NORFOLK SOUTHERN TRACK WARRANT No._______________ ___________, 19__ To:__________________________ At______________ (Mark "X" in box for each item instructed) 1 [ ] Track Warrant No.______________________________ is void. 2 [ ] Proceed from________________________________________________ To_________________________________________________________ On____________________________________________________Track 3 [ ] Work between_______________________________________________ and________________________________________________________ On____________________________________________________Track 4 [ ] This authority expires at___________________ M. 5 [ ] Not in effect until arrival of ______________________________________ At _________________________________________________________ 6 [ ] Hold Main Track at last named point. 7 [ ] Do not foul limits ahead of ______________________________________ 8 [ ] Clear Main Track at last named point. 9 [ ] Between ________________________ & __________________________ Make all movements at yard speed, not exceeding 15 mph. Limits occupied by train or engine. 10 [ ] Between ________________________ & __________________________ Make all movements at yard speed, not exceeding 15 mph, and stop short of men or machines fouling track. 11 [ ] Rule 99 protection not required against following trains on the same track. 12 [ ] Other specific instructions:_______________________________________ ___________________________________________________________. OK______________________M Dispatcher __________ Copied By ______________________________________ Limits Reported Clear at _______________________ M. By _____________________________________________