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        <BusinessNameLine1Txt>HAILEY BANKHEAD FOUNDATION INC</BusinessNameLine1Txt>
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        <AddressLine1Txt>250 GEORGIA AVE EAST STE 362</AddressLine1Txt>
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      <PreparerPersonNm>TANISHA L CLARK</PreparerPersonNm>
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        <ExplanationTxt>Activity: TO SERVE FAMILIES BATTLING CAN Grantee Name: CLAYTON COUNTY COMMISSIONERS BLOCK Grantee Address: 112 SMITH STREET JONESBORO GA 30236 Amount: 10000 Relationship:</ExplanationTxt>
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        <ExplanationTxt>Description: TRAVEL Amount: 573</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: DJ/WAVYHITS Amount: 550</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: RENTAL EVENTS Amount: 750</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: GIFTS AND TROPHIES Amount: 409</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: UHAUL Amount: 189</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: HOST TOWN Amount: 28</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: CLEANING Amount: 250</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: DECOR Amount: 2101</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: ENTERTAINMENT Amount: 100</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: MEDS FOR PATIENT Amount: 150</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: CATERING Amount: 1150</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, line 16</FormAndLineReferenceDesc>
        <ExplanationTxt>Description: BARTENDER ANNUAL EVENT Amount: 225</ExplanationTxt>
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