Enclosure (8) to COMDINST 1750.4D
Release of Information:
I authorize the Coast Guard to collect and maintain my address, telephone number, E-mail
address, and FAX number for the purpose of creating and maintaining an Ombudsman
communications network.
___________________________
___________________________
Name (print)
United States Coast Guard
___________________________
___________________________
Mailing Address
Telephone
___________________________
___________________________
E-mail (if available)
Fax (if available)
___________________________
Cell Phone (if available)
___________________________
___________________________
Signature
Date
1
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