Media/Reprographics Request SECURITY CLASSIFICATION
${sec_class}
ORDER DATE
${request.created_date}
LABOR NUMBER
${request.work_order_labor_number}
MATERIAL NUMBER
${request.work_order_material_number}
WIP
${request.wip_material_number}
DEPT
${request.department_section_group}
CLIENT NAME (REQUESTOR)
${request.contact_name}
EXTENSION
${request.contact_phone}
MAIL ZONE
LOGIC NUMBER

${@.logic_bar_code_number}
Active    Closed
INTENDED USE OF REQUEST
${request.intended_use}
 
JOB TASK NUMBER
${@.job_number_full}
DATE DUE
${request.due_date}
TIME DUE
${request.due_time}
MISCHARGING IS ILLEGAL
TASK AUTHORIZATION
Requestor's Signature
PRIORITY AUTHORIZATION
Authorizing Signature
DESCRIPTION OF WORK / DELIVERY INSTRUCTIONS   Signature gives authorization to work overtime or subcontract
if necesssary to accomplish the task by negotiated date and time
${request.work_description}
  TARGET GROUP: ${target_group} CSR: ${@.csr_name} ext: ${@.csr_phone}
EVENT SERVICES   PROCESSING
 [  ] Presentation    [  ] Photographic
 Event Title  ____________________
   ____________________________
 Date ____________ Time ________
 Contact  ______________________
 Phone  _______________________
 Location   _____________________
 Requirements  _________________
   ____________________________
 
DESCRIPTION / REF. NUMBER QUANTITIES
Page Ct. /
No. Origs
X COPIES = OUTPUT 
B/W
or
Color
PROCESS SCALE
%
             
             
             
             
             
             
             
             
PRINT PARAMETERS
PAPERSTOCK IMPOSITION FINISHING
 Text [  ]  Cover [  ]  Wt. ____ Collated [  ]   Trim _________  Laminating _______
 Drawing  ______________ One Sided [  ]   Folds  ________  Mounting  ________
 Color   ________________ Two Sided [  ]   Binding _______  Packing  _________
SECURITY REQUIREMENTS
CONTROL NUMBER
    (CLASSIFIED ONLY)  _______________________________
   Requesting Department Supervisor Approval
   Print Name ____________________________________
 
   Signature _____________________________________
 
  Number of Pieces Classified As:
Top Secret Secret -
Restricted
Data
Secret Confidential LMPI Unclassified
 
OWNERSHIP
${ownership_items[0].name} ext. ${ownership_items[0].extension}
          Associate Manager / Team Lead
${ownership_items[1].name} ext. ${ownership_items[1].extension}
Q/A
  Control Room _______  Bindery __________
  Eng. Drawing _______  Distribution _______
  Scanner ___________  Customer ________
  Xerox _____________  Q/A  ____________
 
BILLING  (FOR DEPARTMENT USE ONLY)
Date Code Quantity Employee No.
  ${billing_items[0].code} ${billing_items[0].quantity_rollup}  
  ${billing_items[1].code} ${billing_items[1].quantity_rollup}  
  ${billing_items[2].code} ${billing_items[2].quantity_rollup}  
  ${billing_items[3].code} ${billing_items[3].quantity_rollup}  
  ${billing_items[4].code} ${billing_items[4].quantity_rollup}  
  ${billing_items[5].code} ${billing_items[5].quantity_rollup}  
  ${billing_items[6].code} ${billing_items[6].quantity_rollup}  
  ${billing_items[7].code} ${billing_items[7].quantity_rollup}  
  ${billing_items[8].code} ${billing_items[8].quantity_rollup}  
  ${billing_items[9].code} ${billing_items[9].quantity_rollup}  
  ${billing_items[10].code} ${billing_items[10].quantity_rollup}  
  ${billing_items[11].code} ${billing_items[11].quantity_rollup}  
Supplier __________________________________________   PO Number ____________________________________  Invoice # ___________________________
FWP 22028-12162009