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CITY OF ATLANTA
OFFICE OF MODEL CITIES PROGRAM
565 Hill St. SE
Atlanta, Ga. 30312
404-524-8876
Ivan Allen Jr... Mayor
J. C. Johnson, Director
REQUISITION FORM
Neighborhood Funds for Resident Involvemen ¢ /o
Community Affairs Department
3
(Community)
Date Requested: Li ae og G of cd
Date Needed:
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Requested Amount : & oWlh 73 #189. rey,
Purpose: a "17200 Seria
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Authorized Signatures:
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Action: