Form NATF 36 NATF 36 Microfilm Order

OMB Control No. 3095-0046 Expires 04-30-2007

MICROFILM ORDER
Microfilm publication numbers (preceded by and "M" or "T") are assigned to each
microfilm publication. Please enter the microfilm publication number and roll
number(s) in the proper columns. Because we accept orders for individual rolls, as well
as for complete microfilm publications, we must know which rolls you wish to
purchase.

Sample of correctly completed form.
MICRO.
ROLL
PUB.
NUMBER
PRICE
NUMBER(S)

Effective October 1, 2005, the price for each roll of microfilm is $65 for U.S. orders. The
price is $68 per roll for foreign orders. Shipping is included. These prices are subject to
change without notice. For current price information, write to National Archives
Customer Service Center (NWCC2), 8601 Adelphi Road, College Park, MD 20740; or
call 1-866-272-6272 (in the Washington, DC area, call 301-837-2000).

T624

1138

$65.

T1270

88–89

$130.

Additional order forms are available upon request.

Name
ORDERED BY
(Include
organization
if shipping to a
business address)

Organization (if applicable)
Address (number and street)
City, State & ZIP Code
Daytime Telephone Number (include area code)

PAYMENT TYPE
Check one and enter
card number below:

VISA

MasterCard

SEND YOUR ORDER TO:
American Express

Discover

National Archives Trust Fund
Cashier (NAT)
8601 Adelphi Road
College Park, MD 20740
(Credit card orders may be
faxed to: 301-837-3191)

Exp. Date

CREDIT
CARD
Signature

OTHER

Check

Money Order

Make payable to: National Archives Trust Fund

National Archives Trust Fund
P.O. Box 100793
Atlanta, GA 30384-0793

Amount
Enclosed: $

IDENTIFY THE ROLLS YOU WISH TO ORDER
MICRO. PUB.
NUMBER

ROLL
NUMBER(S)

PRICE

MICRO. PUB.
NUMBER

ROLL
NUMBER(S)

Subtotal (this column)
Subtotal from first column
Subtotal (this column)

TOTAL PRICE

NATIONAL ARCHIVES TRUST FUND BOARD NATF Form 36 (rev. 09-2005)

Privacy Act and Paperwork Reduction Act Public Burden statements
are on the reverse of this page.

PRICE

PRIVACY ACT STATEMENT
Collection of this information is authorized by 44 U.S.C. 2108. Disclosure of the information is voluntary; however, we
will be unable to respond to your request if you do not furnish your name and address and the minimum required
information about the records. The information is used by NARA employees to search for the record; to respond to you;
to maintain control over information requests received and answered; and to facilitate preparation of internal statistical
reports. If you provide credit card information, that information is used to bill you for copies.
PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT
A Federal agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a current valid OMB control number. The OMB Control No. for this information collection is 30950046. Public burden reporting for this collection of information is estimated to be 10 minutes per response. Send
comments regarding the burden estimate or any other aspect of the information collection, including suggestions for
reducing this burden, to National Archives and Records Administration (NHP), 8601 Adelphi Road, College Park MD
20740. DO NOT SEND COMPLETED FORMS TO THIS ADDRESS. SEND COMPLETED FORMS TO THE
ADDRESS INDICATED ON THE FORM ITSELF.
NATIONAL ARCHIVES TRUST FUND BOARD NATF Form 36 (rev. 09-2005)