Free 53752.pdf - Indiana


File Size: 85.3 kB
Pages: 2
Date: October 29, 2008
File Format: PDF
State: Indiana
Category: Government
Author: IGONZALES
Word Count: 115 Words, 819 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.state.in.us/icpr/webfile/formsdiv/53752.pdf

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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)