Fillable Printable Transmittal Record

Transmittal Record

TRANSMITTAL RECORD

For use of this form, see AR 25-50; the proponent agency is AASA.

1. SECURITY CLASSIFICATION 2. SHIPMENT NO.

3. TITLE/FILE IDENTIFICATION

4. AS OF DATE (YYYYMMDD) 5. SHIPMENT DATE (YYYYMMDD)

6. AUTHORITY FOR SHIPMENT 7. NUMBER OF RECORDS TRANSMITTED

8. PERSON TO CONTACT (Name and telephone) 9. REQUIREMENT CONTROL SYMBOL (AR 335-15)

10. SHIPPED FROM 11. SHIPPED TO

RETURN RECEIPT REQUESTED (When box is checked, sign

below and return copy to sender.)

10a. TYPED NAME AND TITLE SENDER

11a. TYPED NAME AND TITLE OF RECEIVER

11b. SIGNATURE OF RECEIVER AND DATE (YYYYMMDD)

10b. SIGNATURE OF SENDER

12. TYPE OF MEDIA TRANSMITTED

HARD COPY PUNCHED CARDS CASSETTES

MICROFILM

PHOTO

FICHE

13. NUMBER OF BOXES (Packages)

14. NUMBER OF ITEMS

15. METHOD OF SHIPMENT

COURIER

FIRST CLASS PARCEL POST

EXPRESS MAIL

REGISTERED

16. SPECIAL INSTRUCTIONS

17. TYPE COMPONENT USED (for magnetically recorded data)

18. REMARKS

DA FORM 200, MAY 2013

PREVIOUS EDITIONS ARE OBSOLETE.

APD LC v1.02ES

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