SENDER COMPANY NAME Sender company address
Date	FAX
To: Recipient name
Phone: Recipient phone number
Company Name: Recipient company name
Fax: Recipient fax number
From: Sender name
Phone: Sender phone number
Company Name: Sender company name
Fax: Sender fax number
Number of Pages: Number of pages sent
Urgent: Yes or No
Action Requested: Enter action required