NOTICE OF AGENCY GUIDANCE DOCUMENT
A.R.S. § 41-1013(B)(12)
AGENCY NAME
1. 	Document title and number:
Title and number:
2.	Is this a new guidance document or revision:
Answer
3.	Date of the publication of the guidance document and the effective date of the document if different from the publication date in the Register:
Date published:
Effective date:
4. 	Document summary:
Summary of contents
5.	Contact information:
Name:	First and Last Name
Title:	Title
Division:	Agency Division	
Address:	Street address, city, state, and zip code
Telephone:	Include area code, (xxx) xxx-xxxx
Fax:	(if applicable), include area code, (xxx) xxx-xxxx 
Email:	Email address
Website:	Website address
6.	An electronic copy of the complete document can be viewed at:
Website:	Be specific	
7.	A paper copy of the complete document can be obtained at:
Physical Address: Address
Copy or other fees: Fees per page