NUMBER	Click here to enter POLICY tITLE
Responsible Executive:	Click here to enter
Approving Official:	Click here to enter
Effective Date:	Example Text – 3-27-2014
Revision History:	Example Text ─ 7-21-1967; 6-24-1977; 1-1-2001; 3-27-2014
I.	INTRODUCTION
Click here to enter Introduction text.
II.	POLICY (Including any Forms and Attachments)
Click here to enter Policy
III.	LEGAL SUPPORT, JUSTIFICATION, AND REVIEW OF THIS POLICY
Click here to enter Support Information for Policy
/s/ Name of Approving Official
[Proof of approval retained in file]