Attachment 31-Print Request Form - Blank FLETC Form-142-00-01.pdf
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- Attached to
- Transportation Service FLETC Artesia, NM
- Solicitation number
- 70LART25RPFB00007
About this file
This is a Publishing Services Requisition form (FLETC Form-142-00-01) used by the Department of Homeland Security Federal Law Enforcement Training Centers (FLETC) to request printing and publishing services at their Glynco, GA facility. The form is a blank template that allows users to specify details for digital printing/duplication, bindery services, and CD/DVD/BD/USB duplication.
The form includes fields for contact information, delivery locations (Glynco, Charleston, Artesia, or Cheltenham), product specifications, and accounting details. Users can request various services including black/white or color reproduction, binding options (tape, coil, pad), and media duplication with options for bookmarking/linking and document scanning. The form requires agency/division approval and includes a verification statement regarding copyright and trademark laws. It also contains sections for internal use by the publishing services branch to track costs, processing steps, and completion status.
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Text version
DEPARTMENT OF HOMELAND SECURITY
FEDERAL LAW ENFORCEMENT TRAINING CENTERS
PUBLISHING SERVICES REQUISITION
FLETC/Publishing Services Branch Bldg. 680, Glynco GA.
Contact Information Organization: Bldg./Rm. Number:
Customer Name: Phone Number:
Backup Contact: Phone Number:
Course Title/Acronym:
Funding Type: Funding Code:
Agreement Number:
Publication Title: REV. Date:
PUB PRINT
REQ. NO:
Agency Trkng#:
Date Received:
Date Required:
QUANTITY:
Delivery: Glynco Charleston
Artesia Cheltenham Other
Call for Pickup Warehouse
Distribution
Product Classification (Check all that apply) Digital Print/Duplication
Black/White Reproduction Color Reproduction Face Only Head to Head Head to Foot
Bindery Collate Acetate Staple Fold Saddle Stitch Slip Sheets Drill Rubber Band Laminate Trim
Tape Bind: Trim Size:
Coil Bind: Text Paper:
Pad: Cover Paper:
Indicate Which Covers Print 1 2 3 4 Additional Details/Special Instructions:
CD/DVD/BD/USB Duplication
CD DVD BD USB
Duplication Only Bookmarking/Linking Authoring Label Only Document Scanning
Staff Assigned:
1. Agency/Title
2. Approved Logos 3. JOB
NUMBER/DATE
4. FOUO/LES Verbiage
Area 1:
Area 2:
Area 3: PUB USE ONLY
Area 4:
PUB USE ONLY: (initial & date completed portion) Scan: Print:
Pre-Press: Binding:
Proof: Packaging:
Accounting Information (PUB USE ONLY)
Number of Pages:
Number of Sheets:
Number of Cover Stock:
Number of Tabs:
COST
B/W: BD:
COLOR: USB:
CD:
DVD:
TOTAL:
Print Center File Original GPO
PUB USE ONLY: (initial & date completed portion)
Scan to File:
Linking/Bookmarking:
Authoring:
Duplicated/Printed Label:
Boxed/Packaged into Shells:
Agency/Division Approval Signature: Date:
If materials are submitted with this request, this signature verifies that materials are not in violation of any copyright or trademark laws.
FLETC Form-142-00-01 (10/19) Page 1 of 1
11.0.1.20130830.1.901444
PUBLISHING SERVICES REQUISITION
DHS Form FTC SSD-PUB-8
DEPARTMENT OF HOMELAND SECURITYFEDERAL LAW ENFORCEMENT TRAINING CENTERS
PUBLISHING SERVICES REQUISITION
FLETC/Publishing Services Branch Bldg. 680, Glynco GA.
Contact Information Organization:
Bldg./Rm. Number:
Customer Name:
Phone Number:
Backup Contact:
Phone Number:
Course Title/Acronym:
Funding Type:
Funding Code:
Agreement Number:
Publication Title:
REV. Date:
PUB PRINT REQ. NO:
Agency Trkng#:
Date Received:
Date Required:
QUANTITY:
Delivery:
Glynco Charleston Artesia Cheltenham Other Call for Pickup Warehouse Distribution Product Classification (Check all that apply) Digital Print/Duplication Black/White Reproduction Color Reproduction Face Only Head to Head Head to Foot Bindery Collate Acetate Staple Fold Saddle Stitch Slip Sheets Drill Rubber Band Laminate Trim Tape Bind:
Trim Size:
Coil Bind:
Text Paper:
Pad:
Cover Paper:
Indicate Which Covers Print Additional Details/Special Instructions:
CD/DVD/BD/USB Duplication
CD
DVD
BD
USB
Duplication Only Bookmarking/Linking Authoring Label Only Document Scanning Staff Assigned:
1. Agency/Title
2. Approved Logos
3. JOB NUMBER/DATE
4. FOUO/LES Verbiage Area 1:
Area 2:
Area 3:
PUB USE ONLY
Area 4:
PUB USE ONLY: (initial & date completed portion) Scan:
Print:
Pre-Press:
Binding:
Proof:
Packaging:
Accounting Information (PUB USE ONLY) Number of Pages:
Number of Sheets:
Number of Cover Stock:
Number of Tabs:
COST
B/W:
BD:
COLOR:
USB:
CD:
DVD:
TOTAL:
Print Center File Original
GPO
PUB USE ONLY: (initial & date completed portion) Scan to File:
Linking/Bookmarking:
Authoring:
Duplicated/Printed Label:
Boxed/Packaged into Shells:
Agency/Division Approval Signature:
Date:
If materials are submitted with this request, this signature verifies that materials are not in violation of any copyright or trademark laws.
FLETC Form-142-00-01 (10/19)
| Organization.: |
| Building / Room Number.: |
| Customer Name.: |
| Phone Number. Enter 10 digit telephone number including area code.: |
| Backup Contact.: |
| Course Title/Acronym: |
| Funding Type.: |
| Funding Code: |
| Agreement Number: |
| Publication Title.: |
| Date Required. Enter 2 digit month, 2 digit day and 4 digit year.: |
| Publishing Print Requisition Number.: |
| Agency Tracking number.: |
| Date Received. Enter 2 digit month, 2 digit day and 4 digit year.: |
| Quantity.: |
| Delivery. Other.: 0 |
| Call for Pickup check box: 0 |
| Distribution check box: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Document Scanning check box.: 0 |
| Laminate check box: 0 |
| Tape Bind.: |
| Trim Size.: |
| Coil Bind.: |
| Text Paper.: |
| Pad.: |
| Cover Paper.: |
| Additional Details / Special Instructions.: |
| B D check box. : 0 |
| USB check box: 0 |
| Label only check box.: 0 |
| Staff Assigned: |
| Area 4.: |
| Scan to File.: |
| Print.: |
| Pre-Press.: |
| Binding.: |
| Proof.: |
| Packaging.: |
| Number of Pages.: |
| Number of Sheets.: |
| Number of Cover Stock.: |
| Number of Tabs.: |
| Cost. Black and White.: |
| B D.: |
| Color.: |
| USB: |
| C D.: |
| Other Cost 3.: |
| other cost: |
| D V D.: |
| B D.: |
| Total: |
| Print Center.: 0 |
| File Original.: 0 |
| G P O.: 0 |
| Linking / Bookmarking.: |
| Authoring.: |
| Duplicated / Printed Label.: |
| Boxed / Packaged into Shells.: |
| Agency/Division Approval Signature: |
| Date of Signature. Enter 2 digit month, 2 digit day and 4 digit year.: |
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