UNIVERSITY OF PITTSBURGH FORM INSTRUCTION GUIDE 

FORM NUMBER:      FORM 0002 PITT 1214

FORM TITLE:            Form Approval

PROCEDURE:           01-01-03

EFFECTIVE DATE:    September 6, 1988

PAGE (S):                   1

ENTER THE FOLLOWING INFORMATION WHERE INDICATED:

1.     FORM or FORM/PITT Number (See Policy 01-01-03, Establishing University Forms,

        Paragraph II. FORM Numbering)

2.     Document Number of the University Procedure associated with the form (in which

        the form appears as an exhibit together with a form instruction guide)

3.     FORM APPROVAL Page Number

4.     Date

5.     Form Title

6.     Intended Purpose of the Form

7.     Number of Parts desired

8.     Type of Form (Carbon or Carbonless)

9.     Printer (Central Printing, Computing and Information Systems, or outside vendor)

__________________________________________________________________

APPROVALS

10.   Signature of Data Administrator required with date