+-------------------------------------+--------------------------------+
| **Requisition for**                 | **U.S. Department of Housing** |
|                                     |                                |
| **Visual Arts Services**            | **and Urban Development**      |
|                                     |                                |
|                                     | Office of Administration       |
+-------------------------------------+--------------------------------+

Shaded areas are for use by the Visual Arts Branch.

+---------------------------+---+---------+---+------+-----+---+---+---------+
| Originating Office:       |   | Organ   | A |      | Job |   |   | Control |
|                           |   | ization | p |      | N   |   |   | Number: |
| ----------                |   | Code:   | p |      | umb |   |   |         |
|                           |   |         | r |      | er: |   |   | > ---   |
|                           |   | > ---   | o |      |     |   |   | ------- |
|                           |   | ------- | p |      |     |   |   |         |
|                           |   |         | r |      |     |   |   |         |
|                           |   |         | i |      |     |   |   |         |
|                           |   |         | a |      |     |   |   |         |
|                           |   |         | t |      |     |   |   |         |
|                           |   |         | i |      |     |   |   |         |
|                           |   |         | o |      |     |   |   |         |
|                           |   |         | n |      |     |   |   |         |
|                           |   |         | C |      |     |   |   |         |
|                           |   |         | o |      |     |   |   |         |
|                           |   |         | d |      |     |   |   |         |
|                           |   |         | e |      |     |   |   |         |
|                           |   |         | : |      |     |   |   |         |
|                           |   |         |   |      |     |   |   |         |
|                           |   |         | > |      |     |   |   |         |
|                           |   |         |   |      |     |   |   |         |
|                           |   |         | 2 |      |     |   |   |         |
|                           |   |         | 5 |      |     |   |   |         |
|                           |   |         | 4 |      |     |   |   |         |
|                           |   |         | 7 |      |     |   |   |         |
+---------------------------+---+---------+---+------+-----+---+---+---------+
| Contact Person: (person   |   |         |   | Con  |     | D |   |         |
| most familiar with job)   |   |         |   | tact |     | a |   |         |
|                           |   |         |   | Ph   |     | t |   |         |
| ----------                |   |         |   | one: |     | e |   |         |
|                           |   |         |   |      |     | R |   |         |
|                           |   |         |   | --   |     | e |   |         |
|                           |   |         |   | ---- |     | c |   |         |
|                           |   |         |   | ---- |     | e |   |         |
|                           |   |         |   |      |     | i |   |         |
|                           |   |         |   |      |     | v |   |         |
|                           |   |         |   |      |     | e |   |         |
|                           |   |         |   |      |     | d |   |         |
|                           |   |         |   |      |     | : |   |         |
+---------------------------+---+---------+---+------+-----+---+---+---------+
| Description/Title of Job: |   |         |   |      |     |   | D |         |
|                           |   |         |   |      |     |   | e |         |
| ----------                |   |         |   |      |     |   | l |         |
|                           |   |         |   |      |     |   | i |         |
|                           |   |         |   |      |     |   | v |         |
|                           |   |         |   |      |     |   | e |         |
|                           |   |         |   |      |     |   | r |         |
|                           |   |         |   |      |     |   | y |         |
|                           |   |         |   |      |     |   | D |         |
|                           |   |         |   |      |     |   | a |         |
|                           |   |         |   |      |     |   | t |         |
|                           |   |         |   |      |     |   | e |         |
|                           |   |         |   |      |     |   | R |         |
|                           |   |         |   |      |     |   | e |         |
|                           |   |         |   |      |     |   | q |         |
|                           |   |         |   |      |     |   | u |         |
|                           |   |         |   |      |     |   | e |         |
|                           |   |         |   |      |     |   | s |         |
|                           |   |         |   |      |     |   | t |         |
|                           |   |         |   |      |     |   | e |         |
|                           |   |         |   |      |     |   | d |         |
|                           |   |         |   |      |     |   | : |         |
|                           |   |         |   |      |     |   |   |         |
|                           |   |         |   |      |     |   | > |         |
|                           |   |         |   |      |     |   |   |         |
|                           |   |         |   |      |     |   | - |         |
|                           |   |         |   |      |     |   | - |         |
|                           |   |         |   |      |     |   | - |         |
|                           |   |         |   |      |     |   | - |         |
|                           |   |         |   |      |     |   | - |         |
|                           |   |         |   |      |     |   | - |         |
|                           |   |         |   |      |     |   | - |         |
|                           |   |         |   |      |     |   | - |         |
|                           |   |         |   |      |     |   | - |         |
|                           |   |         |   |      |     |   | - |         |
+---------------------------+---+---------+---+------+-----+---+---+---------+
| Name of Authorizing       | S |         |   |      |     |   |   |         |
| Official:                 | i |         |   |      |     |   |   |         |
|                           | g |         |   |      |     |   |   |         |
| ----------                | n |         |   |      |     |   |   |         |
|                           | a |         |   |      |     |   |   |         |
|                           | t |         |   |      |     |   |   |         |
|                           | u |         |   |      |     |   |   |         |
|                           | r |         |   |      |     |   |   |         |
|                           | e |         |   |      |     |   |   |         |
|                           | & |         |   |      |     |   |   |         |
|                           | D |         |   |      |     |   |   |         |
|                           | a |         |   |      |     |   |   |         |
|                           | t |         |   |      |     |   |   |         |
|                           | e |         |   |      |     |   |   |         |
|                           | : |         |   |      |     |   |   |         |
|                           |   |         |   |      |     |   |   |         |
|                           | X |         |   |      |     |   |   |         |
+---------------------------+---+---------+---+------+-----+---+---+---------+

Type of Service:

Publication Photography Presentation Other ----------

Audience:

----------

Additional Information:

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