|                 | or                  |   | o |                       |
|                 |                     |   | r |                       |
|                 | The Honorable (Full |   | - |                       |
|                 | Name)               |   | e |                       |
|                 |                     |   | l |                       |
|                 | Senator-elect       |   | e |                       |
|                 |                     |   | c |                       |
|                 | United States       |   | t |                       |
|                 | Senate              |   | ( |                       |
|                 |                     |   | S |                       |
|                 | Washington, DC      |   | u |                       |
|                 | 20510               |   | r |                       |
|                 |                     |   | n |                       |
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|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | S |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | t |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | - |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | e |                       |
|                 |                     |   | c |                       |
|                 |                     |   | t |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The Honorable (Full |   | D |                       |
|  Former Senator | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | (No Title)          |   | r |                       |
|                 |                     |   | S |                       |
|                 | (Local Address)     |   | e |                       |
|                 | 00000               |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | t |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The Honorable (Full |   | D |                       |
| Majority Leader | Name)               |   | e |                       |
|                 |                     |   | a |                       |
| or              | Majority/Minority   |   | r |                       |
|                 | Leader              |   | S |                       |
| Minority Leader |                     |   | e |                       |
|                 | United States       |   | n |                       |
|                 | Senate              |   | a |                       |
|                 |                     |   | t |                       |
|                 | Washington, DC      |   | o |                       |
|                 | 20510               |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Com           | The Honorable (Full |   | D |                       |
| mittee Chairman | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Chairman            |   | r |                       |
|                 |                     |   | M |                       |
|                 | Committee on        |   | r |                       |
|                 | \                   |   | . |                       |
|                 | _\_\_\_\_\_\_\_\_\_ |   | / |                       |
|                 |                     |   | M |                       |
|                 | United States       |   | a |                       |
|                 | Senate              |   | d |                       |
|                 |                     |   | a |                       |
|                 | Washington, DC      |   | m |                       |
|                 | 20510               |   | C |                       |
|                 |                     |   | h |                       |
|                 |                     |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Subcommitt    | The Honorable (Full |   | D |                       |
| ee Chairman[^1] | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Chairman            |   | r |                       |
|                 |                     |   | M |                       |
|                 | Subcommittee on     |   | r |                       |
|                 | (Name)              |   | . |                       |
|                 |                     |   | / |                       |
|                 | Committee on        |   | M |                       |
|                 | (Parent Committee)  |   | a |                       |
|                 |                     |   | d |                       |
|                 | United States       |   | a |                       |
|                 | Senate              |   | m |                       |
|                 |                     |   | C |                       |
|                 | Washington, DC      |   | h |                       |
|                 | 20510               |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The Honorable (Full |   | D |                       |
|  Chairman of a  | Name)               |   | e |                       |
| Joint Committee |                     |   | a |                       |
|                 | Chairman            |   | r |                       |
|                 |                     |   | M |                       |
|                 | Joint Committee on  |   | r |                       |
|                 | (Name)              |   | . |                       |
|                 |                     |   | C |                       |
|                 | Washington, DC      |   | h |                       |
|                 | 20510               |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Secretary     | The Honorable (Full |   | D |                       |
|  of the Senate  | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Secretary of the    |   | r |                       |
|                 | Senate              |   | M |                       |
|                 |                     |   | r |                       |
|                 | Washington, DC      |   | . |                       |
|                 | 20510               |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Se            | Mr. (Full Name)     |   | D |                       |
| cretary/Adminis |                     |   | e |                       |
| trative Assista | Secre               |   | a |                       |
| nt to a Senator | tary/Administrative |   | r |                       |
|                 | Assistant to        |   | M |                       |
|                 |                     |   | r |                       |
|                 | The Honorable(Full  |   | . |                       |
|                 | Name)               |   | / |                       |
|                 |                     |   | M |                       |
|                 | United States       |   | s |                       |
|                 | Senate              |   | . |                       |
|                 |                     |   | ( |                       |
|                 | Washington, DC      |   | S |                       |
|                 | 20510               |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Chaplai       | The Reverend (Full  |   | D |                       |
| n of the Senate | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | United States       |   | r |                       |
|                 | Senate              |   | ( |                       |
|                 |                     |   | T |                       |
|                 | Washington, DC      |   | i |                       |
|                 | 20510               |   | t |                       |
|                 |                     |   | l |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | [ |                       |
|                 |                     |   | ^ |                       |
|                 |                     |   | 2 |                       |
|                 |                     |   | ] |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # *             |                     |   |   |                       |
| *THE CONGRESS** |                     |   |   |                       |
|                 |                     |   |   |                       |
| **House of      |                     |   |   |                       |
| Re              |                     |   |   |                       |
| presentatives** |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The Honorable (Full |   | D |                       |
| Speaker of the  | Name)               |   | e |                       |
|                 |                     |   | a |                       |
| U.S. House of   | Speaker of the U.S. |   | r |                       |
| Representatives | House of            |   | M |                       |
|                 |                     |   | r |                       |
|                 | Representatives     |   | . |                       |
|                 |                     |   | / |                       |
|                 | Washington, DC      |   | M |                       |
|                 | 20515               |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | S |                       |
|                 |                     |   | p |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | k |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # United States | The Honorable (Full |   | D |                       |
|  Representative | Name)               |   | e |                       |
|                 |                     |   | a |                       |
| (in Washington, | U.S. House of       |   | r |                       |
| DC)             | Representatives     |   | C |                       |
|                 |                     |   | o |                       |
| (away from      | Washington, DC      |   | n |                       |
| Washington, DC) | 20515               |   | g |                       |
|                 |                     |   | r |                       |
|                 | or                  |   | e |                       |
|                 |                     |   | s |                       |
|                 | The Honorable (Full |   | s |                       |
|                 | Name)               |   | m |                       |
|                 |                     |   | a |                       |
|                 | Member, U.S. House  |   | n |                       |
|                 | of                  |   | / |                       |
|                 |                     |   | w |                       |
|                 | Representatives     |   | o |                       |
|                 |                     |   | m |                       |
|                 | (Local Address)(ZIP |   | a |                       |
|                 | Code)               |   | n |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Repre         | The Honorable (Full |   | D |                       |
| sentative-elect | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Representativ       |   | r |                       |
|                 | e/Congressman-elect |   | R |                       |
|                 |                     |   | e |                       |
|                 | U.S. House of       |   | p |                       |
|                 | Representatives     |   | r |                       |
|                 |                     |   | e |                       |
|                 | Washington, DC      |   | s |                       |
|                 | 20515               |   | e |                       |
|                 |                     |   | n |                       |
|                 | or                  |   | t |                       |
|                 |                     |   | a |                       |
|                 | The Honorable (Full |   | t |                       |
|                 | Name)               |   | i |                       |
|                 |                     |   | v |                       |
|                 | Representativ       |   | e |                       |
|                 | e/Congressman-elect |   | / |                       |
|                 |                     |   | C |                       |
|                 | (Local Address, If  |   | o |                       |
|                 | given) 00000        |   | n |                       |
|                 |                     |   | g |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | - |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | e |                       |
|                 |                     |   | c |                       |
|                 |                     |   | t |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The Honorable (Full |   | D |                       |
| Majority Leader | Name)               |   | e |                       |
|                 |                     |   | a |                       |
| or              | Majority/Minority   |   | r |                       |
|                 | Leader              |   | M |                       |
| Minority Leader |                     |   | r |                       |
|                 | U.S. House of       |   | . |                       |
|                 | Representatives     |   | / |                       |
|                 |                     |   | M |                       |
|                 | Washington, DC      |   | a |                       |
|                 | 20515               |   | d |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | L |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Former        | The Honorable (Full |   | D |                       |
|  Representative | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   | R |                       |
|                 |                     |   | e |                       |
|                 |                     |   | p |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   | a |                       |
|                 |                     |   | t |                       |
|                 |                     |   | i |                       |
|                 |                     |   | v |                       |
|                 |                     |   | e |                       |
|                 |                     |   | / |                       |
|                 |                     |   | C |                       |
|                 |                     |   | o |                       |
|                 |                     |   | n |                       |
|                 |                     |   | g |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Com           | The Honorable (Full |   | D |                       |
| mittee Chairman | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Chairman            |   | r |                       |
|                 |                     |   | M |                       |
|                 | Committee on (Name) |   | r |                       |
|                 |                     |   | . |                       |
|                 | U.S. House of       |   | / |                       |
|                 | Representatives     |   | M |                       |
|                 |                     |   | r |                       |
|                 | Washington, DC      |   | s |                       |
|                 | 20515               |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | C |                       |
|                 |                     |   | h |                       |
|                 |                     |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Subcommitt    | The Honorable (Full |   | D |                       |
| ee Chairman[^3] | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Chairman            |   | r |                       |
|                 |                     |   | M |                       |
|                 | Subcommittee on     |   | r |                       |
|                 | (Name)              |   | . |                       |
|                 |                     |   | / |                       |
|                 | Committee on        |   | M |                       |
|                 | (Parent Committee)  |   | r |                       |
|                 |                     |   | s |                       |
|                 | U.S. House of       |   | . |                       |
|                 | Representatives     |   | / |                       |
|                 |                     |   | M |                       |
|                 | Washington, DC      |   | i |                       |
|                 | 20515               |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | C |                       |
|                 |                     |   | h |                       |
|                 |                     |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The Honorable (Full |   | D |                       |
|                 | Name)[^4]           |   | e |                       |
| #               |                     |   | a |                       |
|                 | Clerk of the U.S.   |   | r |                       |
| #               | House of            |   | M |                       |
|                 |                     |   | r |                       |
| # Cler          | Representatives     |   | . |                       |
| k of the House  |                     |   | / |                       |
|                 | Washington, DC      |   | M |                       |
|                 | 20515               |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Chapla        | The Reverend (Full  |   | D |                       |
| in of the House | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Chaplain of the     |   | r |                       |
|                 | U.S. House of       |   | ( |                       |
|                 |                     |   | T |                       |
|                 | Representatives     |   | i |                       |
|                 |                     |   | t |                       |
|                 | Washington, DC      |   | l |                       |
|                 | 20515               |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | [ |                       |
|                 |                     |   | ^ |                       |
|                 |                     |   | 5 |                       |
|                 |                     |   | ] |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Offic         | Ms. (Full Name)     |   | D |                       |
| e of a Deceased |                     |   | e |                       |
|                 | Chief of            |   | a |                       |
| #               | S                   |   | r |                       |
|  Representative | taff/Administrative |   | M |                       |
|                 | Assistant to the    |   | r |                       |
|                 | late (Full Name)    |   | . |                       |
|                 |                     |   | / |                       |
|                 | U.S. House of       |   | M |                       |
|                 | Representatives     |   | r |                       |
|                 |                     |   | s |                       |
|                 | Washington, DC      |   | . |                       |
|                 | 20515               |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | [ |                       |
|                 |                     |   | ^ |                       |
|                 |                     |   | 6 |                       |
|                 |                     |   | ] |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Reside        | The Honorable (Full |   | D |                       |
| nt Commissioner | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Resident            |   | r |                       |
|                 | Commissioner        |   | M |                       |
|                 |                     |   | r |                       |
|                 | From (Name of Area) |   | . |                       |
|                 |                     |   | / |                       |
|                 | U.S. House of       |   | M |                       |
|                 | Representatives     |   | r |                       |
|                 |                     |   | s |                       |
|                 | Washington, DC      |   | . |                       |
|                 | 20515               |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| **LEGISLATIVE   |                     |   |   |                       |
| AGENCIES**      |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Comp          | The Honorable (Full |   | D |                       |
| troller General | Name)               |   | e |                       |
|                 |                     |   | a |                       |
| (Head of the    | Comptroller General |   | r |                       |
| General         | of                  |   | M |                       |
| Accounting      |                     |   | r |                       |
| Office)         | the United States   |   | . |                       |
|                 |                     |   | / |                       |
|                 | General Accounting  |   | M |                       |
|                 | Office              |   | r |                       |
|                 |                     |   | s |                       |
|                 | Washington, DC      |   | . |                       |
|                 | 20548               |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Public Prin   | The Honorable (Full |   | D |                       |
| ter (Head of U. | Name)               |   | e |                       |
| S. Government P |                     |   | a |                       |
| rinting Office) | Public Printer      |   | r |                       |
|                 |                     |   | M |                       |
|                 | U.S. Government     |   | r |                       |
|                 | Printing Office     |   | . |                       |
|                 |                     |   | / |                       |
|                 | Washington, DC      |   | M |                       |
|                 | 20401               |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Librarian     | The Honorable (Full |   | D |                       |
| of Congress (He | Name)               |   | e |                       |
| ad of the Libra |                     |   | a |                       |
| ry of Congress) | Librarian of        |   | r |                       |
|                 | Congress            |   | M |                       |
|                 |                     |   | r |                       |
|                 | Library of Congress |   | . |                       |
|                 |                     |   | / |                       |
|                 | Washington, DC      |   | M |                       |
|                 | 20540               |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| **EXECUTIVE     |                     |   |   |                       |
| DEPARTMENTS**   |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Members       | The Honorable (Full |   | D |                       |
|  of the Cabinet | Name)               |   | e |                       |
|                 |                     |   | a |                       |
| (Addressed as   | Secretary of (Name  |   | r |                       |
| Secretary)      | of Department)      |   | M |                       |
|                 |                     |   | r |                       |
|                 | Washington, DC      |   | . |                       |
|                 | 00000               |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | S |                       |
|                 |                     |   | e |                       |
|                 |                     |   | c |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | t |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Attorne       | The Honorable (Full |   | D |                       |
| y General (Head | Name)               |   | e |                       |
|  of the Departm |                     |   | a |                       |
| ent of Justice) | Attorney General    |   | r |                       |
|                 |                     |   | M |                       |
|                 | Washington, DC      |   | r |                       |
|                 | 20530               |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | A |                       |
|                 |                     |   | t |                       |
|                 |                     |   | t |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | e |                       |
|                 |                     |   | y |                       |
|                 |                     |   | G |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # U             | The Honorable (Full |   | D |                       |
| nder Secretary  | Name)               |   | e |                       |
| of a Department |                     |   | a |                       |
|                 | Under Secretary of  |   | r |                       |
|                 |                     |   | M |                       |
|                 | (Name of            |   | r |                       |
|                 | Department)         |   | . |                       |
|                 |                     |   | / |                       |
|                 | Washington, DC      |   | M |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # De            | The Honorable (Full |   | D |                       |
| puty Secretary  | Name)               |   | e |                       |
| of a Department |                     |   | a |                       |
|                 | Deputy Secretary of |   | r |                       |
|                 |                     |   | M |                       |
|                 | (Name of            |   | r |                       |
|                 | Department)         |   | . |                       |
|                 |                     |   | / |                       |
|                 | Washington, DC      |   | M |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Assis         | The Honorable (Full |   | D |                       |
| tant Secretary  | Name)               |   | e |                       |
| of a Department |                     |   | a |                       |
|                 | Assistant Secretary |   | r |                       |
|                 | for (Name of        |   | M |                       |
|                 | Office)(Name of     |   | r |                       |
|                 | Department)         |   | . |                       |
|                 |                     |   | / |                       |
|                 | Washington, DC      |   | M |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| **INDEPENDENT   |                     |   |   |                       |
| ORGANIZATIONS** |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Di            | The Honorable (Full |   | D |                       |
| rector of the O | Name)               |   | e |                       |
| ffice of Manage |                     |   | a |                       |
| ment and Budget | Director, Office of |   | r |                       |
|                 |                     |   | M |                       |
|                 | Management and      |   | r |                       |
|                 | Budget              |   | . |                       |
|                 |                     |   | / |                       |
|                 | Washington, DC      |   | M |                       |
|                 | 20503               |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Postmas       | The Honorable (Full |   | D |                       |
| ter General (He | Name)               |   | e |                       |
| ad of the U.S.  |                     |   | a |                       |
| Postal Service) | Postmaster General  |   | r |                       |
|                 |                     |   | M |                       |
|                 | Washington, DC      |   | r |                       |
|                 | 20260               |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | P |                       |
|                 |                     |   | o |                       |
|                 |                     |   | s |                       |
|                 |                     |   | t |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | s |                       |
|                 |                     |   | t |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | G |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The Honorable (Full |   | D |                       |
| Head of a Feder | Name)               |   | e |                       |
| al Agency, Auth |                     |   | a |                       |
| ority, or Board | (Title), (Name of   |   | r |                       |
|                 | Agency)             |   | M |                       |
|                 |                     |   | r |                       |
|                 | Washington, DC      |   | . |                       |
|                 | 00000               |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # H             | The Honorable (Full |   | D |                       |
| ead of a Major  | Name)               |   | e |                       |
| Organization wi |                     |   | a |                       |
| th an Agency (I | (Title), (Name of   |   | r |                       |
| f the Official  | Organization)       |   | M |                       |
| is Appointed by |                     |   | r |                       |
|  the President) | (Name of Agency)    |   | . |                       |
|                 |                     |   | / |                       |
|                 | Washington, DC      |   | M |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # President     | The Honorable (Full |   | D |                       |
| of a Commission | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | President, (Name of |   | r |                       |
|                 | Commission)         |   | M |                       |
|                 |                     |   | r |                       |
|                 | Washington, DC      |   | . |                       |
|                 | 00000               |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Chairman      | The Honorable (Full |   | D |                       |
| of a Commission | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Chairman, (Name of  |   | r |                       |
|                 | Commission)         |   | : |                       |
|                 |                     |   | M |                       |
|                 | Washington, DC      |   | r |                       |
|                 | 00000               |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | C |                       |
|                 |                     |   | h |                       |
|                 |                     |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Chai          | The Honorable (Full |   | D |                       |
| rman of a Board | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | Chairman, (Name of  |   | r |                       |
|                 | Board)              |   | : |                       |
|                 |                     |   | M |                       |
|                 | Washington, DC      |   | r |                       |
|                 | 00000               |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | C |                       |
|                 |                     |   | h |                       |
|                 |                     |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| **OTHER FEDERAL |                     |   |   |                       |
| GOVERNMENT      |                     |   |   |                       |
| AGENCIES**      |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Co            | The Honorable (Full |   | D |                       |
| mmissioner of I | Name)               |   | e |                       |
| nternal Revenue |                     |   | a |                       |
|                 | Commissioner of     |   | r |                       |
|                 | Internal Revenue    |   | : |                       |
|                 |                     |   | M |                       |
|                 | Department of the   |   | r |                       |
|                 | Treasury            |   | . |                       |
|                 |                     |   | / |                       |
|                 | Washington, DC      |   | M |                       |
|                 | 20224               |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Distric       | Mr. (Full Name)     |   | D |                       |
| t Director of I |                     |   | e |                       |
| nternal Revenue | District Director   |   | a |                       |
|                 | of Internal Revenue |   | r |                       |
|                 |                     |   | : |                       |
|                 | (Local Address)     |   | M |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| **American      |                     |   |   |                       |
| Missions**      |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Amer          | The Honorable (Full |   | S |                       |
| ican Ambassador | Name)               |   | i |                       |
|                 |                     |   | r |                       |
|                 | American Ambassador |   | : |                       |
|                 |                     |   | ( |                       |
|                 | (City), (Country)   |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | A |                       |
|                 |                     |   | m |                       |
|                 |                     |   | b |                       |
|                 |                     |   | a |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Amer          | (Full Rank) (Full   |   | S |                       |
| ican Ambassador | Name)               |   | i |                       |
|                 |                     |   | r |                       |
| (With Military  | American Ambassador |   | : |                       |
| Rank)           |                     |   | ( |                       |
|                 | (City), (Country)   |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | A |                       |
|                 |                     |   | m |                       |
|                 |                     |   | b |                       |
|                 |                     |   | a |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | R |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | k |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Former Amer   | The Honorable (Full |   | D |                       |
| ican Ambassador | Name)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | A |                       |
|                 |                     |   | m |                       |
|                 |                     |   | b |                       |
|                 |                     |   | a |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Am            | The Honorable (Full |   | S |                       |
| erican Minister | Name)               |   | i |                       |
|                 |                     |   | r |                       |
|                 | American Minister   |   | : |                       |
|                 |                     |   | ( |                       |
|                 | (City), (Country)   |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | t |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # American      | (Full Rank) (Full   |   | S |                       |
|  Minister (With | Name)               |   | i |                       |
|  Military Rank) |                     |   | r |                       |
|                 | American Minister   |   | : |                       |
|                 |                     |   | ( |                       |
|                 | (City), (Country)   |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | A |                       |
|                 |                     |   | m |                       |
|                 |                     |   | b |                       |
|                 |                     |   | a |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | R |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | k |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # American      | (Full Name)         |   | D |                       |
|  Consul General |                     |   | e |                       |
|                 | American Consul     |   | a |                       |
| or              | General             |   | r |                       |
|                 |                     |   | M |                       |
| American Consul | or                  |   | r |                       |
|                 |                     |   | . |                       |
|                 | American Consul     |   | / |                       |
|                 |                     |   | M |                       |
|                 | (City), (Country)   |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| **MISSIONS TO   |                     |   |   |                       |
| THE UNITED      |                     |   |   |                       |
| STATES**        |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Foreign A     | His Excellency      |   | E |                       |
| mbassador in th |                     |   | x |                       |
| e United States | (Full Name)         |   | c |                       |
|                 |                     |   | e |                       |
|                 | Ambassador of       |   | l |                       |
|                 | (Country)           |   | l |                       |
|                 |                     |   | e |                       |
|                 | (Local Address)     |   | n |                       |
|                 | 00000               |   | c |                       |
|                 |                     |   | y |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | A |                       |
|                 |                     |   | m |                       |
|                 |                     |   | b |                       |
|                 |                     |   | a |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| # Foreign       | The Honorable (Full |   | S |                       |
|  Minister in th | Name)               |   | i |                       |
| e United States |                     |   | r |                       |
|                 | Minister of         |   | : |                       |
|                 | (Country)           |   | ( |                       |
|                 |                     |   | F |                       |
|                 | (Local Address)     |   | o |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | t |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| Foreign Charge  | Mr./Mrs./Miss/Ms.   |   | S |                       |
| d'Affaires in   | (Full Name)         |   | i |                       |
| the United      |                     |   | r |                       |
| States          | Charge d'Affaires   |   | : |                       |
|                 | of (Country)        |   | ( |                       |
|                 |                     |   | F |                       |
|                 | (Local Address)     |   | o |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | C |                       |
|                 |                     |   | h |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | g |                       |
|                 |                     |   | e |                       |
|                 |                     |   | d |                       |
|                 |                     |   | ' |                       |
|                 |                     |   | A |                       |
|                 |                     |   | f |                       |
|                 |                     |   | f |                       |
|                 |                     |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## THE O        |                     |   |   |                       |
| RGANIZATION OF  |                     |   |   |                       |
| AMERICAN STATES |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| Secretary       | The Honorable (Full |   | S |                       |
| General of the  | Name)               |   | i |                       |
| Organization of |                     |   | r |                       |
| American States | Secretary General   |   | : |                       |
|                 | of the Organization |   | ( |                       |
|                 |                     |   | F |                       |
|                 | of American States  |   | o |                       |
|                 |                     |   | r |                       |
|                 | Pan American Union  |   | m |                       |
|                 |                     |   | a |                       |
|                 | Washington, DC      |   | l |                       |
|                 | 20006               |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | S |                       |
|                 |                     |   | e |                       |
|                 |                     |   | c |                       |
|                 |                     |   | r |                       |
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|                 |                     |   | t |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | G |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
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|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | D |                       |
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|                 |                     |   | . |                       |
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|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| Assistant       | The Honorable (Full |   | S |                       |
| Secretary       | Name)               |   | i |                       |
|                 |                     |   | r |                       |
| General of the  | Assistant Secretary |   | : |                       |
| Organization of | General of the      |   | ( |                       |
| American States |                     |   | F |                       |
|                 | Organization of     |   | o |                       |
|                 | American States     |   | r |                       |
|                 |                     |   | m |                       |
|                 | Pan American Union  |   | a |                       |
|                 |                     |   | l |                       |
|                 | Washington, DC      |   | ) |                       |
|                 | 20006               |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | , |                       |
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|                 |                     |   | r |                       |
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+-----------------+---------------------+---+---+-----------------------+
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+-----------------+---------------------+---+---+-----------------------+
| ##              |                     |   |   |                       |
|  United Nations |                     |   |   |                       |
|                 |                     |   |   |                       |
| Communications  |                     |   |   |                       |
| to the United   |                     |   |   |                       |
| Nations are     |                     |   |   |                       |
| addressed to    |                     |   |   |                       |
| the United      |                     |   |   |                       |
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| to the United   |                     |   |   |                       |
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| through the     |                     |   |   |                       |
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| exceptions to   |                     |   |   |                       |
| this are        |                     |   |   |                       |
| communications  |                     |   |   |                       |
| that are sent   |                     |   |   |                       |
| directly to the |                     |   |   |                       |
| United States   |                     |   |   |                       |
| Representative  |                     |   |   |                       |
| including those |                     |   |   |                       |
| addressed to    |                     |   |   |                       |
| the Economic    |                     |   |   |                       |
| and Social      |                     |   |   |                       |
| Council, the    |                     |   |   |                       |
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| the delegation  |                     |   |   |                       |
| to the General  |                     |   |   |                       |
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| session).       |                     |   |   |                       |
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| with the United |                     |   |   |                       |
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| inappropriate.  |                     |   |   |                       |
| When necessary, |                     |   |   |                       |
| the             |                     |   |   |                       |
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| should be sent  |                     |   |   |                       |
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| by means of a   |                     |   |   |                       |
| cover letter.   |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Secretary    | ## His Excellency   |   | # |                       |
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+-----------------+---------------------+---+---+-----------------------+
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+-----------------+---------------------+---+---+-----------------------+
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+-----------------+---------------------+---+---+-----------------------+
| ## Seni         | (Full Rank) (Full   |   | # |                       |
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| isor to the Uni |                     |   |   |                       |
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+-----------------+---------------------+---+---+-----------------------+
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|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The Honorable (Full |   | # |                       |
| # United States | Name)               |   | # |                       |
|  Representative |                     |   |   |                       |
|  to the United  | United States       |   | S |                       |
| Nations Disarma | Representative      |   | i |                       |
| ment Commission |                     |   | r |                       |
|                 | on the Disarmament  |   | : |                       |
|                 | Commission          |   |   |                       |
|                 |                     |   | ( |                       |
|                 | of the United       |   | F |                       |
|                 | Nations             |   | o |                       |
|                 |                     |   | r |                       |
|                 | New York, New York  |   | m |                       |
|                 | 10017               |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## United Sta   | The Honorable (Full |   | # |                       |
| tes Representat | Name)               |   | # |                       |
| ive to the Trus |                     |   |   |                       |
| teeship Council | United States       |   | S |                       |
|                 | Representative      |   | i |                       |
|                 |                     |   | r |                       |
|                 | on the Trusteeship  |   | : |                       |
|                 | Council             |   |   |                       |
|                 |                     |   | ( |                       |
|                 | of the United       |   | F |                       |
|                 | Nations             |   | o |                       |
|                 |                     |   | r |                       |
|                 | New York, New York  |   | m |                       |
|                 | 10017               |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | V |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              |                     |   |   |                       |
|                 |                     |   |   |                       |
| ## State and Lo |                     |   |   |                       |
| cal Governments |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Gove         | The Honorable (Full |   | # |                       |
| rnor of a State | Name)               |   | # |                       |
|                 |                     |   |   |                       |
|                 | Governor of (Name   |   | D |                       |
|                 | of State)           |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | G |                       |
|                 |                     |   | o |                       |
|                 |                     |   | v |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Acting Gove  | The Honorable (Full |   | # |                       |
| rnor of a State | Name)               |   | # |                       |
|                 |                     |   |   |                       |
|                 | Acting Governor of  |   | D |                       |
|                 | (Name of State)     |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | The Honorable (Full |   | # |                       |
| Lieutenant Gove | Name)               |   | # |                       |
| rnor of a State |                     |   |   |                       |
|                 | Lieutenant Governor |   | D |                       |
|                 | of (Name of State)  |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | The Honorable (Full |   | # |                       |
|  Secretary of S | Name)               |   | # |                       |
| tate of a State |                     |   |   |                       |
|                 | Secretary of State  |   | D |                       |
|                 | of (Name)           |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | e |                       |
|                 |                     |   | c |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | t |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | The Honorable (Full |   | # |                       |
| Chief Justice o | Name)               |   | # |                       |
| f the Supreme C |                     |   |   |                       |
| ourt of a State | Chief Justice       |   | D |                       |
|                 |                     |   | e |                       |
|                 | Supreme Court of    |   | a |                       |
|                 | the State           |   | r |                       |
|                 |                     |   |   |                       |
|                 | of (Name)           |   | M |                       |
|                 |                     |   | r |                       |
|                 | (Local Address)     |   | . |                       |
|                 | 00000               |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   |   |                       |
|                 |                     |   | C |                       |
|                 |                     |   | h |                       |
|                 |                     |   | i |                       |
|                 |                     |   | e |                       |
|                 |                     |   | f |                       |
|                 |                     |   |   |                       |
|                 |                     |   | J |                       |
|                 |                     |   | u |                       |
|                 |                     |   | s |                       |
|                 |                     |   | t |                       |
|                 |                     |   | i |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Attorney Gen | The Honorable (Full |   | # |                       |
| eral of a State | Name)               |   | # |                       |
|                 |                     |   |   |                       |
|                 | Attorney General    |   | D |                       |
|                 |                     |   | e |                       |
|                 | State of (Name)     |   | a |                       |
|                 |                     |   | r |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | A |                       |
|                 |                     |   | t |                       |
|                 |                     |   | t |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | e |                       |
|                 |                     |   | y |                       |
|                 |                     |   |   |                       |
|                 |                     |   | G |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | The Honorable (Full |   | # |                       |
| Treasurer, Comp | Name)               |   | # |                       |
| troller, or Aud |                     |   |   |                       |
| itor of a State | State Treasurer     |   | D |                       |
|                 | (Comptroller)       |   | e |                       |
|                 | (Auditor)           |   | a |                       |
|                 |                     |   | r |                       |
|                 | State of (Name)     |   |   |                       |
|                 |                     |   | M |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Pres         | The Honorable (Full |   | # |                       |
| ident of the Se | Name)               |   | # |                       |
| nate of a State |                     |   |   |                       |
|                 | President of the    |   | D |                       |
|                 | Senate of           |   | e |                       |
|                 |                     |   | a |                       |
|                 | the State of (Name) |   | r |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   | M |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The Honorable (Full |   | # |                       |
| # State Senator | Name)               |   | # |                       |
|                 |                     |   |   |                       |
|                 | (Name of State)     |   | D |                       |
|                 | Senate              |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Speake       | The Honorable (Full |   | # |                       |
| r of the House  | Name)               |   | # |                       |
| of Representati |                     |   |   |                       |
| ves or the Asse | Speaker of the      |   | D |                       |
| mbly or the Hou | House of            |   | e |                       |
| se of Delegates |                     |   | a |                       |
|  of a State[^7] | Representatives (or |   | r |                       |
|                 | Assembly or         |   |   |                       |
|                 |                     |   | M |                       |
|                 | House of Delegates) |   | r |                       |
|                 |                     |   | . |                       |
|                 | (Local Address)     |   | / |                       |
|                 | 00000               |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## S            | The Honorable (Full |   | # |                       |
| tate Representa | Name)               |   | # |                       |
| tive, Assemblym |                     |   |   |                       |
| an, or Delegate | (Name of State)     |   | D |                       |
|                 | House of            |   | e |                       |
|                 |                     |   | a |                       |
|                 | Representatives (or |   | r |                       |
|                 | Assembly or         |   |   |                       |
|                 |                     |   | M |                       |
|                 | House of Delegates) |   | r |                       |
|                 |                     |   | . |                       |
|                 | (Local Address)     |   | / |                       |
|                 | 00000               |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## State        | Mr./Ms. (Full Name) |   | # |                       |
|  Secretaries of |                     |   | # |                       |
|  Transportation | (Local Address)     |   |   |                       |
|                 | 00000               |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Mayor        | The Honorable (Full |   | # |                       |
|                 | Name)               |   | # |                       |
|                 |                     |   |   |                       |
|                 | Mayor of (Name of   |   | D |                       |
|                 | City)               |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Preside      | The Honorable (Full |   | # |                       |
| nt of a Board o | Name)               |   | # |                       |
| f Commissioners |                     |   |   |                       |
|                 | President, Board of |   | D |                       |
|                 | Commissioners of    |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Name of City)      |   | r |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   | M |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Ec           |                     |   |   |                       |
| clesiastical Or |                     |   |   |                       |
| ganizations[^8] |                     |   |   |                       |
|                 |                     |   |   |                       |
| ##  Roman       |                     |   |   |                       |
| Catholic Church |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## The Pope     | His Holiness the    |   | # |                       |
|                 | Pope                |   | # |                       |
|                 |                     |   |   |                       |
|                 | Vatican City, Italy |   | Y |                       |
|                 |                     |   | o |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | H |                       |
|                 |                     |   | o |                       |
|                 |                     |   | l |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | o |                       |
|                 |                     |   | s |                       |
|                 |                     |   | t |                       |
|                 |                     |   | H |                       |
|                 |                     |   | o |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | F |                       |
|                 |                     |   | a |                       |
|                 |                     |   | t |                       |
|                 |                     |   | h |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | U |                       |
|                 |                     |   | s |                       |
|                 |                     |   | u |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Cardinal     | His Eminence        |   | # |                       |
|                 | (Christian Name)    |   | # |                       |
|                 | Cardinal (Surname)  |   |   |                       |
|                 |                     |   | Y |                       |
|                 | Archbishop of       |   | o |                       |
|                 | (Province)          |   | u |                       |
|                 |                     |   | r |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   | E |                       |
|                 |                     |   | m |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | C |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | d |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Archbishop   | The Most Reverend   |   | # |                       |
|                 | (Full Name)         |   | # |                       |
|                 |                     |   |   |                       |
|                 | Archbishop of       |   | Y |                       |
|                 | (Province)          |   | o |                       |
|                 |                     |   | u |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | E |                       |
|                 |                     |   | x |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | l |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | y |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | A |                       |
|                 |                     |   | r |                       |
|                 |                     |   | c |                       |
|                 |                     |   | h |                       |
|                 |                     |   | b |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | h |                       |
|                 |                     |   | o |                       |
|                 |                     |   | p |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Bishop       | The Most Reverend   |   | # |                       |
|                 | (Full Name)         |   | # |                       |
|                 |                     |   |   |                       |
|                 | Bishop of           |   | Y |                       |
|                 | (Province)          |   | o |                       |
|                 |                     |   | u |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | E |                       |
|                 |                     |   | x |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | l |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | y |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | B |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | h |                       |
|                 |                     |   | o |                       |
|                 |                     |   | p |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The Very Reverend   |   | # |                       |
| # Monsignor[^9] | Monsignor (Full     |   | # |                       |
|                 | Name)               |   |   |                       |
|                 |                     |   | V |                       |
|                 | (Local Address)     |   | e |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | y |                       |
|                 |                     |   |   |                       |
|                 |                     |   | R |                       |
|                 |                     |   | e |                       |
|                 |                     |   | v |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | o |                       |
|                 |                     |   | n |                       |
|                 |                     |   | s |                       |
|                 |                     |   | i |                       |
|                 |                     |   | g |                       |
|                 |                     |   | n |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | o |                       |
|                 |                     |   | n |                       |
|                 |                     |   | s |                       |
|                 |                     |   | i |                       |
|                 |                     |   | g |                       |
|                 |                     |   | n |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Priest       | The Reverend[^10]   |   | # |                       |
|                 | (Full Name) (Add    |   | # |                       |
|                 | Initials of Order,  |   |   |                       |
|                 | If Any)             |   | R |                       |
|                 |                     |   | e |                       |
|                 | (Local Address)     |   | v |                       |
|                 | 00000               |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | F |                       |
|                 |                     |   | a |                       |
|                 |                     |   | t |                       |
|                 |                     |   | h |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Superior     | The Reverend Mother |   | # |                       |
| of a Sisterhood | Superior            |   | # |                       |
|                 |                     |   |   |                       |
|                 | (Name of            |   | D |                       |
|                 | Institution)        |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | R |                       |
|                 |                     |   | e |                       |
|                 |                     |   | v |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | o |                       |
|                 |                     |   | t |                       |
|                 |                     |   | h |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | o |                       |
|                 |                     |   | t |                       |
|                 |                     |   | h |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | N |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Sister       | Sister (Full Name)  |   | # |                       |
| of a Sisterhood |                     |   | # |                       |
|                 | (Name of            |   |   |                       |
|                 | Organization)       |   | D |                       |
|                 |                     |   | e |                       |
|                 | (Local Address)     |   | a |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | t |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | l |                       |
|                 |                     |   |   |                       |
|                 |                     |   | N |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Superior o   | Brother (Name)      |   | # |                       |
| f a Brotherhood |                     |   | # |                       |
|                 | Superior (Name of   |   |   |                       |
|                 | Institution)        |   | D |                       |
|                 |                     |   | e |                       |
|                 | (Local Address)     |   | a |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | B |                       |
|                 |                     |   | r |                       |
|                 |                     |   | o |                       |
|                 |                     |   | t |                       |
|                 |                     |   | h |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Member o     | Brother (Full Name) |   | # |                       |
| f a Brotherhood |                     |   | # |                       |
|                 | (Name of            |   |   |                       |
|                 | Organization)       |   | D |                       |
|                 |                     |   | e |                       |
|                 | (Local Address)     |   | a |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | B |                       |
|                 |                     |   | r |                       |
|                 |                     |   | o |                       |
|                 |                     |   | t |                       |
|                 |                     |   | h |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | u |                       |
|                 |                     |   | l |                       |
|                 |                     |   | l |                       |
|                 |                     |   |   |                       |
|                 |                     |   | N |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Pr           |                     |   |   |                       |
| otestant Episco |                     |   |   |                       |
| pal Church[^11] |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Bishop       | The Right Reverend  |   | # |                       |
|                 | (Full Name)         |   | # |                       |
|                 |                     |   |   |                       |
|                 | Bishop of (Name)    |   | R |                       |
|                 |                     |   | i |                       |
|                 | (Local Address)     |   | g |                       |
|                 | 00000               |   | h |                       |
|                 |                     |   | t |                       |
|                 |                     |   |   |                       |
|                 |                     |   | R |                       |
|                 |                     |   | e |                       |
|                 |                     |   | v |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | B |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | h |                       |
|                 |                     |   | o |                       |
|                 |                     |   | p |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Archdeacon   | The Venerable (Full |   | # |                       |
|                 | Name)               |   | # |                       |
|                 |                     |   |   |                       |
|                 | Archdeacon of       |   | V |                       |
|                 | (Name)              |   | e |                       |
|                 |                     |   | n |                       |
|                 | (Local Address)     |   | e |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | b |                       |
|                 |                     |   | l |                       |
|                 |                     |   | e |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | y |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | A |                       |
|                 |                     |   | r |                       |
|                 |                     |   | c |                       |
|                 |                     |   | h |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | c |                       |
|                 |                     |   | o |                       |
|                 |                     |   | n |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Dean         | The Very Reverend   |   | # |                       |
|                 | (Full Name)         |   | # |                       |
|                 |                     |   |   |                       |
|                 | Dean of (Church)    |   | V |                       |
|                 |                     |   | e |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   | y |                       |
|                 |                     |   |   |                       |
|                 |                     |   | R |                       |
|                 |                     |   | e |                       |
|                 |                     |   | v |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Canon        | The Reverend (Full  |   | # |                       |
|                 | Name)               |   | # |                       |
|                 |                     |   |   |                       |
|                 | Canon of (Church)   |   | R |                       |
|                 |                     |   | e |                       |
|                 | (Local Address)     |   | v |                       |
|                 | 00000               |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | y |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | C |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | o |                       |
|                 |                     |   | n |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Rector       | The Reverend (Full  |   | # |                       |
|                 | Name)               |   | # |                       |
|                 |                     |   |   |                       |
|                 | The Rector of       |   | R |                       |
|                 | (Name)              |   | e |                       |
|                 |                     |   | v |                       |
|                 | (Local Address)     |   | e |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | D |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              |                     |   |   |                       |
|  Clergy of Othe |                     |   |   |                       |
| r Denominations |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## M            | The Reverend (Full  |   | # |                       |
| ethodist Bishop | Name)               |   | # |                       |
|                 |                     |   |   |                       |
|                 | Methodist Bishop    |   | R |                       |
|                 |                     |   | e |                       |
|                 | (Local Address)     |   | v |                       |
|                 | 00000               |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | B |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | h |                       |
|                 |                     |   | o |                       |
|                 |                     |   | p |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Presbyt      | The Moderator of    |   | # |                       |
| erian Moderator | (Name)              |   | # |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   | M |                       |
|                 | 00000               |   | y |                       |
|                 |                     |   |   |                       |
|                 | or                  |   | d |                       |
|                 |                     |   | e |                       |
|                 | The Reverend (Full  |   | a |                       |
|                 | Name)               |   | r |                       |
|                 |                     |   |   |                       |
|                 | Moderator of (Name) |   | M |                       |
|                 |                     |   | r |                       |
|                 | (Local Address)     |   | . |                       |
|                 | 00000               |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | o |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | t |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | D |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | Rabbi (Full Name)   |   | # |                       |
| # Rabbi (With D |                     |   | # |                       |
| octoral Degree) | (Local Address)     |   |   |                       |
|                 | 00000               |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | R |                       |
|                 |                     |   | a |                       |
|                 |                     |   | b |                       |
|                 |                     |   | b |                       |
|                 |                     |   | i |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## R            | Rabbi (Full Name)   |   | # |                       |
| abbi (Without D |                     |   | # |                       |
| octoral Degree) | (Local Address)     |   |   |                       |
|                 | 00000               |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | R |                       |
|                 |                     |   | a |                       |
|                 |                     |   | b |                       |
|                 |                     |   | b |                       |
|                 |                     |   | i |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Mormon       | The President       |   | # |                       |
|  President[^12] |                     |   | # |                       |
|                 | Church of Jesus     |   |   |                       |
|                 | Christ of           |   | S |                       |
|                 |                     |   | i |                       |
|                 | Latter Day Saints   |   | r |                       |
|                 |                     |   | : |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | B |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | h |                       |
|                 |                     |   | o |                       |
|                 |                     |   | p |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Mormon El    | Elder (or           |   | # |                       |
| der[^13]**^2^** | Brother)(Full Name) |   | # |                       |
|                 |                     |   |   |                       |
|                 | Church of Jesus     |   | D |                       |
|                 | Christ of           |   | e |                       |
|                 |                     |   | a |                       |
|                 | Latter Day Saints   |   | r |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   | E |                       |
|                 | 00000               |   | l |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | The President       |   | # |                       |
| # Seventh-Day A |                     |   | # |                       |
| dventist Presid | General Conference  |   |   |                       |
| ent[^14]**^2^** | of                  |   | M |                       |
|                 |                     |   | y |                       |
|                 | Seventh-day         |   |   |                       |
|                 | Adventists          |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | P |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | i |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | P |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | i |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Seventh-D    | Elder (Full Name)   |   | # |                       |
| ay Adventist El |                     |   | # |                       |
| der[^15]**^2^** | General Conference  |   |   |                       |
|                 | of                  |   | D |                       |
|                 |                     |   | e |                       |
|                 | Seventh-day         |   | a |                       |
|                 | Adventists          |   | r |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   | E |                       |
|                 | 00000               |   | l |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Minis        | The Reverend (Full  |   | # |                       |
| ter, Pastor, or | Name)               |   | # |                       |
|  Rector (with D |                     |   |   |                       |
| octoral Degree) | (Title), (Name of   |   | D |                       |
|                 | Church)             |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Minister     | The Reverend (Full  |   | # |                       |
| , Pastor, or Re | Name)               |   | # |                       |
| ctor (Without D |                     |   |   |                       |
| octoral Degree) | (Title), (Name of   |   | D |                       |
|                 | Church)             |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | Chaplain (Full      |   | # |                       |
| # Chaplain (Mil | Name)               |   | # |                       |
| itary Services) |                     |   |   |                       |
|                 | (Rank, Service      |   | D |                       |
|                 | Designation)        |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Post Office        |   | r |                       |
|                 | Address of          |   |   |                       |
|                 | Organization and    |   | C |                       |
|                 | Station)            |   | h |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | p |                       |
|                 | 00000               |   | l |                       |
|                 |                     |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Education    |                     |   |   |                       |
| al Institutions |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | Dr. (Full Name)     |   | # |                       |
|  President of a |                     |   | # |                       |
|  University or  | President, (Name of |   |   |                       |
| College (With D | Institution)        |   | D |                       |
| octoral Degree) |                     |   | e |                       |
|                 | (Local Address)     |   | a |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Pr           | Mr. (Full Name)     |   | # |                       |
| esident of a Un |                     |   | # |                       |
| iversity or Col | President, (Name of |   |   |                       |
| lege (Without D | Institution)        |   | D |                       |
| octoral Degree) |                     |   | e |                       |
|                 | (Local Address)     |   | a |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Presi        | The Very Reverend   |   | # |                       |
| dent of a Theol | (Full Name)         |   | # |                       |
| ogical Seminary |                     |   |   |                       |
|                 | President, (Name of |   | D |                       |
|                 | Institution)        |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | P |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | i |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | D |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | The President of    |   | # |                       |
|  President of a | (Name of            |   | # |                       |
|  Religious Scho | Institution)        |   |   |                       |
| ol (Protestant) |                     |   | M |                       |
|                 | (Local Address)     |   | y |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   | d |                       |
|                 | or                  |   | e |                       |
|                 |                     |   | a |                       |
|                 | The Reverend (Full  |   | r |                       |
|                 | Name)               |   |   |                       |
|                 |                     |   | S |                       |
|                 | President of (Name  |   | i |                       |
|                 | of Institution)     |   | r |                       |
|                 |                     |   | : |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   |   |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | y |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | P |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | i |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | F |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | D |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | I |                       |
|                 |                     |   | n |                       |
|                 |                     |   | f |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Dean of a    | Dr. (Full Name)     |   | # |                       |
|  University or  |                     |   | # |                       |
| College (With D | Dean, School of     |   |   |                       |
| octoral Degree) | (Name)              |   | D |                       |
|                 |                     |   | e |                       |
|                 | (Name of            |   | a |                       |
|                 | Institution)        |   | r |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   | D |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Dean of a Un | Dean (Full Name)    |   | # |                       |
| iversity or Col |                     |   | # |                       |
| lege (Without D | School of (Name)    |   |   |                       |
| octoral Degree) |                     |   | D |                       |
|                 | (Name of            |   | e |                       |
|                 | Institution)        |   | a |                       |
|                 |                     |   | r |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Pr           | Dr. or Professor    |   | # |                       |
| ofessor (With D | (Full Name)         |   | # |                       |
| octoral Degree) |                     |   |   |                       |
|                 | Department of       |   | D |                       |
|                 | (Name)              |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Name of            |   | r |                       |
|                 | Institution)        |   |   |                       |
|                 |                     |   | D |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | P |                       |
|                 |                     |   | r |                       |
|                 |                     |   | o |                       |
|                 |                     |   | f |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Profe        | Professor (Full     |   | # |                       |
| ssor (Without D | Name)               |   | # |                       |
| octoral Degree) |                     |   |   |                       |
|                 | Department of       |   | D |                       |
|                 | (Name)              |   | e |                       |
|                 |                     |   | a |                       |
|                 | (Name of            |   | r |                       |
|                 | Institution)        |   |   |                       |
|                 |                     |   | P |                       |
|                 | (Local Address)     |   | r |                       |
|                 | 00000               |   | o |                       |
|                 |                     |   | f |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Profe        | The Reverend        |   | # |                       |
| ssor in a Theol | Professor (Full     |   | # |                       |
| ogical Seminary | Name)               |   |   |                       |
|                 |                     |   | D |                       |
|                 | (Name of            |   | e |                       |
|                 | Institution)        |   | a |                       |
|                 |                     |   | r |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   | P |                       |
|                 |                     |   | r |                       |
|                 |                     |   | o |                       |
|                 |                     |   | f |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | D |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Associate Pr | Mr. (Full Name)     |   | # |                       |
| ofessor or Assi |                     |   | # |                       |
| stant Professor | Associate (or       |   |   |                       |
|                 | Assistant)          |   | D |                       |
|                 | Professor           |   | e |                       |
|                 |                     |   | a |                       |
|                 | Department of       |   | r |                       |
|                 | (Name)              |   |   |                       |
|                 |                     |   | P |                       |
|                 | (Name of            |   | r |                       |
|                 | Institution)        |   | o |                       |
|                 |                     |   | f |                       |
|                 | (Local Address)     |   | e |                       |
|                 | 00000               |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Superinten   | The Superintendent  |   | # |                       |
| dent of Schools | of (Name)           |   | # |                       |
|                 |                     |   |   |                       |
| (State and      | (Local Address)     |   | D |                       |
| Local)          | 00000               |   | e |                       |
|                 |                     |   | a |                       |
|                 | or                  |   | r |                       |
|                 |                     |   |   |                       |
|                 | Dr. (Mr. or Ms.)    |   | S |                       |
|                 | (Full Name)         |   | i |                       |
|                 |                     |   | r |                       |
|                 | Superintendent of   |   | / |                       |
|                 | (Name Schools)      |   | M |                       |
|                 |                     |   | a |                       |
|                 | (Local Address)     |   | d |                       |
|                 | 00000               |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Boa          | The Board of        |   | # |                       |
| rd of Education | Education           |   | # |                       |
|                 |                     |   |   |                       |
| or              | or                  |   | G |                       |
|                 |                     |   | e |                       |
| Members, Board  | Mr./Ms. (Full Name) |   | n |                       |
| of Education    |                     |   | t |                       |
| (State and      | Member, (Location)  |   | l |                       |
| Local)          | Board of Education  |   | e |                       |
|                 |                     |   | m |                       |
|                 | (Local Address)     |   | e |                       |
|                 | 00000               |   | n |                       |
|                 |                     |   | / |                       |
|                 |                     |   | L |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | i |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | G |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   | l |                       |
|                 |                     |   | e |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   |   |                       |
|                 |                     |   | L |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | i |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## School Board | The (Location)      |   | # |                       |
|                 | School Board        |   | # |                       |
| or              |                     |   |   |                       |
|                 | or                  |   | G |                       |
| Member of       |                     |   | e |                       |
| School Board    | Mr./Ms. (Full Name) |   | n |                       |
|                 |                     |   | t |                       |
|                 | Member, (Location)  |   | l |                       |
|                 | School Board        |   | e |                       |
|                 |                     |   | m |                       |
|                 | (Local Address)     |   | e |                       |
|                 | 00000               |   | n |                       |
|                 |                     |   | / |                       |
|                 |                     |   | L |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | i |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | G |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   | l |                       |
|                 |                     |   | e |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   |   |                       |
|                 |                     |   | L |                       |
|                 |                     |   | a |                       |
|                 |                     |   | d |                       |
|                 |                     |   | i |                       |
|                 |                     |   | e |                       |
|                 |                     |   | s |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Princi       | Mr./Ms. (Full Name) |   | # |                       |
| pal of a School |                     |   | # |                       |
|                 | Principal of        |   |   |                       |
|                 | (School)            |   | D |                       |
|                 |                     |   | e |                       |
|                 | (Local Address)     |   | a |                       |
|                 | 00000               |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Teacher      | Mr./Ms. (Full Name) |   | # |                       |
|                 |                     |   | # |                       |
|                 | (School)            |   |   |                       |
|                 |                     |   | D |                       |
|                 | (Local Address)     |   | e |                       |
|                 | 00000               |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Military     |                     |   |   |                       |
|                 |                     |   |   |                       |
| ##              |                     |   |   |                       |
|  Army, Air Forc |                     |   |   |                       |
| e, Marine Corps |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## G            | (Full Grade) (Full  |   | # |                       |
| eneral, Lieuten | Name),              |   | # |                       |
| ant General, Ma | (Abbreviation of    |   |   |                       |
| jor General, Br | Service             |   | D |                       |
| igadier General | Designation)        |   | e |                       |
|                 |                     |   | a |                       |
|                 | Title               |   | r |                       |
|                 |                     |   |   |                       |
|                 | (Post Office        |   | G |                       |
|                 | Address of          |   | e |                       |
|                 | Organization and    |   | n |                       |
|                 | Station) 00000      |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Colonel, Lie | (Same as Above)     |   | # |                       |
| utenant Colonel |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | C |                       |
|                 |                     |   | o |                       |
|                 |                     |   | l |                       |
|                 |                     |   | o |                       |
|                 |                     |   | n |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Major        | (Same as Above)     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | j |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Captain      | (Same as Above)     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | C |                       |
|                 |                     |   | a |                       |
|                 |                     |   | p |                       |
|                 |                     |   | t |                       |
|                 |                     |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## First        | (Same as Above)     |   | # |                       |
|  Lieutenant, Se |                     |   | # |                       |
| cond Lieutenant |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | L |                       |
|                 |                     |   | i |                       |
|                 |                     |   | e |                       |
|                 |                     |   | u |                       |
|                 |                     |   | t |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Chief Wa     | (Same as Above)     |   | # |                       |
| rrant Officer,  |                     |   | # |                       |
| Warrant Officer |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | r |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | s |                       |
|                 |                     |   | / |                       |
|                 |                     |   | M |                       |
|                 |                     |   | s |                       |
|                 |                     |   | . |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | (Same as Above)     |   | # |                       |
|  Sergeant Major |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | g |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | j |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Mast         | (Same as Above)     |   | # |                       |
| er Sergeant, Gu |                     |   | # |                       |
| nnery Sergeant, |                     |   |   |                       |
|  Technical Serg |                     |   | D |                       |
| eant, Staff Ser |                     |   | e |                       |
| geant, Sergeant |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | g |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Corporal,    | (Same as Above)     |   | # |                       |
|  Lance Corporal |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | C |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | p |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Specialist,  | (Same as Above)     |   | # |                       |
|  Classes 4 to 9 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | p |                       |
|                 |                     |   | e |                       |
|                 |                     |   | c |                       |
|                 |                     |   | i |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | i |                       |
|                 |                     |   | s |                       |
|                 |                     |   | t |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | (Same as Above)     |   | # |                       |
| # Private First |                     |   | # |                       |
|  Class, Private |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | P |                       |
|                 |                     |   | r |                       |
|                 |                     |   | i |                       |
|                 |                     |   | v |                       |
|                 |                     |   | a |                       |
|                 |                     |   | t |                       |
|                 |                     |   | e |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Recruit      | (Same as Above)     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | R |                       |
|                 |                     |   | e |                       |
|                 |                     |   | c |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | i |                       |
|                 |                     |   | t |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | (Same as Above)     |   | # |                       |
| # Airman First  |                     |   | # |                       |
| Class, Airman S |                     |   |   |                       |
| econd Class, Ai |                     |   | D |                       |
| rman Third Clas |                     |   | e |                       |
| s, Basic Airman |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | A |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | (Full Grade) (Full  |   | # |                       |
| Retired Officer | Name),              |   | # |                       |
|                 | (Abbreviation of    |   |   |                       |
|                 | Service             |   | D |                       |
|                 | Designation),       |   | e |                       |
|                 | Retired             |   | a |                       |
|                 |                     |   | r |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   | ( |                       |
|                 |                     |   | R |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | k |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##  Na          |                     |   |   |                       |
| vy, Coast Guard |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Admir        | (Full Grade) (Full  |   | # |                       |
| al, Vice Admira | Name),              |   | # |                       |
| l, Rear Admiral | (Abbreviation of    |   |   |                       |
|                 | Service             |   | D |                       |
|                 | Designation)        |   | e |                       |
|                 |                     |   | a |                       |
|                 | Title               |   | r |                       |
|                 |                     |   |   |                       |
|                 | (Post Office        |   | A |                       |
|                 | Address of          |   | d |                       |
|                 | Organization and    |   | m |                       |
|                 | Station) 00000      |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Commodore    | (Same as Above)     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | C |                       |
|                 |                     |   | o |                       |
|                 |                     |   | m |                       |
|                 |                     |   | m |                       |
|                 |                     |   | o |                       |
|                 |                     |   | d |                       |
|                 |                     |   | o |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Captain      | (Same as Above)     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | C |                       |
|                 |                     |   | a |                       |
|                 |                     |   | p |                       |
|                 |                     |   | t |                       |
|                 |                     |   | a |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## C            | (Same as Above)     |   | # |                       |
| ommander, Lieut |                     |   | # |                       |
| enant Commander |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | C |                       |
|                 |                     |   | o |                       |
|                 |                     |   | m |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | d |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Lieutenant   | (Same as Above)     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | L |                       |
|                 |                     |   | i |                       |
|                 |                     |   | e |                       |
|                 |                     |   | u |                       |
|                 |                     |   | t |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Ensign,      | (Same as Above)     |   | # |                       |
|                 |                     |   | # |                       |
| ##              |                     |   |   |                       |
|                 |                     |   | D |                       |
| ## Chief Wa     |                     |   | e |                       |
| rrant Officer,  |                     |   | a |                       |
| Warrant Officer |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | E |                       |
|                 |                     |   | n |                       |
|                 |                     |   | s |                       |
|                 |                     |   | i |                       |
|                 |                     |   | g |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | C |                       |
|                 |                     |   | h |                       |
|                 |                     |   | i |                       |
|                 |                     |   | e |                       |
|                 |                     |   | f |                       |
|                 |                     |   | W |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   | O |                       |
|                 |                     |   | f |                       |
|                 |                     |   | f |                       |
|                 |                     |   | i |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | W |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | r |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   | O |                       |
|                 |                     |   | f |                       |
|                 |                     |   | f |                       |
|                 |                     |   | i |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Chie         | (Same as Above)     |   | # |                       |
| f Petty Officer |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | C |                       |
|                 |                     |   | h |                       |
|                 |                     |   | i |                       |
|                 |                     |   | e |                       |
|                 |                     |   | f |                       |
|                 |                     |   |   |                       |
|                 |                     |   | P |                       |
|                 |                     |   | e |                       |
|                 |                     |   | t |                       |
|                 |                     |   | t |                       |
|                 |                     |   | y |                       |
|                 |                     |   |   |                       |
|                 |                     |   | O |                       |
|                 |                     |   | f |                       |
|                 |                     |   | f |                       |
|                 |                     |   | i |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Petty Off    | (Same as Above)     |   | # |                       |
| icer First Clas |                     |   | # |                       |
| s, Petty Office |                     |   |   |                       |
| r Second Class, |                     |   | D |                       |
|  and Petty Offi |                     |   | e |                       |
| cer Third Class |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | P |                       |
|                 |                     |   | e |                       |
|                 |                     |   | t |                       |
|                 |                     |   | t |                       |
|                 |                     |   | y |                       |
|                 |                     |   |   |                       |
|                 |                     |   | O |                       |
|                 |                     |   | f |                       |
|                 |                     |   | f |                       |
|                 |                     |   | i |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | (Same as Above)     |   | # |                       |
| Seaman, Seaman  |                     |   | # |                       |
| Apprentice, and |                     |   |   |                       |
|  Seaman Recruit |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Fir          | (Same as Above)     |   | # |                       |
| eman, Fireman A |                     |   | # |                       |
| pprentice, and  |                     |   |   |                       |
| Fireman Recruit |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | F |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | (Same as Above)     |   | # |                       |
| Airman, Airman  |                     |   | # |                       |
| Apprentice, and |                     |   |   |                       |
|  Airman Recruit |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | A |                       |
|                 |                     |   | i |                       |
|                 |                     |   | r |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Constructio  | (Same as Above)     |   | # |                       |
| n Man, Construc |                     |   | # |                       |
| tion Man Appren |                     |   |   |                       |
| tice, Construct |                     |   | D |                       |
| ion Man Recruit |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | C |                       |
|                 |                     |   | o |                       |
|                 |                     |   | n |                       |
|                 |                     |   | s |                       |
|                 |                     |   | t |                       |
|                 |                     |   | r |                       |
|                 |                     |   | u |                       |
|                 |                     |   | c |                       |
|                 |                     |   | t |                       |
|                 |                     |   | i |                       |
|                 |                     |   | o |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | M |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Hospitalman  | (Same as Above)     |   | # |                       |
| , Hospitalman A |                     |   | # |                       |
| pprentice, Hosp |                     |   |   |                       |
| italman Recruit |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | H |                       |
|                 |                     |   | o |                       |
|                 |                     |   | s |                       |
|                 |                     |   | p |                       |
|                 |                     |   | i |                       |
|                 |                     |   | t |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Dentalman    | (Same as Above)     |   | # |                       |
| , Dentalman App |                     |   | # |                       |
| rentice, and De |                     |   |   |                       |
| ntalman Recruit |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | n |                       |
|                 |                     |   | t |                       |
|                 |                     |   | a |                       |
|                 |                     |   | l |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Stewardsman  | (Same as Above)     |   | # |                       |
| , Stewardsman A |                     |   | # |                       |
| pprentice, Stew |                     |   |   |                       |
| ardsman Recruit |                     |   | D |                       |
|                 |                     |   | e |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | t |                       |
|                 |                     |   | e |                       |
|                 |                     |   | w |                       |
|                 |                     |   | a |                       |
|                 |                     |   | r |                       |
|                 |                     |   | d |                       |
|                 |                     |   | s |                       |
|                 |                     |   | m |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | # |                       |
|                 |                     |   | # |                       |
|                 |                     |   |   |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | (Full Grade) (Full  |   | # |                       |
| Retired Officer | Name),              |   | # |                       |
|                 |                     |   |   |                       |
|                 | (Abbreviation of    |   | D |                       |
|                 | Service             |   | e |                       |
|                 | Designation),       |   | a |                       |
|                 | Retired             |   | r |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   | ( |                       |
|                 | 00000               |   | R |                       |
|                 |                     |   | a |                       |
|                 |                     |   | n |                       |
|                 |                     |   | k |                       |
|                 |                     |   | ) |                       |
|                 |                     |   |   |                       |
|                 |                     |   | ( |                       |
|                 |                     |   | S |                       |
|                 |                     |   | u |                       |
|                 |                     |   | r |                       |
|                 |                     |   | n |                       |
|                 |                     |   | a |                       |
|                 |                     |   | m |                       |
|                 |                     |   | e |                       |
|                 |                     |   | ) |                       |
|                 |                     |   | : |                       |
|                 |                     |   |   |                       |
|                 |                     |   | S |                       |
|                 |                     |   | i |                       |
|                 |                     |   | n |                       |
|                 |                     |   | c |                       |
|                 |                     |   | e |                       |
|                 |                     |   | r |                       |
|                 |                     |   | e |                       |
|                 |                     |   | l |                       |
|                 |                     |   | y |                       |
|                 |                     |   | , |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Military     |                     |   |   |                       |
| Mail (Overseas) |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Army         | Show full grade;    |   | # |                       |
|                 | full name,          |   | # |                       |
|                 | including first     |   |   |                       |
|                 | name and middle     |   |   |                       |
|                 | name or initial;    |   |   |                       |
|                 | social security     |   |   |                       |
|                 | account number;     |   |   |                       |
|                 | organizations; and  |   |   |                       |
|                 | APO number and post |   |   |                       |
|                 | office through      |   |   |                       |
|                 | which mail is to be |   |   |                       |
|                 | routed. Example:    |   |   |                       |
|                 |                     |   |   |                       |
|                 | Gen. Kenneth A.     |   |   |                       |
|                 | O'Brien, Jr.,       |   |   |                       |
|                 |                     |   |   |                       |
|                 | 300-900-0241        |   |   |                       |
|                 |                     |   |   |                       |
|                 | 801^st^ Infantry    |   |   |                       |
|                 | Regt.               |   |   |                       |
|                 |                     |   |   |                       |
|                 | APO New York 09801  |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Air Force    | Show full grade;    |   | # |                       |
|                 | full name,          |   | # |                       |
|                 | including first     |   |   |                       |
|                 | name and middle     |   |   |                       |
|                 | name or initial;    |   |   |                       |
|                 | social security     |   |   |                       |
|                 | account number;     |   |   |                       |
|                 | Postal Service      |   |   |                       |
|                 | Center (PSC) box    |   |   |                       |
|                 | number if served by |   |   |                       |
|                 | PSC, or             |   |   |                       |
|                 | organization if not |   |   |                       |
|                 | served by PSC (and  |   |   |                       |
|                 | box number, if      |   |   |                       |
|                 | appropriate); and   |   |   |                       |
|                 | APO number and the  |   |   |                       |
|                 | post office through |   |   |                       |
|                 | which the mail is   |   |   |                       |
|                 | to be routed.       |   |   |                       |
|                 | Example:            |   |   |                       |
|                 |                     |   |   |                       |
|                 | Personnel Served by |   |   |                       |
|                 | PSC                 |   |   |                       |
|                 |                     |   |   |                       |
|                 | A1C James LaVar     |   |   |                       |
|                 | Green,              |   |   |                       |
|                 |                     |   |   |                       |
|                 | FR-891-04-1978      |   |   |                       |
|                 |                     |   |   |                       |
|                 | PSC Box 913         |   |   |                       |
|                 |                     |   |   |                       |
|                 | APO New York 09109  |   |   |                       |
|                 |                     |   |   |                       |
|                 | Personnel Served by |   |   |                       |
|                 | Unit Mail Room      |   |   |                       |
|                 |                     |   |   |                       |
|                 | Sgt. Montgomery     |   |   |                       |
|                 | Stanback,           |   |   |                       |
|                 |                     |   |   |                       |
|                 | FR-801-04-0278      |   |   |                       |
|                 |                     |   |   |                       |
|                 | 124-24 Elect Instl. |   |   |                       |
|                 | Sq., Box 139        |   |   |                       |
|                 |                     |   |   |                       |
|                 | APO San Francisco   |   |   |                       |
|                 | 96274               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Navy a       | Show full name,     |   |   | ##                    |
| nd Marine Corps | including first     |   |   |                       |
|                 | name and middle     |   |   |                       |
|                 | name or initial,    |   |   |                       |
|                 | rank or rating,     |   |   |                       |
|                 | service number,     |   |   |                       |
|                 | shore base          |   |   |                       |
|                 | organization unit   |   |   |                       |
|                 | with Navy number,   |   |   |                       |
|                 | or mobile unit      |   |   |                       |
|                 | designation or name |   |   |                       |
|                 | of ship, and the    |   |   |                       |
|                 | fleet post office   |   |   |                       |
|                 | (FPO) through which |   |   |                       |
|                 | the mail is to be   |   |   |                       |
|                 | routed. Example:    |   |   |                       |
|                 |                     |   |   |                       |
|                 | NAVY                |   |   |                       |
|                 |                     |   |   |                       |
|                 | Mary D. Woodard     |   |   |                       |
|                 | QMSN 680-92-79 USN  |   |   |                       |
|                 |                     |   |   |                       |
|                 | USS Irvin Wallace   |   |   |                       |
|                 | (DD729)             |   |   |                       |
|                 |                     |   |   |                       |
|                 | FPO San Francisco   |   |   |                       |
|                 | 96601               |   |   |                       |
|                 |                     |   |   |                       |
|                 | Mary D. Woodard,    |   |   |                       |
|                 | AQF-1, 319 04 02    |   |   |                       |
|                 | USN                 |   |   |                       |
|                 |                     |   |   |                       |
|                 | U.S. Naval Air      |   |   |                       |
|                 | Facility            |   |   |                       |
|                 |                     |   |   |                       |
|                 | FPO New York 09521  |   |   |                       |
|                 |                     |   |   |                       |
|                 | USMC                |   |   |                       |
|                 |                     |   |   |                       |
|                 | Maj. William K.     |   |   |                       |
|                 | Lewis, 139042 USMC  |   |   |                       |
|                 |                     |   |   |                       |
|                 | Staff, Fleet Marine |   |   |                       |
|                 | Force Pacific       |   |   |                       |
|                 |                     |   |   |                       |
|                 | FPO San Francisco   |   |   |                       |
|                 | 96602               |   |   |                       |
|                 |                     |   |   |                       |
|                 | Lt. Joseph S.       |   |   |                       |
|                 | Woodard, 020478,    |   |   |                       |
|                 | USMC                |   |   |                       |
|                 |                     |   |   |                       |
|                 | U.S. Marine Corps   |   |   |                       |
|                 | Air Facility        |   |   |                       |
|                 |                     |   |   |                       |
|                 | FPO San Francisco   |   |   |                       |
|                 | 96672               |   |   |                       |
|                 |                     |   |   |                       |
|                 | Dependents Residing |   |   |                       |
|                 | with Military       |   |   |                       |
|                 | Personnel           |   |   |                       |
|                 |                     |   |   |                       |
|                 | Miss Mary D.        |   |   |                       |
|                 | Woodard             |   |   |                       |
|                 |                     |   |   |                       |
|                 | c/o Sgt. Paul L.    |   |   |                       |
|                 | Woodard,            |   |   |                       |
|                 | 021-04-1978         |   |   |                       |
|                 |                     |   |   |                       |
|                 | Company A, 1^st^    |   |   |                       |
|                 | Bn. 16^th^ Inf.     |   |   |                       |
|                 |                     |   |   |                       |
|                 | APO New York 09036  |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Arm          | Show grade; full    |   |   | ##                    |
| y and Air Force | name, including     |   |   |                       |
|                 | first name and      |   |   |                       |
|                 | middle name or      |   |   |                       |
|                 | initial; social     |   |   |                       |
|                 | security account    |   |   |                       |
|                 | number;             |   |   |                       |
|                 | organization;       |   |   |                       |
|                 | military            |   |   |                       |
|                 | installation; and   |   |   |                       |
|                 | the State and the   |   |   |                       |
|                 | ZIP Code. Examples: |   |   |                       |
|                 |                     |   |   |                       |
|                 | Personnel Served by |   |   |                       |
|                 | PSC                 |   |   |                       |
|                 |                     |   |   |                       |
|                 | Sgt. Keith P.       |   |   |                       |
|                 | Watkins,            |   |   |                       |
|                 | FR-212-03-1978      |   |   |                       |
|                 |                     |   |   |                       |
|                 | PSC Box 1978        |   |   |                       |
|                 |                     |   |   |                       |
|                 | Vandenberg AFB CA   |   |   |                       |
|                 | 93437               |   |   |                       |
|                 |                     |   |   |                       |
|                 | Personnel Served by |   |   |                       |
|                 | Unit Mail Room      |   |   |                       |
|                 |                     |   |   |                       |
|                 | A1C Melvin C.       |   |   |                       |
|                 | Schott,             |   |   |                       |
|                 | FR-002-04-1978      |   |   |                       |
|                 |                     |   |   |                       |
|                 | 1 Strat Aerosp Div, |   |   |                       |
|                 | Box 107             |   |   |                       |
|                 |                     |   |   |                       |
|                 | Vandenberg AFB CA   |   |   |                       |
|                 | 93437               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Navy a       | Show full name      |   |   | ##                    |
| nd Marine Corps | including first     |   |   |                       |
|                 | name and middle     |   |   |                       |
|                 | name or initial,    |   |   |                       |
|                 | rank or rating,     |   |   |                       |
|                 | service number,     |   |   |                       |
|                 | organization,       |   |   |                       |
|                 | military            |   |   |                       |
|                 | installation and    |   |   |                       |
|                 | the ZIP Code.       |   |   |                       |
|                 | Example:            |   |   |                       |
|                 |                     |   |   |                       |
|                 | Bill T. Hennessee,  |   |   |                       |
|                 | SK2, 513 02 64 USN  |   |   |                       |
|                 |                     |   |   |                       |
|                 | U.S. Naval Supply   |   |   |                       |
|                 | Depot               |   |   |                       |
|                 |                     |   |   |                       |
|                 | Great Lakes, IL     |   |   |                       |
|                 | 60088               |   |   |                       |
|                 |                     |   |   |                       |
|                 | M/SGT Bill T.       |   |   |                       |
|                 | Hennessee, 0204197  |   |   |                       |
|                 | USMC                |   |   |                       |
|                 |                     |   |   |                       |
|                 | Headquarters        |   |   |                       |
|                 | Battalion           |   |   |                       |
|                 |                     |   |   |                       |
|                 | Headquarters U.S.   |   |   |                       |
|                 | Marine Corps        |   |   |                       |
|                 |                     |   |   |                       |
|                 | Henderson Hall      |   |   |                       |
|                 |                     |   |   |                       |
|                 | Arlington, VA 22214 |   |   |                       |
|                 |                     |   |   |                       |
|                 | Dependents Residing |   |   |                       |
|                 | with Military       |   |   |                       |
|                 | Personnel           |   |   |                       |
|                 |                     |   |   |                       |
|                 | Master Darrell L.   |   |   |                       |
|                 | Hennessee           |   |   |                       |
|                 |                     |   |   |                       |
|                 | c/o Sgt. William    |   |   |                       |
|                 | Hennessee,          |   |   |                       |
|                 | 081-32-1978         |   |   |                       |
|                 |                     |   |   |                       |
|                 | Company M. 9^th^    |   |   |                       |
|                 | Bn., 9^th^ Inf.     |   |   |                       |
|                 |                     |   |   |                       |
|                 | Fort Gordon, GA     |   |   |                       |
|                 | 30905               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Corporatio   |                     |   |   |                       |
| ns, Companies,  |                     |   |   |                       |
| and Federations |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## A Company    | (Name of Company or |   |   | ##                    |
|  or Corporation | Corporation)        |   |   | Ladies and Gentlemen: |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   | Sincerely,            |
|                 | 00000               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## A Federation | (Name of Official)  |   |   | ## De                 |
|                 |                     |   |   | ar Mr./Ms. (Surname): |
|                 | (Title), (Name of   |   |   |                       |
|                 | Federation)         |   |   | Sincerely,            |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Medical[^16] |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Physician    | (Full Name),        |   |   | #                     |
|                 | (Appropriate        |   |   | # Dear Dr. (Surname): |
|                 | Abbreviation)       |   |   |                       |
|                 |                     |   |   | Sincerely,            |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   |   |                       |
|                 | Abbreviations[^17]  |   |   |                       |
|                 |                     |   |   |                       |
|                 | C.B. Bachelor of    |   |   |                       |
|                 | Surgery             |   |   |                       |
|                 |                     |   |   |                       |
|                 | D.O. Doctor of      |   |   |                       |
|                 | Osteopathy          |   |   |                       |
|                 |                     |   |   |                       |
|                 | D.P.H. Doctor of    |   |   |                       |
|                 | Public Health       |   |   |                       |
|                 |                     |   |   |                       |
|                 | M.B. (for B.M.)     |   |   |                       |
|                 | Bachelor of         |   |   |                       |
|                 | Medicine            |   |   |                       |
|                 |                     |   |   |                       |
|                 | M.D. Doctor of      |   |   |                       |
|                 | Medicine            |   |   |                       |
|                 |                     |   |   |                       |
|                 | Pod. D. Doctor of   |   |   |                       |
|                 | Podiatry            |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              | Drs. (Full Name)    |   |   | ## Dear Drs. (Su      |
|  Two Physicians | and (Full Name)     |   |   | rname) and (Surname): |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   | Sincerely,            |
|                 | 00000               |   |   |                       |
|                 |                     |   |   | or                    |
|                 | or                  |   |   |                       |
|                 |                     |   |   | Dear Drs. (Surname):  |
|                 | Drs. (Same Surname) |   |   |                       |
|                 |                     |   |   | Sincerely,            |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Dentist      | (Full Name),        |   |   | #                     |
|                 | (Appropriate        |   |   | # Dear Dr. (Surname): |
|                 | Abbreviation)       |   |   |                       |
|                 |                     |   |   | Sincerely,            |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   |   |                       |
|                 | Abbreviations       |   |   |                       |
|                 |                     |   |   |                       |
|                 | B.D.S. Bachelor of  |   |   |                       |
|                 | Dental Surgery      |   |   |                       |
|                 |                     |   |   |                       |
|                 | D.D.S. Doctor of    |   |   |                       |
|                 | Dental Surgery      |   |   |                       |
|                 |                     |   |   |                       |
|                 | D.M.D. Doctor of    |   |   |                       |
|                 | Dental Medicine     |   |   |                       |
|                 |                     |   |   |                       |
|                 | M.D.S. Master of    |   |   |                       |
|                 | Dental Surgery      |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Veterinarian | (Full Name),        |   |   | #                     |
|                 | (Appropriate        |   |   | # Dear Dr. (Surname): |
|                 | Abbreviation)       |   |   |                       |
|                 |                     |   |   | Sincerely,            |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   |   |                       |
|                 | Abbreviations       |   |   |                       |
|                 |                     |   |   |                       |
|                 | B.V.Sc. Bachelor of |   |   |                       |
|                 | Veterinary Science  |   |   |                       |
|                 |                     |   |   |                       |
|                 | D.V.M. for V.M.D.   |   |   |                       |
|                 | Doctor of           |   |   |                       |
|                 | Veterinary Medicine |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Pharmacist   | Mr./Ms. (Full       |   |   | ## De                 |
|                 | Name), (Appropriate |   |   | ar Mr./Ms. (Surname): |
|                 | Abbreviation)       |   |   |                       |
|                 |                     |   |   | Sincerely,            |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   | or                    |
|                 |                     |   |   |                       |
|                 | or                  |   |   | Dear Dr. (Surname):   |
|                 |                     |   |   |                       |
|                 | (Full Name),        |   |   | Sincerely,            |
|                 | (Appropriate        |   |   |                       |
|                 | Abbreviation)       |   |   |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   |   |                       |
|                 | Abbreviations       |   |   |                       |
|                 |                     |   |   |                       |
|                 | Phar.B Bachelor of  |   |   |                       |
|                 | Pharmacy            |   |   |                       |
|                 |                     |   |   |                       |
|                 | Phar.D Doctor of    |   |   |                       |
|                 | Pharmacy            |   |   |                       |
|                 |                     |   |   |                       |
|                 | Phar.M. Master of   |   |   |                       |
|                 | Pharmacy            |   |   |                       |
|                 |                     |   |   |                       |
|                 | Ph.C.               |   |   |                       |
|                 | Pharmaceutical      |   |   |                       |
|                 | Chemist             |   |   |                       |
|                 |                     |   |   |                       |
|                 | R.Ph. Registered    |   |   |                       |
|                 | Pharmacist          |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Nurse        | Mr./Ms. (Full       |   |   | ## De                 |
|                 | Name), (Appropriate |   |   | ar Mr./Ms. (Surname): |
|                 | Abbreviation)       |   |   |                       |
|                 |                     |   |   | Sincerely,            |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   |   |                       |
|                 | Abbreviations       |   |   |                       |
|                 |                     |   |   |                       |
|                 | L.P.N. Licensed     |   |   |                       |
|                 | Practical Nurse     |   |   |                       |
|                 |                     |   |   |                       |
|                 | P.N. Practical      |   |   |                       |
|                 | Nurse               |   |   |                       |
|                 |                     |   |   |                       |
|                 | R.N. Registered     |   |   |                       |
|                 | Nurse               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              |                     |   |   |                       |
| Other Addresses |                     |   |   |                       |
|                 |                     |   |   |                       |
| ## Single       |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## A Man        | Mr. (Full Name)     |   |   | ## Dear Sir:          |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   | Sincerely,            |
|                 | 00000               |   |   |                       |
|                 |                     |   |   | or                    |
|                 |                     |   |   |                       |
|                 |                     |   |   | Dear Mr. (Surname):   |
|                 |                     |   |   |                       |
|                 |                     |   |   | Sincerely,            |
+-----------------+---------------------+---+---+-----------------------+
| ## An Unmar     | Ms. (Full Name)     |   |   | #                     |
| ried Woman[^18] |                     |   |   | # Dear Ms. (Surname): |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   | Sincerely,            |
+-----------------+---------------------+---+---+-----------------------+
| A Married Woman | Mrs. (Husband's     |   |   | ##                    |
| or Widow        | Full Name)          |   |   |  Dear Mrs. (Surname): |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   | Sincerely,            |
|                 | 00000               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               | Messrs. (Surname)   |   |   | ##                    |
| # Multiple[^19] | and (Surname)       |   |   |  Gentlemen (Surname): |
|                 |                     |   |   |                       |
| Two or More Men | (Local Address)     |   |   | Sincerely,            |
|                 | 00000               |   |   |                       |
|                 |                     |   |   | or                    |
|                 | or                  |   |   |                       |
|                 |                     |   |   | Dear Mr. (Surname)    |
|                 | Mr. (Full Name) and |   |   | and Mr. (Surname):    |
|                 | Mr. (Full Name)     |   |   |                       |
|                 |                     |   |   | Sincerely,            |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
|                 |                     |   |   |                       |
|                 | or                  |   |   |                       |
|                 |                     |   |   |                       |
|                 | The Messrs.         |   |   |                       |
|                 | (Surname)           |   |   |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Tw           | Messrs. (Given      |   |   | ## De                 |
| o or More Men o | Name) and (Given    |   |   | ar Messrs. (Surname): |
| f the Same Name | Name) (Surname)     |   |   |                       |
|                 |                     |   |   | Sincerely,            |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   | or Gentlemen:         |
|                 |                     |   |   |                       |
|                 | or                  |   |   | Sincerely,            |
|                 |                     |   |   |                       |
|                 | The Messrs.         |   |   |                       |
|                 | (Surname)           |   |   |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Two or More  | The Mses. (Surname) |   |   | ##                    |
| Unmarried Women | and (Surname)       |   |   | Ladies (or Mesdames): |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   | Sincerely,            |
|                 | 00000               |   |   |                       |
|                 |                     |   |   | Dear Misses (Surname) |
|                 | Miss (Full Name)    |   |   | and (Surname):        |
|                 | and Miss (Full      |   |   |                       |
|                 | Name)               |   |   | Sincerely,            |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Tw           | Ms. (Full Name) and |   |   | ##                    |
| o or More Women | Mrs. (Full Name)    |   |   | Ladies (or Mesdames): |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   | Sincerely,            |
|                 | 00000               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## One Ma       | Mr. (Full Name) and |   |   | ## Dear Mr. (Surnam   |
| n and One Woman | Ms. (Full Name)     |   |   | e) and Ms. (Surname): |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   | Sincerely,            |
|                 | 00000               |   |   |                       |
|                 |                     |   |   | or                    |
|                 | or                  |   |   |                       |
|                 |                     |   |   | Dear Mr. And Mrs.     |
|                 | Mr. and Ms. (His    |   |   | (Surname-Surname)     |
|                 | Surname and Her     |   |   |                       |
|                 | Surname Separated   |   |   |                       |
|                 | by a Hyphen)        |   |   |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Men          | Ms. (Full Name),    |   |   | ## M                  |
|  and Women[^20] | Mrs. (Full Name)    |   |   | esdemes and Dear Sir: |
|                 | and Mr. (Full Name) |   |   |                       |
|                 |                     |   |   | Sincerely,            |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   | or                    |
|                 |                     |   |   |                       |
|                 | or                  |   |   | Dear Madam and        |
|                 |                     |   |   | Gentlemen:            |
|                 | Mrs. (Full Name),   |   |   |                       |
|                 | Mr. (Full Name) and |   |   | Sincerely,            |
|                 | Mrs. (Full Name)    |   |   |                       |
|                 |                     |   |   |                       |
|                 | (Local Address)     |   |   |                       |
|                 | 00000               |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Single       |                     |   |   |                       |
| Addressees Mult |                     |   |   |                       |
| iple Addressees |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               |                     |   |   |                       |
| # The Secretary |                     |   |   |                       |
|                 |                     |   |   |                       |
| The Deputy      |                     |   |   |                       |
| Secretary       |                     |   |   |                       |
|                 |                     |   |   |                       |
| General Counsel |                     |   |   |                       |
| Secretarial     |                     |   |   |                       |
| Officers:       |                     |   |   |                       |
|                 |                     |   |   |                       |
| Assistant       |                     |   |   |                       |
| Secretary for   |                     |   |   |                       |
| (organizational |                     |   |   |                       |
| title)          |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              |                     |   |   |                       |
| Federal Aviatio |                     |   |   |                       |
| n Administrator |                     |   |   |                       |
|                 |                     |   |   |                       |
| Federal Highway |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
|                 |                     |   |   |                       |
| National        |                     |   |   |                       |
| Highway Traffic |                     |   |   |                       |
| Safety          |                     |   |   |                       |
|                 |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
|                 |                     |   |   |                       |
| Federal         |                     |   |   |                       |
| Railroad        |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
|                 |                     |   |   |                       |
| Federal Transit |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
|                 |                     |   |   |                       |
| Administrator,  |                     |   |   |                       |
| Saint Lawrence  |                     |   |   |                       |
|                 |                     |   |   |                       |
| Seaway          |                     |   |   |                       |
| Development     |                     |   |   |                       |
| Corporation     |                     |   |   |                       |
| Heads of        |                     |   |   |                       |
| Operating       |                     |   |   |                       |
| A               |                     |   |   |                       |
| dministrations: |                     |   |   |                       |
|                 |                     |   |   |                       |
| Administrator,  |                     |   |   |                       |
| Research and    |                     |   |   |                       |
|                 |                     |   |   |                       |
| Special         |                     |   |   |                       |
| Programs        |                     |   |   |                       |
| Administration  |                     |   |   |                       |
|                 |                     |   |   |                       |
| Administrator,  |                     |   |   |                       |
| Maritime        |                     |   |   |                       |
| Administration  |                     |   |   |                       |
|                 |                     |   |   |                       |
| Federal Motor   |                     |   |   |                       |
| Carrier Safety  |                     |   |   |                       |
|                 |                     |   |   |                       |
| Administration  |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
|                 |                     |   |   |                       |
| Director,       |                     |   |   |                       |
| Bureau of       |                     |   |   |                       |
| Transportation  |                     |   |   |                       |
| Statistics      |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| #               |                     |   |   |                       |
| # Chief Counsel |                     |   |   |                       |
|  Chief Counsel: |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Asso         |                     |   |   |                       |
| ciate Administr |                     |   |   |                       |
| ator for Policy |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for             |                     |   |   |                       |
| Infrastructure  |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for Planning,   |                     |   |   |                       |
| Environment,    |                     |   |   |                       |
| and Realty      |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for Operations  |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for Federal     |                     |   |   |                       |
| Lands Highway   |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for Safety      |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrators: |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for Research,   |                     |   |   |                       |
| Development and |                     |   |   |                       |
| Technology      |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for             |                     |   |   |                       |
| Administration  |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for Civil       |                     |   |   |                       |
| Rights          |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for Public      |                     |   |   |                       |
| Affairs         |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for Corporate   |                     |   |   |                       |
| Management      |                     |   |   |                       |
|                 |                     |   |   |                       |
| Associate       |                     |   |   |                       |
| Administrator   |                     |   |   |                       |
| for             |                     |   |   |                       |
| Professional    |                     |   |   |                       |
| Development     |                     |   |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## [Offices]{   |                     | # |   |                       |
| .underline} und |                     | # |   |                       |
| er [all]{.under |                     |   |   |                       |
| line} Associate |                     | A |   |                       |
|  Administrators |                     | l |   |                       |
|                 |                     | l |   |                       |
| Offices under   |                     |   |   |                       |
| [o              |                     | P |   |                       |
| ne]{.underline} |                     | r |   |                       |
| Associate       |                     | o |   |                       |
| Administrator   |                     | g |   |                       |
|                 |                     | r |   |                       |
| Example:        |                     | a |   |                       |
|                 |                     | m |   |                       |
| Director,       |                     |   |   |                       |
| Office of Human |                     | O |   |                       |
| Resources       |                     | f |   |                       |
|                 |                     | f |   |                       |
| Director,       |                     | i |   |                       |
| Office of       |                     | c |   |                       |
| Budget and      |                     | e |   |                       |
| Finance         |                     | s |   |                       |
|                 |                     |   |   |                       |
| Director,       |                     | E |   |                       |
| Office of       |                     | x |   |                       |
| Information and |                     | a |   |                       |
| Management      |                     | m |   |                       |
| Services        |                     | p |   |                       |
|                 |                     | l |   |                       |
| Director,       |                     | e |   |                       |
| Office of       |                     | : |   |                       |
| Acquisition     |                     |   |   |                       |
| Management      |                     | A |   |                       |
|                 |                     | l |   |                       |
|                 |                     | l |   |                       |
|                 |                     | A |   |                       |
|                 |                     | d |   |                       |
|                 |                     | m |   |                       |
|                 |                     | i |   |                       |
|                 |                     | n |   |                       |
|                 |                     | i |   |                       |
|                 |                     | s |   |                       |
|                 |                     | t |   |                       |
|                 |                     | r |   |                       |
|                 |                     | a |   |                       |
|                 |                     | t |   |                       |
|                 |                     | i |   |                       |
|                 |                     | o |   |                       |
|                 |                     | n |   |                       |
|                 |                     | P |   |                       |
|                 |                     | r |   |                       |
|                 |                     | o |   |                       |
|                 |                     | g |   |                       |
|                 |                     | r |   |                       |
|                 |                     | a |   |                       |
|                 |                     | m |   |                       |
|                 |                     | O |   |                       |
|                 |                     | f |   |                       |
|                 |                     | f |   |                       |
|                 |                     | i |   |                       |
|                 |                     | c |   |                       |
|                 |                     | e |   |                       |
|                 |                     | s |   |                       |
|                 |                     | : |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Dire         |                     | # |   |                       |
| ctor of Field S |                     | # |   |                       |
| ervices -- East |                     |   |   |                       |
|                 |                     | D |   |                       |
| Director of     |                     | i |   |                       |
| Field Services  |                     | r |   |                       |
| -- South        |                     | e |   |                       |
|                 |                     | c |   |                       |
| Director of     |                     | t |   |                       |
| Field           |                     | o |   |                       |
| Services - West |                     | r |   |                       |
|                 |                     | s |   |                       |
|                 |                     |   |   |                       |
|                 |                     | o |   |                       |
|                 |                     | f |   |                       |
|                 |                     |   |   |                       |
|                 |                     | F |   |                       |
|                 |                     | i |   |                       |
|                 |                     | e |   |                       |
|                 |                     | l |   |                       |
|                 |                     | d |   |                       |
|                 |                     |   |   |                       |
|                 |                     | S |   |                       |
|                 |                     | e |   |                       |
|                 |                     | r |   |                       |
|                 |                     | v |   |                       |
|                 |                     | i |   |                       |
|                 |                     | c |   |                       |
|                 |                     | e |   |                       |
|                 |                     | s |   |                       |
|                 |                     | : |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Eastern      |                     | # |   |                       |
| Resource Center |                     | # |   |                       |
|                 |                     |   |   |                       |
| Midwestern      |                     | R |   |                       |
| Resource Center |                     | e |   |                       |
|                 |                     | s |   |                       |
| Southern        |                     | o |   |                       |
| Resource Center |                     | u |   |                       |
|                 |                     | r |   |                       |
| Western         |                     | c |   |                       |
| Resource Center |                     | e |   |                       |
|                 |                     |   |   |                       |
|                 |                     | C |   |                       |
|                 |                     | e |   |                       |
|                 |                     | n |   |                       |
|                 |                     | t |   |                       |
|                 |                     | e |   |                       |
|                 |                     | r |   |                       |
|                 |                     |   |   |                       |
|                 |                     | M |   |                       |
|                 |                     | a |   |                       |
|                 |                     | n |   |                       |
|                 |                     | a |   |                       |
|                 |                     | g |   |                       |
|                 |                     | e |   |                       |
|                 |                     | r |   |                       |
|                 |                     | s |   |                       |
|                 |                     | : |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ## Alabama      |                     | # |   |                       |
| Division Office |                     | # |   |                       |
|                 |                     |   |   |                       |
| (each State has |                     | D |   |                       |
| a Division      |                     | i |   |                       |
| Office plus     |                     | v |   |                       |
| Puerto Rico and |                     | i |   |                       |
| the District of |                     | s |   |                       |
| Columbia)       |                     | i |   |                       |
|                 |                     | o |   |                       |
|                 |                     | n |   |                       |
|                 |                     |   |   |                       |
|                 |                     | A |   |                       |
|                 |                     | d |   |                       |
|                 |                     | m |   |                       |
|                 |                     | i |   |                       |
|                 |                     | n |   |                       |
|                 |                     | i |   |                       |
|                 |                     | s |   |                       |
|                 |                     | t |   |                       |
|                 |                     | r |   |                       |
|                 |                     | a |   |                       |
|                 |                     | t |   |                       |
|                 |                     | o |   |                       |
|                 |                     | r |   |                       |
|                 |                     | s |   |                       |
|                 |                     | : |   |                       |
+-----------------+---------------------+---+---+-----------------------+
| ##              |                     | # |   |                       |
| Eastern Federal |                     | # |   |                       |
|  Lands Highway  |                     |   |   |                       |
| Division Office |                     | F |   |                       |
|                 |                     | e |   |                       |
| Central Federal |                     | d |   |                       |
| Lands Highway   |                     | e |   |                       |
| Division Office |                     | r |   |                       |
|                 |                     | a |   |                       |
| Western Federal |                     | l |   |                       |
| Lands Highway   |                     |   |   |                       |
| Division Office |                     | L |   |                       |
|                 |                     | a |   |                       |
|                 |                     | n |   |                       |
|                 |                     | d |   |                       |
|                 |                     | s |   |                       |
|                 |                     |   |   |                       |
|                 |                     | H |   |                       |
|                 |                     | i |   |                       |
|                 |                     | g |   |                       |
|                 |                     | h |   |                       |
|                 |                     | w |   |                       |
|                 |                     | a |   |                       |
|                 |                     | y |   |                       |
|                 |                     |   |   |                       |
|                 |                     | D |   |                       |
|                 |                     | i |   |                       |
|                 |                     | v |   |                       |
|                 |                     | i |   |                       |
|                 |                     | s |   |                       |
|                 |                     | i |   |                       |
|                 |                     | o |   |                       |
|                 |                     | n |   |                       |
|                 |                     |   |   |                       |
|                 |                     | E |   |                       |
|                 |                     | n |   |                       |
|                 |                     | g |   |                       |
|                 |                     | i |   |                       |
|                 |                     | n |   |                       |
|                 |                     | e |   |                       |
|                 |                     | e |   |                       |
|                 |                     | r |   |                       |
|                 |                     | s |   |                       |
|                 |                     | : |   |                       |
+-----------------+---------------------+---+---+-----------------------+

## 

[^1]: If the complete address exceeds five lines, omit the name of the
    parent committee from the letter. However, the complete address
    should always be included on the envelope.

[^2]: The title is Dr., Mr., etc., as appropriate. The title Reverend is
    not used with the surname alone but may be used with another title;
    e.g., Reverend Dr. Smith or Rev. Mr. Smith.

[^3]: See Footnote ^1^

[^4]: If the Clerk's name is not known, use only his/her title in the
    address and Dear M. Clerk: in the salutation.

[^5]: See Footnote^2^

[^6]: If it is not known whether the addressee is a man or a woman, use
    either the full name such as "Dear Leslie Doe" or "Dear M. Doe."

[^7]: In most States, the lower branch of the legislature is the House
    of Representative. In some States, such as California and New York,
    the lower house is known as the Assembly. In others, such as
    Maryland, Virginia, and West Virginia, it is known as the House of
    Delegates. Nebraska has a one-house legislature. Its members are
    classed as Senators.

[^8]: Additional ecclesiastical information may be found in *The World
    Almanac and Book of Facts* available in the Departmental Library,
    the GSA Retail Store, and in other publications available from the
    DOT Library.

[^9]: There are two classes of Monsignori one (Domestic Prelates) are
    addressed as *The Right Reverend*. The other (Papal Chamberlains)
    are addressed as *The Very Reverend*. The Official Directory will
    give the correct designations. In the absence of definite
    information, it is always courteous to address any Monsignor as *The
    Right Reverend*.

[^10]: In all cases, *The Reverend* should not be used with a surname
    only, as *The Reverend Smith*. To say *The Reverend Smith* is like
    saying *The Respected Smith*. Hence, there must always be an
    intervening Christian name or initial, or a title such as *Dr., Mr.,
    Ms., or Professor* between *The Reverend* and the surname.

[^11]: The names of the clergy of the Episcopal Church may be found in
    *The Episcopal Church Annual*.

[^12]: The title *Reverend* is not used in either the Mormon Church or
    the Seventh-day Adventist. Mr. may be used for any of their
    ecclesiastical ranks, or preferably Elder for their pastors.

[^13]: ^1^

[^14]: ^1^

[^15]: ^1^

[^16]: Titles may be used in connection with Dr., except M.D., D.D., or
    other degree letters that mean Doctor.

[^17]: These abbreviations do not constitute a complete listing but
    consist of the most frequently used to serve as a guideline.
    Appropriate abbreviations may be found in a standard dictionary and
    other reference books available from the DOT Library and the GSA
    Retail Store. Reference should also be made to incoming
    correspondence, if any, for correct degree letters and titles.

[^18]: In modern usage, women may be addressed by Ms., Mrs., and/or
    Miss. Married women may assume the name of their husbands or retain
    the name they had before marriage. In some instances, married
    couples combine their surnames with a hyphen. In all cases it is the
    preference of the addressee, when known, that should be followed.
    Incoming correspondence, if any, should be referenced. For
    Secretarial correspondence, the Executive Secretariat may be
    contacted. In the case of local correspondence when such questions
    arise, a telephone call to the addressee's office may be made to
    obtain the information. The plural of Ms. is either Mses. Or Mss.

[^19]: A letter to two or more persons may be addressed as illustrated,
    or to only one of them when the letter is mentioned by name in the
    opening paragraph.

[^20]: When the names of both men and women occur in the inside address,
    the individual whose name appears first should be addressed first in
    the salutation.