Message Origin Information:

Date Filed:     Time Filed:    (Optional)

Message Number:    

(A message number assigned to keep track of messages originating through your station. You assign your message numbers as you see fit.)

Precedence:   Routine Welfare Priorty Emrgncy

(This gives the importance of the message - Routine, Welfare, Priority, or Emergency.)

Handling Code (HX):   G_ General Handling Code - No special requirements. C_ Report date and time of message delivery. E_ Return reply message requested. CE Combination of HXC and HXE DE Combination of HXD and HXE D_ Report station received from / sent to and date/times. A_ Collect call authorized within XX miles. B_ Cancel message if not delivered in XX hours of filing tme. F_ Hold delivery until XX/XX date.

Handling Code Number (Codes A,B,F Only):  

(Handling codes give instructions to the station(s) receiving and delivering the message. Handling code "G" is used for most messages. The codes may be combined when necessary. As an option, some codes require a number.)

Station of Origin:    

Place of Origin   (City and State) :    

Recipient Information:

Name (and Call):  

Address Line 1 :  

Address Line 2 :  

City Name :  

State Abbrev :     ZIP:  

Phone Number :      

Message Text Information:

Do NOT use the ENTER key. Enter about 5 words per line but you may enter more as needed. For end of sentence use a letter X by itself.

Message Text:

Check   :  

(The Check is the word count for your message (text only).   It is part of the message header and the program will calculate it when you enter your message.   Note: An "X" -for end of sentence- is counted as a word.   You can fool the program, so double check the word count and enter the correct count if necessary.)

Signature:

Signed:     Call: