This is a picture of a Form 2345. In the upper right corner is Identification Information, the Document Form No. with 941, then Volume of 78, then File with RPS, N/R or W/R then the Master File types beside it, the Program 11200, Sequence 456 the Pg. 1 of 1. Then the second row begins below the Document Form No. and is the Sched. Release Day 141 and Cycle 16, then Earliest Received Date is 126, Account Type Code is next, the DIS Release Information is last item in the row. Then below a section for Date and Time In/Out, Unit and Due out is the Ref 1 Alpha ABC, FLC 00, Class/Doc. 141, Date 132, Block 000, Yr. 6, and Count 78. In the bottom left corner of the form is a check box for Operation 180 or 190, Initials 1122, then Date/Hour is 5/11/xx, 8:30 a.m.