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STATE OF INDIANA TRAFFIC REQUISITION
Please return completed form to Stephanie Genrich [email protected] Phone 232-1012 Date: State Agency: State Agency Contact: Phone: E-Mail: Campaign: Creative Agency: Creative Agency Contact: Phone: E-Mail: Flight Dates: P.O. Number:
RADIO SPOTS
Spot Distribution Method ____ ____ ____ DG Systems E-mail MP3 CD Spot Length Production House: Production House Contact: Production House Phone: Spot Title Spot Rotation Spot Flight Dates
Spot ISCI Code
TELEVISION/CABLE SPOTS
Spot Distribution Method ____ ____ ____ DG Systems Beta-SP DVD Spot Length Production House: Production House Contact: Production House Phone: Spot Title Spot Rotation Spot Flight Dates
Spot ISCI Code
VALUE-ADDED COPY (IF ANY)
COMMENTS/SPECIAL INSTRUCTIONS
State Form 53752 (10-08)