Submit CIS

Community Impact Statement
Contact Information
Neighborhood Council:
Name

First Name Last Name
Phone Number

- Area Code Phone Number
Email
example@example.com
Date of NC Board Action

- Month - Day Year
Date
The Board approved this CIS by a vote of

Number of Votes

YEA

NAY

ABSTAIN

INELIGIBLE

RECUAL
Type of NC Board Action

For For if Amended Against Against unless Amended No Position Neutral Position
Impact Information
Today's Date

- Month - Day Year
Date
Update to a Previous Submittal?

Yes No
Directed to
Council File Number
(##-#### or ##-####-S###, If Known or Applicable)
Agenda Date

- Month - Day Year
Date
Item Number
Brief Summary

(Limited to 2000 characters or approximately 300 words) 0/300
Attachments

Browse Files
2 Files allowed) Note: Only pdf document will be accepted only Cancel of
Should be Empty:

Community Impact Statement