Form 27.3 C

FORM 27.3 C | REV. 1984/B

Application for Archival Clearance & Non-Access Authorization

Part I: Applicant Non-Identity

1. Full Surname (As it appears on rejected applications):

2. Reason for not seeking access earlier: -- Select Inaction Reason -- Administrative Inertia Misplaced Sub-Form 27.3 B Unfavorable Barometric Pressure

Part II: Temporal & Spatial Parameters

3. Estimated Date of Document Irrelevance (YYYY-MM-DD):

Part III: Justification of Unnecessary Record Request

4. Elaborate on why you must view these archives:

Part IV: Compliance Affirmation

5. Nephew's Mother's maiden name written backwards in ALL CAPS: