LAW ENFORCENLENT AGENCY (LEA) ARMORED TACTICAL VEHICLE REQUEST SCREENERID: 2 AGENCY 5:9qu away?! 2651:? bag/1 Poc- ADDRESS (No P.0. AM l/Ltm?m. v, CITY: SD 1991/ Hqu ZIP. 03 lab EMAIL: r1001? Han?! PHONE: ?7 - FAX: 7% 9 1 Type of Armored Tactical Vehicle Requested (if a speci?c type is required): VI lie; ,0 2. Number of Armored Vehicles Requested: I - Geographic Responsibility (Square Miles CoveredHigh Intensity Drug Traf?cking Area (HIDTAJ: Yes No Verify at hyny?lwmv.WhitehousedruRoolicy . 40v: hidta 5 Is the LEA Willing to accept an Armored Tactical Vehicle that is Trackch Wheeled Either 6. of l208/ 1033 Armored Tactical Vehicles Currently on Inventory: I) IV 7. SpecralConsiderations: we swear item ls 0Q Lg qwct?ln?c) we. when]: Jae/Herni? Skaggxg Na Sluts. 4: (egg mil Bar-?7' (2444 4 The Chief Executive Of?cial/Head of Agency {Local Field Of?ce), by signing, certi?es that the requesting agency/?43? ?Ll listed above has the appropriate funds, personnel, and equipment to operate and maintain the requested vehicle. It is also understood that this agency W111 not sell, trade, or cannibalize for parts, armored vehicles acquired through the 1033 Program. They certify that all information contained above is accurate and the request for an armored tactical vehicle is warranted and has been apprm ed CHIEF EXECUTIVE HEAD OF LOCAL AGENCY 3?1 3 at; trunk/y STATE COORDINATOR: do GEM, DATE: 2 ?3 (NOT REQUIRED FOR FEDERAL) tarmac UNANIRE LESO USE LESO OFFICIAL: (?-243 DATE LEA WAS ADDED TO I HE NATIONAL PRIORITY LIST: LESO DISAPPROVED BY REASON: We.