<table style="width:100%;">
<colgroup>
<col style="width: 28%" />
<col style="width: 1%" />
<col style="width: 11%" />
<col style="width: 8%" />
<col style="width: 11%" />
<col style="width: 15%" />
<col style="width: 1%" />
<col style="width: 11%" />
<col style="width: 0%" />
<col style="width: 10%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="2"><h1 id="lanl-proposal-number">LANL Proposal
Number</h1></td>
<td colspan="4"><h3 id="project">Project</h3></td>
<td colspan="4"><strong>LANL Program Code</strong></td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>R-</p>
</blockquote></td>
<td colspan="4"><strong>New</strong> <strong>Continuing</strong> </td>
<td colspan="4">New or Rcode</td>
</tr>
<tr class="odd">
<td colspan="10"><strong>Proposal Title</strong></td>
</tr>
<tr class="even">
<td colspan="10"><blockquote>
<p>(enter)</p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="10"><strong>Sponsoring Agency</strong></td>
</tr>
<tr class="even">
<td colspan="10"><blockquote>
<p>National Aeronautics and Space Administration</p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="7"><strong>Agency Contact and Address</strong></td>
<td colspan="3"><strong>Telephone</strong></td>
</tr>
<tr class="even">
<td colspan="7"><blockquote>
<p>(enter) (enter e-mail address if known)</p>
</blockquote></td>
<td colspan="3">(enter)</td>
</tr>
<tr class="odd">
<td colspan="10"><strong>Mailing Address if Different from
Sponsor</strong></td>
</tr>
<tr class="even">
<td colspan="10"><blockquote>
<p>(enter)</p>
</blockquote></td>
</tr>
<tr class="odd">
<td><strong>Project Leader</strong></td>
<td colspan="2"><strong>Org.</strong></td>
<td><strong>MS</strong></td>
<td><strong>Telephone</strong></td>
<td colspan="4"><strong>Signature</strong></td>
<td><strong>Date</strong></td>
</tr>
<tr class="even">
<td><blockquote>
<p>(enter)</p>
</blockquote></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="4"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="10"><strong>Approvals</strong></td>
</tr>
<tr class="even">
<td><strong>Approved by</strong></td>
<td colspan="2"><strong>Org</strong></td>
<td><strong>MS</strong></td>
<td><strong>Telephone</strong></td>
<td colspan="3"><strong>Signature</strong></td>
<td colspan="2"><strong>Date</strong></td>
</tr>
<tr class="odd">
<td><strong>Line Manager</strong></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="3"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>(enter)</td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="3"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td><strong>Financial</strong></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="3"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>O. E. Garnica</td>
<td colspan="2">BUS-3</td>
<td>P292</td>
<td>5-6297</td>
<td colspan="3"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td><strong>NASA Programs</strong></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="3"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>D. J. McComas</td>
<td colspan="2">CSSE</td>
<td>D466</td>
<td>7-1264</td>
<td colspan="3"></td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

**Helpful information:**

Principal Investigator: <xxxx@lanl.gov>

Fiscal Analyst: <xxxx@lanl.gov> and phone

CSSE: csse@lanl.gov

BUS Division: <ogarnica@lanl.gov>

**DEADLINE TO NASA:** enter date

+------------------+---+---+-----+-------+----+-------+------+------+
| # LANL Proposal  |   | * |     |       |    | *     |      |      |
| Number {#lanl-pr |   | * |     |       |    | *LANL |      |      |
| oposal-number-1} |   | B |     |       |    | Pr    |      |      |
|                  |   | & |     |       |    | ogram |      |      |
|                  |   | R |     |       |    | C     |      |      |
|                  |   | C |     |       |    | ode** |      |      |
|                  |   | a |     |       |    |       |      |      |
|                  |   | t |     |       |    |       |      |      |
|                  |   | e |     |       |    |       |      |      |
|                  |   | g |     |       |    |       |      |      |
|                  |   | o |     |       |    |       |      |      |
|                  |   | r |     |       |    |       |      |      |
|                  |   | y |     |       |    |       |      |      |
|                  |   | * |     |       |    |       |      |      |
|                  |   | * |     |       |    |       |      |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| > R-             |   | > |     |       |    | > New |      |      |
|                  |   |   |     |       |    | > or  |      |      |
|                  |   | 4 |     |       |    | >     |      |      |
|                  |   | 0 |     |       |    |  Rxxx |      |      |
|                  |   | - |     |       |    |       |      |      |
|                  |   | 0 |     |       |    |       |      |      |
|                  |   | 4 |     |       |    |       |      |      |
|                  |   | - |     |       |    |       |      |      |
|                  |   | 0 |     |       |    |       |      |      |
|                  |   | 9 |     |       |    |       |      |      |
|                  |   | - |     |       |    |       |      |      |
|                  |   | 9 |     |       |    |       |      |      |
|                  |   | 0 |     |       |    |       |      |      |
|                  |   | - |     |       |    |       |      |      |
|                  |   | 0 |     |       |    |       |      |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| **Proposal       |   |   |     |       |    |       |      |      |
| Title**          |   |   |     |       |    |       |      |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| > (enter)        |   |   |     |       |    |       |      |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| **Sponsoring     |   |   |     |       |    |       |      |      |
| Agency**         |   |   |     |       |    |       |      |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| > National       |   |   |     |       |    |       |      |      |
| > Aeronautics    |   |   |     |       |    |       |      |      |
| > and Space      |   |   |     |       |    |       |      |      |
| > Administration |   |   |     |       |    |       |      |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| ### Agency Con   |   |   |     |       |    |       | *    |      |
| tact and Address |   |   |     |       |    |       | *Tel |      |
|                  |   |   |     |       |    |       | epho |      |
|                  |   |   |     |       |    |       | ne** |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| > (enter) (enter |   |   |     |       |    |       | >    |      |
| > e-mail address |   |   |     |       |    |       |  (en |      |
| > if known)      |   |   |     |       |    |       | ter) |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| **Mailing        |   |   |     |       |    |       |      |      |
| Address if       |   |   |     |       |    |       |      |      |
| Different from   |   |   |     |       |    |       |      |      |
| Sponsor**        |   |   |     |       |    |       |      |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| > (enter)        |   |   |     |       |    |       |      |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| **Principal      | * |   | **M | **T   |    |       |      |      |
| Investigator**   | * |   | S** | eleph |    |       |      |      |
|                  | O |   |     | one** |    |       |      |      |
|                  | r |   |     |       |    |       |      |      |
|                  | g |   |     |       |    |       |      |      |
|                  | . |   |     |       |    |       |      |      |
|                  | * |   |     |       |    |       |      |      |
|                  | * |   |     |       |    |       |      |      |
+------------------+---+---+-----+-------+----+-------+------+------+
| > (enter)        |   |   |     |       |    |       |      |      |
+------------------+---+---+-----+-------+----+-------+------+------+

+-----------------------------------------------------+--------+------+
| **Please select which of the following White        | **     | **Se |
| House/Office of Science and Technology Policy       | Select | lect |
| (OSTP) National Goal Categories apply to this       | All    | One  |
| project. You may pick more than one. Also choose a  | Applic | P    |
| single primary category.**                          | able** | rima |
|                                                     |        | ry** |
|                                                     | **     |      |
|                                                     | Catego |      |
|                                                     | ries** |      |
+-----------------------------------------------------+--------+------+

**(double-click on boxes to check or uncheck)**

+-----------------------------------------------------------------------+
| > Health, Safety & Food                                               |
+-----------------------------------------------------------------------+
| > Communication                                                       |
+-----------------------------------------------------------------------+
| > National Security                                                   |
+-----------------------------------------------------------------------+
| > Civilian Industrial Technology                                      |
+-----------------------------------------------------------------------+
| > Fundamental Science (Basic Research)                                |
+-----------------------------------------------------------------------+
| > International Science & Engineering                                 |
+-----------------------------------------------------------------------+
| > Environment & Natural Resources                                     |
+-----------------------------------------------------------------------+
| > Transportation                                                      |
+-----------------------------------------------------------------------+
| > Education & Training                                                |
+-----------------------------------------------------------------------+

  -----------------------------------------------------------------------
  **Are there classified activities in this project? Yes** **No**

  -----------------------------------------------------------------------

**Executive Summary**

(Insert proposal abstract here.)

\"Title\"

to be performed by:

Los Alamos National Laboratory

Los Alamos, NM 87545

(under DOE contract W-7405-ENG-36)

Submitted to:

(Submission Address)

Proposed by:

(Name of Project Leader)

Date

####### Insert Title Here

This report format is optional and is provided only to assist the PI if
no instructions were provided by NASA (typically in Appendix C of the
Announcement of Opportunity).

  -------- -----------------------------------------------------------------
  **I.**   **Executive Summary**

  -------- -----------------------------------------------------------------

> (Describe the proposed work in a **[few sentences]{.underline}**.)
> Insert BRIEF description here.

  --------- -----------------------------------------------------------------
  **II.**   **Technical Description**

  --------- -----------------------------------------------------------------

> DeDescription of the work to be accomplished by the Laboratory;
> including the objective of the project, why the work is being
> proposed, task descriptions, overall approach, experiments, unique
> Laboratory capabilities, relevant previous work done at the
> Laboratory, etc.) scribe technical objectives, benefits to sponsor,
> unique Laboratory capabilities, and any relevant previous work done at
> the Laboratory. A strong, concise uniqueness statement is critical to
> DOE/AL endorsement.

  ---------- -----------------------------------------------------------------
  **III.**   **Proposed Scope of Work**

  ---------- -----------------------------------------------------------------

> Description of the work to be accomplished by the Laboratory;
> including the objective of the project, why the work is being
> proposed, task descriptions, overall approach, experiments, unique
> Laboratory capabilities, relevant previous work done at the
> Laboratory, etc.) Provide description of overall approach. Include
> tasks, task descriptions, and deliverables.

  --------- -----------------------------------------------------------------
  **IV.**   **Schedule/Milestones** (insert or delete rows as needed)

  --------- -----------------------------------------------------------------

> List major project milestones. A schedule/milestone chart(s) broken
> out by tasks is desirable, but not mandatory (unless required by
> sponsor).
>
> [Description]{.underline} Date

+----------------------------------------------------+-----------------+
| > Insert [major]{.underline} deliverable/milestone | > Expected date |
| > here                                             |                 |
+----------------------------------------------------+-----------------+
| > Insert [major]{.underline} deliverable/milestone | > Expected date |
| > here                                             |                 |
+----------------------------------------------------+-----------------+
| > Insert [major]{.underline} deliverable/milestone | > Expected date |
| > here                                             |                 |
+----------------------------------------------------+-----------------+
| > Insert [major]{.underline} deliverable/milestone | > Expected date |
| > here                                             |                 |
+----------------------------------------------------+-----------------+
| > Insert [major]{.underline} deliverable/milestone | > Expected date |
| > here                                             |                 |
+----------------------------------------------------+-----------------+

  -------- -----------------------------------------------------------------
  **V.**   **Financial Requirements**

  -------- -----------------------------------------------------------------

> Include DOE departmental overhead (3%), even if requesting waiver.
> Include continuity funds if Proposal is multi-year. For construction
> projects, the sponsor is responsible for obtaining necessary
> Congressional approval.

  --------- -----------------------------------------------------------------
  **VI.**   **Reporting**

  --------- -----------------------------------------------------------------

> Address sponsor reporting requirements (e.g., monthly progress
> letters).

  ---------- -----------------------------------------------------------------
  **VII.**   **Management and Personnel**

  ---------- -----------------------------------------------------------------

> Indicate Project Leader; the NASA Program Manager is David J. McComas.
> For large, multi-organizational or teaming proposals, identify other
> key participants by organization and responsibilities. If you are
> teaming in support of another organization\'s proposal, also complete
> an Endorsement letter.

  ----------- -----------------------------------------------------------------
  **VIII.**   **Property Management**

  ----------- -----------------------------------------------------------------

Equipment that is acquired with sponsor funding will be disposed of
according to instructions provided by the sponsor in the funding
document. Otherwise, equipment will revert to the DOE and be retained at
the Laboratory at the termination of the project.

> (Include property, buildings, equipment, and waste disposition costs
> in proposal budget.) Insert text here if appropriate or delete this
> sentence.

  --------- -----------------------------------------------------------------
  **IX.**   **ES&H Issues**

  --------- -----------------------------------------------------------------

> (Use the ES&H checklist and D&C form to determine if this project
> requires ES&H compliance actions. If "Yes" responses are generated
> through the ES&H checklist or the D&C Form, delete the "Not
> Applicable" statement and address the compliance requirements, explain
> how they will be mitigated, and the estimated schedule and budget for
> implementation. Also include a statement that assigns responsibility
> for those costs to the sponsor. If there are no ES&H issues, type "Not
> Applicable.") Insert text here or type Not Applicable.

  -------- -----------------------------------------------------------------
  **X.**   **Classification and Security**

  -------- -----------------------------------------------------------------

> (Choose one of the following statements and **delete others**.
> Indicate Classification Guide and date where applicable.)
>
> This project will not involve generating or handling classified
> information or materials at Los Alamos.
>
> (or)
>
> This project will involve handling classified information or material
> at Los Alamos, but no classified information will be generated.
>
> (or)
>
> This project will involve generating and handling classified
> information or material at Los Alamos. The sponsor has provided
> classification guidance as follows: Classification Guide, dated date.

  --------- -----------------------------------------------------------------
  **XI.**   **Related Work/Technical References**

  --------- -----------------------------------------------------------------

> (Add curricula vitae, references, and specific information relevant to
> this proposal. [Delete this section if not applicable.)]{.underline}
> Insert text here or delete section if not used.

+------------------------------------+---------------------------------+
| **LANL Proposal Number**           | ### B&R Line Number             |
+------------------------------------+---------------------------------+
| R-                                 | > 40-04-09-90-0                 |
+------------------------------------+---------------------------------+
| **Project/Proposal Title**         |                                 |
+------------------------------------+---------------------------------+
|                                    |                                 |
+------------------------------------+---------------------------------+

**FACILITY IDENTIFICATION:**

+------------------------------------+---------+---------+------------+
| **Facility Operator**              | ##      |         |            |
|                                    | # Progr |         |            |
|                                    | am Area |         |            |
+------------------------------------+---------+---------+------------+
| Los Alamos National Laboratory     | NASA    |         |            |
+------------------------------------+---------+---------+------------+
| **Program Manager**                | **Lab   | **Mail  | **T        |
|                                    | Org**   | Stop**  | elephone** |
+------------------------------------+---------+---------+------------+
| David J. McComas                   | CSSE    | D466    | 50         |
|                                    |         |         | 5-667-1624 |
+------------------------------------+---------+---------+------------+
| **Project Leader**                 | **Lab   | **Mail  | **T        |
|                                    | Org**   | Stop**  | elephone** |
+------------------------------------+---------+---------+------------+
| (enter)                            |         |         | 505-66     |
+------------------------------------+---------+---------+------------+

**SPONSOR IDENTIFICATION:**

+-------------------------------------------------------+--------------+
| ######## Sponsoring Agency                            |              |
+-------------------------------------------------------+--------------+
| > National Aeronautics and Space Administration       |              |
+-------------------------------------------------------+--------------+
| **Agency Contact and Address**                        | *            |
|                                                       | *Telephone** |
+-------------------------------------------------------+--------------+
| (enter) (enter e-mail address if known)               | (enter)      |
+-------------------------------------------------------+--------------+
| **Mailing Address if Different from Sponsor**         |              |
+-------------------------------------------------------+--------------+
| (enter)                                               |              |
+-------------------------------------------------------+--------------+
| **Administrative POC Name**                           | *            |
|                                                       | *Telephone** |
+-------------------------------------------------------+--------------+
| (enter) (enter e-mail address, if known)              | (enter)      |
+-------------------------------------------------------+--------------+

+---+--------------------------------------------------------------------+
| * | **COMPLIANCE WITH DEPARTMENTAL POLICY (DOE ORDER 481.1, PARAGRAPH  |
| * | 4A):**                                                             |
| 1 |                                                                    |
| . | (Satisfactory justification to support Items A through D must be   |
| * | provided to DOE on supplemental sheet.)                            |
| * |                                                                    |
+---+--------------------------------------------------------------------+

**(double-click on boxes to check or uncheck)**

+----+-----------------------------------------------------------------+
|    | > Is consistent with or complementary to DOE\'s missions and    |
| A. | > the missions of the facility to which the work is to be       |
|    | > assigned.                                                     |
+----+-----------------------------------------------------------------+
|    | > Would not adversely impact execution of assigned programs of  |
| B. | > the facility.                                                 |
+----+-----------------------------------------------------------------+
|    | > Would not place the facility in direct competition with the   |
| C. | > domestic private sector.                                      |
+----+-----------------------------------------------------------------+
|    | > Would not create a detrimental future burden on DOE           |
| D. | > resources.                                                    |
+----+-----------------------------------------------------------------+

**(double-click on boxes to check or uncheck)**

<table>
<colgroup>
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 25%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 19%" />
<col style="width: 5%" />
<col style="width: 13%" />
<col style="width: 2%" />
<col style="width: 13%" />
</colgroup>
<tbody>
<tr class="odd">
<td><strong>2.</strong></td>
<td colspan="9"><strong>REQUIRED DOE HQ APPROVALS and
NOTIFICATIONS:</strong></td>
</tr>
<tr class="even">
<td></td>
<td>A.</td>
<td colspan="6"><p>Involves construction greater than GPP level
($1.7M).</p>
<p>If yes, DOE HQ approval required. (DOE's Action)</p></td>
<td colspan="2">Yes No </td>
</tr>
<tr class="odd">
<td></td>
<td>B.</td>
<td colspan="6">Involves use of human subjects. (If yes, contact
Institutional Review Board (IRB), ESH-2, 7-7251; enter date of IRB
approval.)</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td>Approval Authority:</td>
<td></td>
<td>IRB</td>
<td><blockquote>
<p>DOE HQ (ER-70)</p>
</blockquote></td>
<td></td>
<td colspan="2"><blockquote>
<p>Date Received:</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td colspan="6">Sensitive Nature (e.g., international locations,
nontraditional sponsors).</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td colspan="6">If yes, DOE HQ (ER-70) notified. (Notification done
annually by ESH-2.)</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="odd">
<td></td>
<td>C.</td>
<td colspan="6">Involves use of animal subjects. (If yes, contact
Institutional Animal Care and Use Committee [IACUC], 7-3448.)</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td colspan="6">Sensitive nature (e.g., international locations,
nontraditional sponsors).</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td colspan="6">If yes, DOE HQ (ER-70) notified. (LANL's [IACUC]
Action)</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="even">
<td></td>
<td>D.</td>
<td colspan="6">Involves Space Nuclear and Noncommercial Power Reactor
and Radioisotope Power Source Projects.</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td colspan="6">If yes, DOE HQ (NE-50) approval required. (DOE's
Action)</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="even">
<td></td>
<td>E.</td>
<td colspan="6">Involves Nuclear Nonproliferation Detection
Technology.</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td colspan="6">If yes, add Nonproliferation and International Security
[NIS] Division, MS F650, to sponsor letter for distribution.</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="even">
<td></td>
<td>F.</td>
<td colspan="6">Involves travel outside the continental United
States.</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td colspan="6">If yes, DOE HQ (DP-15) notified. (LANL's Action)</td>
<td colspan="2">Yes </td>
</tr>
</tbody>
</table>

<table style="width:100%;">
<colgroup>
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 17%" />
<col style="width: 16%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 28%" />
<col style="width: 3%" />
<col style="width: 12%" />
</colgroup>
<tbody>
<tr class="odd">
<td><strong>3.</strong></td>
<td colspan="9"><strong>OTHER CONSIDERATIONS:</strong></td>
</tr>
<tr class="even">
<td></td>
<td>A.</td>
<td colspan="6">Classified project.</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td colspan="6"><p>If yes, Classification Guidance and Security
Considerations Certification completed (WFOFA-6).</p>
<p>(If Special Access Program, contact H. T. Hawkins, DDNIS,
5-1259.)</p></td>
<td colspan="2">Yes </td>
</tr>
<tr class="even">
<td></td>
<td>B.</td>
<td colspan="6">ES&amp;H compliance requirements checklist completed and
on file (ES&amp;H Documentation for Proposals WFOFA-5 found later in
this file).</td>
<td colspan="2">Yes </td>
</tr>
<tr class="odd">
<td></td>
<td>C.</td>
<td colspan="6">National Environmental Policy Act (NEPA). (check one of
the following 4 boxes)</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td>1.</td>
<td colspan="3">Categorical Exclusion A (CX-A)</td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td>2.</td>
<td colspan="3">Categorical Exclusion B (CX-B)</td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td>2a.</td>
<td>NEPA ECL ADM</td>
<td></td>
<td colspan="4">Submitted to DOE with recommendations for</td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td>3.</td>
<td colspan="3">Environmental Assessment (EA)</td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td>4.</td>
<td colspan="3">Environmental Impact Statement (EIS)</td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td></td>
<td>D.</td>
<td colspan="6">Subcontracting Activity</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td>1.</td>
<td colspan="5">Scope of work and selection of subcontractor made by DOE
contractor</td>
<td colspan="2">Yes </td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td>2.</td>
<td colspan="5">In direct support of DOE contractor</td>
<td colspan="2">Yes </td>
</tr>
<tr class="even">
<td></td>
<td>E.</td>
<td colspan="6">Aviation Operations</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td>1.</td>
<td colspan="5">AL TSD notified (approval required prior to commencement
of aviation operations).</td>
<td colspan="2">Yes </td>
</tr>
<tr class="even">
<td></td>
<td>F.</td>
<td colspan="6">Sharing of Excess Data Processing Capacity</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="odd">
<td></td>
<td>G.</td>
<td colspan="6">Waiver of Depreciation and/or DOE Added Factor requested
(DOE Form 2110.1A [WFOFA-7] and justification letter attached).</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="even">
<td></td>
<td>H.</td>
<td colspan="6">Response to a Broad Agency Announcement (BAA). (If in
response to a NASA NRA or AO, check "Yes", and replace this blue text
with NRA/AO number.)</td>
<td colspan="2">Yes No </td>
</tr>
<tr class="odd">
<td></td>
<td>I.</td>
<td colspan="6">Response to NIH Grant. (If yes, send proposal to DOE/AL.
DOE will officially transmit [endorse] proposal.)</td>
<td colspan="2">Yes No </td>
</tr>
</tbody>
</table>

Based on the Los Alamos review, I certify that all the determinations as
required by DOE Order 481.1 have been met. I further certify that all
the actions stated above have been met and appropriate documentation is
on file at Los Alamos.

Certification for NASA Programs:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_

David J. McComas, Center Director Date

Center for Space Science & Exploration

Los Alamos National Laboratory

Based on my review and DOE contractor certification, I conclude that
this proposed effort complies with DOE policies and procedures and,
therefore, endorse the proposal as reimbursable work for other federal
agencies.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_

DOE AL WFO Projects Manager Date

**Supplemental Sheet**

Supporting Justification for Items A through D

+-----+-----------------------------------------------------------------+
| >   | > **Justification**                                             |
|  ** |                                                                 |
| Ite |                                                                 |
| m** |                                                                 |
+-----+-----------------------------------------------------------------+
|     |                                                                 |
+-----+-----------------------------------------------------------------+
| A.  | The proposed work is within the scope of the Laboratory         |
|     | Institutional Plan and is consistent with DOE\'s mission and    |
|     | the mission of the Los Alamos National Laboratory in the        |
|     | area(s) described herein: (insert proposed research area, e.g.  |
|     | space science, space physics, astronomy, astrobiology, etc.).   |
+-----+-----------------------------------------------------------------+
|     |                                                                 |
+-----+-----------------------------------------------------------------+
| B.  | The requirements of this project can be met without negatively  |
|     | affecting the performance of assigned DOE programs at Los       |
|     | Alamos.                                                         |
+-----+-----------------------------------------------------------------+
|     |                                                                 |
+-----+-----------------------------------------------------------------+
| C.  | (Replace this text with a strong, concise uniqueness statement. |
|     | This is critical to DOE/AL endorsement of this proposal.)       |
+-----+-----------------------------------------------------------------+
|     |                                                                 |
+-----+-----------------------------------------------------------------+
| D.  | The proposed work will not negatively impact the commitment of  |
|     | Laboratory personnel or facilities for DOE programs, thereby    |
|     | permitting this project to be undertaken without any            |
|     | detrimental burden on DOE resources.                            |
+-----+-----------------------------------------------------------------+

+------------------+---+------+-----+-------+----------+---+------+------+
| # LANL Proposal  |   | ###  |     |       |          | * |      |      |
| Number {#lanl-pr |   | Proj |     |       |          | * |      |      |
| oposal-number-2} |   | ect  |     |       |          | L |      |      |
|                  |   | {#pr |     |       |          | A |      |      |
|                  |   | ojec |     |       |          | N |      |      |
|                  |   | t-1} |     |       |          | L |      |      |
|                  |   |      |     |       |          | P |      |      |
|                  |   |      |     |       |          | r |      |      |
|                  |   |      |     |       |          | o |      |      |
|                  |   |      |     |       |          | g |      |      |
|                  |   |      |     |       |          | r |      |      |
|                  |   |      |     |       |          | a |      |      |
|                  |   |      |     |       |          | m |      |      |
|                  |   |      |     |       |          | C |      |      |
|                  |   |      |     |       |          | o |      |      |
|                  |   |      |     |       |          | d |      |      |
|                  |   |      |     |       |          | e |      |      |
|                  |   |      |     |       |          | * |      |      |
|                  |   |      |     |       |          | * |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| > R-             |   | **N  |     |       |          | N |      |      |
|                  |   | ew** |     |       |          | e |      |      |
|                  |   | **   |     |       |          | w |      |      |
|                  |   | Cont |     |       |          | o |      |      |
|                  |   | inui |     |       |          | r |      |      |
|                  |   | ng** |     |       |          | R |      |      |
|                  |   |      |     |       |          | x |      |      |
|                  |   |      |     |       |          | x |      |      |
|                  |   |      |     |       |          | x |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| **Proposal       |   |      |     |       |          |   |      |      |
| Title**          |   |      |     |       |          |   |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| > (Enter)        |   |      |     |       |          |   |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| **Sponsoring     |   |      |     |       |          |   |      |      |
| Agency**         |   |      |     |       |          |   |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| > National       |   |      |     |       |          |   |      |      |
| > Aeronautics    |   |      |     |       |          |   |      |      |
| > and Space      |   |      |     |       |          |   |      |      |
| > Administration |   |      |     |       |          |   |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| **Agency Contact |   |      |     |       |          |   | *    |      |
| and Address**    |   |      |     |       |          |   | *Tel |      |
|                  |   |      |     |       |          |   | epho |      |
|                  |   |      |     |       |          |   | ne** |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| > (enter) (enter |   |      |     |       |          |   | (en  |      |
| > e-mail address |   |      |     |       |          |   | ter) |      |
| > if known)      |   |      |     |       |          |   |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| **Mailing        |   |      |     |       |          |   |      |      |
| Address if       |   |      |     |       |          |   |      |      |
| Different from   |   |      |     |       |          |   |      |      |
| Sponsor**        |   |      |     |       |          |   |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| > (enter)        |   |      |     |       |          |   |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| **Project        | * |      | **M | **T   |          |   |      |      |
| Leader**         | * |      | S** | eleph |          |   |      |      |
|                  | O |      |     | one** |          |   |      |      |
|                  | r |      |     |       |          |   |      |      |
|                  | g |      |     |       |          |   |      |      |
|                  | . |      |     |       |          |   |      |      |
|                  | * |      |     |       |          |   |      |      |
|                  | * |      |     |       |          |   |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+
| > (enter)        |   |      |     |       |          |   |      |      |
+------------------+---+------+-----+-------+----------+---+------+------+

All Los Alamos projects must satisfy ES&H regulatory requirements,
including developing necessary ES&H analyses and documentation, and
obtaining necessary ES&H regulatory permits. Los Alamos must review
research activities to ensure that all ES&H costs (startup, operating,
and shutdown) are addressed before beginning any project. Below are some
guidelines to help the Project Leader decide if there is a need to
further evaluate the proposal for ES&H concerns. If any question below
is answered YES, the Project Leader should evaluate the potential for
possible delays in the starting date and possible increases in costs.
There may be a requirement for additional ES&H analyses or special
permits.

  ---------------------------------------------------------- ------------
  **1. Preliminary ES&H Determinations:**                    

  \(a\) Will this project involve any construction,          Yes No
  renovation, remodeling, or decommissioning activities?     

  \(b\) Will this project generate any airborne emissions or Yes No
  liquid effluents?                                          

  \(c\) Will this project involve any high-energy sources    Yes No
  (e.g., radiation, electromagnetic radiation, lasers,       
  propellants, and explosives)?                              

  \(d\) Will this project involve any toxic, carcinogenic,   Yes No
  or corrosive chemicals, biological materials (including    
  blood or organs), radioactive substances, or infectious    
  agents?                                                    

  \(e\) Will this project generate or transport any waste    Yes No
  materials that are classified as radioactive waste, mixed  
  waste, or hazardous waste per 40 CFR, or the Los Alamos    
  National Laboratory\'s *Environment, Safety, and Health    
  Manual,* \"Administrative Requirements?\"                  

  **If \"yes,\" contact your Facility Manager/ES&H Team      
  Leader for guidance. Your project may require a detailed   
  ES&H review, which can be accomplished through the ESH-ID  
  Process (contact ESH-3, 7‑2703 or refer to ESH-3 web page: 
  http://drambuie.lanl.gov/esh/esh3).**                      

                                                             

  **2. Laboratory Oversight Committees:**                    

  \(a\) Will this project involve the use of firearms or     Yes No
  firearms ammunition?\                                      
  (Firearms Safety Committee, S-SPO, 5-3505)                 

  \(b\) Will this project involve the use of bulk explosives Yes No
  or explosive articles?\                                    
  (Explosives Review Committee, DX-16, 5-0111.)              

  \(c\) Will this project involve the use of human           Yes No
  subjects?\                                                 
  (Institutional Review Board, ESH-2, 7-7251.)               

  \(d\) Will this project involve the use of animal research Yes No
  subjects?\                                                 
  (Institutional Animal Care and Use Committee, 7-3448.)     

  \(e\) Will this project involve the use of fissile         Yes No
  materials?\                                                
  (Nuclear Criticality Safety, ESH-6, 7-7628; and/or Reactor 
  Safety Committee, ESH‑12, 7‑5296.)                         

  **If \"yes,\" contact the Laboratory oversight committee   
  indicated and provide additional information on the        
  supplemental sheet.**                                      

                                                             

  **3. Operational Hazards:**                                

  Will this project involve operational hazards (physical,   Yes No
  environmental, electrical, etc.)?                          

  **If \"yes,\" you may need an approved SWP or SOP and      
  special training before commencing work.**                 

  **If you have checked \"yes\" on any of the above, please  
  include a short description on the supplemental sheet.**   
  ---------------------------------------------------------- ------------

+-------------+-------------------+-----------+----------+-----------+
| **4.        |                   |           |          |           |
| Aviation    |                   |           |          |           |
| Op          |                   |           |          |           |
| erations:** |                   |           |          |           |
+-------------+-------------------+-----------+----------+-----------+
| Does this   |                   |           |          | Yes No    |
| project     |                   |           |          |           |
| involve     |                   |           |          |           |
| aviation    |                   |           |          |           |
| operations  |                   |           |          |           |
| as defined  |                   |           |          |           |
| by ASDP     |                   |           |          |           |
| Notice #29? |                   |           |          |           |
|             |                   |           |          |           |
| **If        |                   |           |          |           |
| \"yes,\"    |                   |           |          |           |
| contact     |                   |           |          |           |
| Operational |                   |           |          |           |
| Safety,     |                   |           |          |           |
| ESH-5,      |                   |           |          |           |
| 5-8503, and |                   |           |          |           |
| complete    |                   |           |          |           |
| this        |                   |           |          |           |
| section.**  |                   |           |          |           |
+-------------+-------------------+-----------+----------+-----------+
| **Concise   |                   |           |          |           |
| Description |                   |           |          |           |
| of Proposed |                   |           |          |           |
| Aviation    |                   |           |          |           |
| Op          |                   |           |          |           |
| erations:** |                   |           |          |           |
|             |                   |           |          |           |
| **DELETE OR |                   |           |          |           |
| REPLACE**:  |                   |           |          |           |
| (Address    |                   |           |          |           |
| the         |                   |           |          |           |
| following   |                   |           |          |           |
| issues as   |                   |           |          |           |
| applicable. |                   |           |          |           |
| Identify    |                   |           |          |           |
| proposed    |                   |           |          |           |
| aircraft    |                   |           |          |           |
| type. Will  |                   |           |          |           |
| there be    |                   |           |          |           |
| aircraft    |                   |           |          |           |
| mo          |                   |           |          |           |
| difications |                   |           |          |           |
| installed   |                   |           |          |           |
| on hard     |                   |           |          |           |
| points of   |                   |           |          |           |
| aircraft?   |                   |           |          |           |
| Abnormal    |                   |           |          |           |
| flight      |                   |           |          |           |
| operations  |                   |           |          |           |
| or          |                   |           |          |           |
| performance |                   |           |          |           |
| re          |                   |           |          |           |
| quirements? |                   |           |          |           |
| Weight of   |                   |           |          |           |
| pay         |                   |           |          |           |
| load/descri |                   |           |          |           |
| ption/instr |                   |           |          |           |
| umentation, |                   |           |          |           |
| etc. LANL   |                   |           |          |           |
| personnel   |                   |           |          |           |
| on          |                   |           |          |           |
| aircraft?   |                   |           |          |           |
| Describe    |                   |           |          |           |
| places,     |                   |           |          |           |
| routes,     |                   |           |          |           |
| altitudes,  |                   |           |          |           |
| estimated   |                   |           |          |           |
| dates of    |                   |           |          |           |
| operations, |                   |           |          |           |
| and any     |                   |           |          |           |
| unique      |                   |           |          |           |
| aspects of  |                   |           |          |           |
| flight      |                   |           |          |           |
| plan/       |                   |           |          |           |
| operations. |                   |           |          |           |
| Use         |                   |           |          |           |
| s           |                   |           |          |           |
| upplemental |                   |           |          |           |
| sheet if    |                   |           |          |           |
| additional  |                   |           |          |           |
| space is    |                   |           |          |           |
| required.)  |                   |           |          |           |
+-------------+-------------------+-----------+----------+-----------+
| **Aircraft  |                   |           |          |           |
| Operat      |                   |           |          |           |
| or/Owner:** |                   |           |          |           |
+-------------+-------------------+-----------+----------+-----------+
| > **DoD**   | >                 | > **DOE** | >        |           |
|             | > *               |           | > **Co   |           |
|             | *OFA/Government** |           | mmercial |           |
|             |                   |           | > C      |           |
|             |                   |           | harter** |           |
+-------------+-------------------+-----------+----------+-----------+
|             |                   |           |          |           |
+-------------+-------------------+-----------+----------+-----------+
| **Signature |                   |           |          |           |
| of          |                   |           |          |           |
| Operational |                   |           |          |           |
| Safety      |                   |           |          |           |
| Rep         |                   |           |          |           |
| resentative |                   |           |          |           |
| (ESH-5)     |                   |           |          |           |
| Date**      |                   |           |          |           |
+-------------+-------------------+-----------+----------+-----------+
|             |                   |           |          |           |
+-------------+-------------------+-----------+----------+-----------+

+---------------------------------+-----------------+---------+------+
| **5. Proposed National          |                 |         |      |
| Environmental Policy Act (NEPA) |                 |         |      |
| Category:**                     |                 |         |      |
+---------------------------------+-----------------+---------+------+
| Contact the Facility Manager or |                 |         |      |
| ES&H Team Leader for guidance   |                 |         |      |
| in selecting one NEPA category  |                 |         |      |
| as a preliminary designation.   |                 |         |      |
| ESH-20 (5-5717) can provide     |                 |         |      |
| additional guidance.            |                 |         |      |
+---------------------------------+-----------------+---------+------+
| **Categorical Exclusion A       |                 |         |      |
| (CX-A)** \[Refer to             |                 |         |      |
| Project/Activity Description    |                 |         |      |
| Memorandum, ALO 93-0001\]. ES&H |                 |         |      |
| Team Leader can make            |                 |         |      |
| identification and sign in      |                 |         |      |
| place of ESH-20; ESH-20 can     |                 |         |      |
| supply copies of ALO 93-0001.)  |                 |         |      |
+---------------------------------+-----------------+---------+------+
| **Existing Approved NEPA Review |                 |         |      |
| & Determination** (ESH-20 has   |                 |         |      |
| limited authority and must sign |                 |         |      |
| below.)                         |                 |         |      |
+---------------------------------+-----------------+---------+------+
| **Other/NEPA Determination      |                 |         |      |
| Pending (CX-B, Environmental    |                 |         |      |
| Assessment (EA), Environmental  |                 |         |      |
| Impact Statement (EIS))**       |                 |         |      |
| (ESH-20 will help with          |                 |         |      |
| identification and planning,    |                 |         |      |
| must sign below and will        |                 |         |      |
| prepare NEPA review for DOE     |                 |         |      |
| determination after Project     |                 |         |      |
| Leader initiates ESH-ID process |                 |         |      |
| with ESH-3, 5-7455. Funds will  |                 |         |      |
| be held until process is        |                 |         |      |
| complete.)                      |                 |         |      |
+---------------------------------+-----------------+---------+------+
| **Brief Description of Project  |                 |         |      |
| Environmental Considerations    |                 |         |      |
| (Required):**                   |                 |         |      |
|                                 |                 |         |      |
| **REPLACE:** (Reference ongoing |                 |         |      |
| work, prior or existing NEPA    |                 |         |      |
| umbrella documentation, or      |                 |         |      |
| documented categorical          |                 |         |      |
| exclusions, as applicable. Use  |                 |         |      |
| supplemental sheet if           |                 |         |      |
| additional space is required.)  |                 |         |      |
+---------------------------------+-----------------+---------+------+
| **NEPA Representative (ESH-20)  |                 |         |      |
| Signature Date**                |                 |         |      |
+---------------------------------+-----------------+---------+------+
|                                 |                 |         |      |
+---------------------------------+-----------------+---------+------+
| The following individuals are   |                 |         |      |
| designated by the cognizant Los |                 |         |      |
| Alamos Program Director to      |                 |         |      |
| receive a copy of the completed |                 |         |      |
| CX-B determination from         |                 |         |      |
| DOE/LAAO, and are responsible   |                 |         |      |
| for ensuring that all           |                 |         |      |
| NEPA-related activities on this |                 |         |      |
| project will not be started     |                 |         |      |
| until NEPA determinations are   |                 |         |      |
| completed.                      |                 |         |      |
+---------------------------------+-----------------+---------+------+
| **NEPA Designee (NASA           | *               | **      | **   |
| Programs)**                     | *Organization** | Phone** | Mail |
|                                 |                 |         | St   |
|                                 |                 |         | op** |
+---------------------------------+-----------------+---------+------+
| D. J. McComas, S. P. Gary, or   | CSSE            | 7-1264  | D466 |
| L. L. Hixson                    |                 |         |      |
+---------------------------------+-----------------+---------+------+

+---------------------------------+------------------------------------+
| ##                              | **Facility Mgr/ES&H Team Ldr       |
| # Project Leader Signature Date | Signature Date**                   |
+---------------------------------+------------------------------------+
|                                 |                                    |
+---------------------------------+------------------------------------+

Supplemental Sheet

+-----+----------------------------------------------------------------+
| ### | > **Information**                                              |
| # I |                                                                |
| tem |                                                                |
+-----+----------------------------------------------------------------+
|     |                                                                |
+-----+----------------------------------------------------------------+
|     |                                                                |
+-----+----------------------------------------------------------------+
|     |                                                                |
+-----+----------------------------------------------------------------+
|     |                                                                |
+-----+----------------------------------------------------------------+
|     |                                                                |
+-----+----------------------------------------------------------------+
|     |                                                                |
+-----+----------------------------------------------------------------+
|     |                                                                |
+-----+----------------------------------------------------------------+
|     |                                                                |
+-----+----------------------------------------------------------------+

+----------------------------+-----------------------------------------+
| # Los Alamos               | *Date:* date                            |
|                            |                                         |
| NATIONAL LABORATORY        | *Refer to:* R-xxxx-xx-0                 |
|                            |                                         |
| ***Center for Space        |                                         |
| Science and                |                                         |
| Exploration,***            |                                         |
|                            |                                         |
| ***NASA Programs***        |                                         |
|                            |                                         |
| Mail Stop D466             |                                         |
|                            |                                         |
| Los Alamos, New Mexico     |                                         |
| 87545                      |                                         |
|                            |                                         |
| \(505\) 667-1624 / FAX     |                                         |
| (505) 665-3332             |                                         |
|                            |                                         |
| e-mail: csse@lanl.gov v    |                                         |
+----------------------------+-----------------------------------------+

(Insert NASA address here)

**Subject: Los Alamos Proposal (Insert number, title, and PI name)**

Dear (Insert appropriate name):

Enclosed are xxx copies of the subject Los Alamos Proposal. This
proposal is submitted to you for your consideration in parallel with its
submission to the Department of Energy, Albuquerque Operations Office
(DOE/AL) for its endorsement.

If NASA decides to fund the proposed effort, the funding document should
be sent to:

Mr. L. Douglas Rigdon, Director

Laboratory Programs Division

U.S. Department of Energy

Albuquerque Operations Office

P. O. Box 5400

Albuquerque, NM 87185-5400

Please send a copy of any information regarding this proposal to me at
the address or facsimile provided in the letterhead.

To assist you in working with DOE/AL, I have enclosed the DOE
administrative instructions for submission of interagency agreements
(funding documents) to DOE/AL for reimbursable work. Your funding
document and supporting documentation should include information
required by the DOE as delineated in these instructions under Items 1
through 9. Technical questions regarding this proposal should be
directed to insert Project Leader\'s name at insert telephone number.

Sincerely,

Laurie L. Hixson

Center Administrator,

Center for Space Science and Exploration

Enclosures: a/s

Cy: L. D. Rigdon, LPD, DOE/AL, MS A906 O. E. Garnica, BUS-3, MS P292

Principal Investigator, Org., MS CIC-10, MS A150

Group Leader, Org., MS CSSE files

Fiscal Analyst, Org., MS

+----------------------------+-----------------------------------------+
| # Los Alamos               | *Date:* date                            |
|                            |                                         |
| NATIONAL LABORATORY        | *Refer to:* R-xxxx-xx-0                 |
|                            |                                         |
| ***Center for Space        |                                         |
| Science and                |                                         |
| Exploration,***            |                                         |
|                            |                                         |
| ***NASA Programs***        |                                         |
|                            |                                         |
| Mail Stop D466             |                                         |
|                            |                                         |
| Los Alamos, New Mexico     |                                         |
| 87545                      |                                         |
|                            |                                         |
| \(505\) 667-1624 / FAX     |                                         |
| (505) 665-3332             |                                         |
|                            |                                         |
| e-mail: csse@lanl.gov v    |                                         |
+----------------------------+-----------------------------------------+

Insert address of PI

**Subject: Los Alamos Proposal (Insert number, title, and PI name)**

Dear (insert appropriate name):

Enclosed you will find 1 copy of the subject Los Alamos proposal which
is part of the larger proposal you are submitting to NASA with the same
title. Please incorporate the Los Alamos statement of work and include
the budget summary in the final proposal. This proposal is being
submitted in parallel to the Department of Energy, Albuquerque
Operations Office (DOE/AL) for its endorsement.

If NASA approves the proposal and decides to fund the effort, the
funding for the Los Alamos portion of the work shall be sent to Los
Alamos National Laboratory via the DOE/AL.

Upon confirmation of acceptance and anticipated funding, this office
will submit a letter to NASA requesting the funding be sent to Los
Alamos separately with a set of DOE administrative instructions for
submission of interagency agreements (funding documents) for
reimbursable work. The funding documents shall be sent to Mr. L. Douglas
Rigdon, who is the Director of the Laboratory Programs Division at the
U.S. Department of Energy, Albuquerque Operations Office.

Please send a copy of any information you receive from NASA regarding
this proposal to me at the address or facsimile provided in the
letterhead.

Sincerely,

Laurie L. Hixson

Center Administrator,

Center for Space Science and Exploration

Enclosures: a/s

Cy: L. D. Rigdon, LPD, DOE/AL, MS A906 O. E. Garnica, BUS-3, MS P292

Principal Investigator, Org., MS CIC-10, MS A150

Group Leader, Org., MS CSSE files

Fiscal Analyst, Org., MS

+----------------------------+-----------------------------------------+
| # Los Alamos               | *Date:* date                            |
|                            |                                         |
| NATIONAL LABORATORY        | *Refer to:* R-xxxx-xx-0                 |
|                            |                                         |
| ***Center for Space        |                                         |
| Science and                |                                         |
| Exploration,***            |                                         |
|                            |                                         |
| ***NASA Programs***        |                                         |
|                            |                                         |
| Mail Stop D466             |                                         |
|                            |                                         |
| Los Alamos, New Mexico     |                                         |
| 87545                      |                                         |
|                            |                                         |
| \(505\) 667-1624 / FAX     |                                         |
| (505) 665-3332             |                                         |
|                            |                                         |
| e-mail: csse@lanl.gov v    |                                         |
+----------------------------+-----------------------------------------+

(Insert address of NASA contact)

**Subject: Los Alamos Proposal (Insert number, title, and PI name)**

Dear (Insert appropriate name):

Enclosed you will find 1 copy of the subject Los Alamos proposal which
is part of a larger proposal of the same title which was submitted to
you by the Principal Investigator, insert name of PI of the insert
organization and has been accepted and approved for funding. This letter
serves as guidance for the methodology in which funding is to be
provided to Los Alamos. The funding document for the Los Alamos portion
of the work should be sent to:

Mr. L. Douglas Rigdon, Director

Laboratory Programs Division

U.S. Department of Energy

Albuquerque Operations Office

P. O. Box 5400

Albuquerque, NM 87185-5400

To assist you in working with DOE/AL, I enclose its administrative
instructions for submission of interagency agreements (funding
documents) for reimbursable work. Your funding document and supporting
documentation should include information required by the DOE as
delineated in these instructions under Items 1 through 9.

Please send a copy of the funding document to me at the address or
facsimile provided in the letterhead.

Thank you for the opportunity to work on this exciting project.

Sincerely,

Laurie L. Hixson

Center Administrator,

Center for Space Science and Exploration

Enclosures: a/s

Cy: L. D. Rigdon, LPD, DOE/AL, MS A906 O. E. Garnica, BUS-3, MS P292

Principal Investigator, Org., MS CIC-10, MS A150

Group Leader, Org., MS CSSE files

Fiscal Analyst, Org., MS