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    ║         DEPARTMENT OF INFORMATION            ║
    ║            RETRIEVAL  (D.O.I.R.)             ║
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    ║  FORM 27B STROKE 6                           ║
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    ║  Purpose of request: ___________________     ║
    ║  Authorising officer: ___________________    ║
    ║  Counter-authorisation: _________________    ║
    ║  Department: ____________________________    ║
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    ║  ☐ I have read the regulations               ║
    ║  ☐ I accept full responsibility              ║
    ║  ☐ I understand this form is mandatory       ║
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    ║  STATUS: PENDING INDEFINITELY                ║
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    ║  "We're all in it together."                 ║
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