Form Hud-21019 - Hud Headquarters Library Retained Loan Request - U.s. Department Of Housing And Urban Development

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HUD Headquarters Library

U.S. Department of Housing

and Urban Development

Retained Loan Request

Office of Administration

Return completed request to HUD Library, Room 8141

1. Date of request

2. Title of Publication

3. Number of copies

requested

4. Author (For book requests, provide other information, if known, such as publisher, date of publication, and price)

5. Subscription start/end dates (For journals, attach renewal notice, mailing label and/or other information, if known, such as publisher, date of publication, and price)

Library Materials to be Retained by

(For multiple copies, attach a page which provides the information below for each person)

6a. Name

6b. Phone (include extension)

6c. Office Name

6d. Room Number

6e. Nine-digit Zip Code Number

7. Justification

8a. Authorized Requesting Official (Name)

8b. Title

8c. Signature

8d. Date