ATLANTA POLICE DEPARTMENT

REQUEST FOR ISSUANCE OF

UNDERCOVER DRIVER'S LICENSE

Georgia Department of Public Safety

Drivers License Bureau

2206 Eastview Parkway

Conyers, Georgia 30013

Because of the covert nature of organized crime, intelligence gathering, narcotic and other police investigation and the inherent danger to those police personnel involved, I request that the State of Georgia issue an undercover Georgia Driver's License to the following law enforcement officer under my command.

Investigator's Regular License Information
Undercover License Information
Name:

License:
Address:
Race:
DOB:
Height:
Weight:
Class:

Section Commander:
Date:
(OPS or SIS)	(Signature Required)

Sworn Employee:
Date:
(Signature Required)

APD Form 321 - Created 3/23/00

(revised 12/5/00)

ATLANTA POLICE DEPARTMENT

AJordan

2008-02-21

VLivsey

Atlanta Police Department