Report Information Agency [Insert legal agency name] Agency Number: [Insert agency code] Name: Date Submitted: [Insert date of SSR submission] IRS Reviewer: [Leave blank] IRS Reference Number [Leave blank] and Date Received: Please adhere to the following guidelines when submitting correspondence, reports, and attachments to the Office of Safeguards:
Report Information Agency Name: [Insert legal agency name] Agency Number: [Insert agency code] Date Submitted: [Insert date of SSR submission] IRS Reviewer: [Leave blank] IRS Reference Number and Date Received: [Leave blank] Please adhere to the following guidelines when submitting correspondence, reports, and attachments to the Office of Safeguards:
Safeguard_Security_Report_Template.docx