Section 1676.APPENDIX A Request for Public Records

TO: Freedom of Information Officer Civil Service Commission 425½ South Fourth Street Springfield, Illinois 62701	FROM:
		Name
		Address
		AC /
		Telephone

DESCRIPTION OF REQUESTED RECORD(S):

Please indicate if you wish to inspect the records identified above or wish to copy them:

Inspect

Copy

Both

FOR OFFICE USE ONLY:


Date Received		Date Response Due