CITY OF ATLANTA

VEHICLE USE OUT OF CITY/STATE

TRAVEL REQUEST

Chief Operating Officer

68 Mitchell Street

2nd Floor, City Hall

Atlanta, GA 30303

Name
Position Title
Employee is required to travel Out of City/State to
for the period of	to
Travel in City-owned vehicle number	is required
Requesting Department/Bureau
EXPLANATION:	(if needed, please provide attachment)
Department Head Signature	Date
FOR OFFICE OF FLEET SERVICES USE ONLY:
Disapproved
Approved
Vehicle Description
Date

11-M-194 Revised 09/07

CITY OF ATLANTA

VLivsey

2008-04-18

Atlanta Police Department