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*, Ed T467). ‘ene §. DEPARTMENT OF JUSTICE) + : * WASHINGTON, D. C. 20530 REQUEST FOR ACCESS TO OFFICIAL RECORD CHF LE UNDER 5 U.S.C. 552( a) and 28 CFR PART 16 P See instructions for payment and delivery of this form at bottom of page MBER OF COPIES OF FICE AND CITY WHERE RECORD DO You WisH TO RECEIVE CoPlES 7 SXves [Jno [NUMBER OF C 1S LOCATED {if known) iF YES, SO INDICATE (no more thon i0 coptes of any ; document will be furnished). | f fer | DESCRIPTION OF RECORD REQUESTED (Include any Informetion which may be helpful in locating record) OURT (check one)| DISTRICT NAME OF CASE FEDERAL { ] STATE FILL IN EF iN PENDING =» | LITIGATION foe one ata {G6 HST Writs, THE QEPARTMENT § 3.00 EAC GSA CHARGE TOTAL CHARGE Payment under this section shall be made in cash, or by United States money order, or by check payable to the Treasurer of the United States. Postage stamps will not be accepted. This form may be delivered to any of the offices listed in 28C. F. R. 16.2 or mailed to: Office of the Deputy Attorney General, Department of Justice, Washington, D. C. 20530 / = by (2 3 OY aan be ora