1. Date of transfer

2. ELCA Unit or Agency

3. Sub-Unit

4. Records Series Title

5. Inclusive Dates of Records

From:    To:

6. Brief Description and Comments
(e.g. person(s) who created records, types of material, how material is arranged: chronologically, alphabetically, by subject)

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7. Quantity

Box number of

8. Contact

Title:
Ext.

9. Person Preparing Shipment