Public Document Depository Program Please include this completed form with all deposits of publications (tangible and digital). Agency Name: Contact Name: Position: Today’s Contact Email: Phone: Date: Please use only one entry per title (e.g., multiple copies of Minutes” may be entered in #1). To see examples of “Meeting how different types of publications may be entered, please view the sample form on the agency web page at . and Subtitle: #1 Format(s) Number of Print/Hard Copy Date(s) of Distributed to Issues / Digital Publication: Public: Editions Sent: and Subtitle: #2 Format(s) Number of Print/Hard Copy Date(s) of Distributed to Issues / Digital Publication: Public: Editions Sent: Title and Subtitle: #3 Format(s) Number of Copy Date(s) of Distributed to Issues / Digital Publication: Public: Editions Sent: Title and Subtitle: #4 Format(s) Number of Print/Hard Copy Date(s) of Distributed to Issues / Digital Publication: Public: Editions Sent:
Public Document Depository Program Please include this completed form with all deposits of publications (tangible and digital). Agency Name: Contact Name: Position: Contact Email: Phone: Today’s Date: Please use only one entry per title (e.g., multiple copies of “Meeting Minutes” may be entered in #1). To see examples of how different types of publications may be entered, please view the sample form on the agency web page at . #1 and Subtitle: Format(s) Distributed to Public: Print/Hard Copy Digital Number of Issues / Editions Sent: Date(s) of Publication: #2 and Subtitle: Format(s) Distributed to Public: Print/Hard Copy Digital Number of Issues / Editions Sent: Date(s) of Publication: #3 Title and Subtitle: Format(s) Distributed to Public: Copy Digital Number of Issues / Editions Sent: Date(s) of Publication: #4 Title and Subtitle: Format(s) Distributed to Public: Print/Hard Copy Digital Number of Issues / Editions Sent: Date(s) of Publication:
agency-document-submittal-form-editable_-_2014_rev.docx