Fax Cover

Date Total Pages

Sent {mm/dd/yy} (including this cover) {x}
To Individual
Name {Name}
Company
Name {Company}
Department Mail Stop/
Name {Dept.} Floor {Mail Stop}
Fax Phone Voice Phone
Number {xxx-xxx-xxxx} Number {xxx-xxx-xxxx}
From Individual
Name {Name}
Company
Name {Company}
Department
Name {Dept.}
Address (Street, City, State, Zip Code, Country)
{Street}
{City, State, Zip Code, Country}
Fax Phone Voice Phone
Number {xxx-xxx-xxxx} Number {xxx-xxx-xxxx}
Email
Address {name@domain.com}
Message
{Type Message Here}

If you experience fax transmission problems, please call the “From Voice Phone Number” above. The
DOCUCORP name, symbol, and logo are trademarks of DOCUCORP International.
Form 102, 5-19-97 Edition