Section 1201.APPENDIX A Request
for Public Records
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TO:
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Freedom of Information Officer
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FROM:
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Name
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Illinois Department of Revenue
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Department/Agency
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Address
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101 W. Jefferson
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Address
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P.O. Box 19014
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Springfield, IL 62794-9014
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Phone
Number
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DESCRIPTION OF REQUESTED
RECORD(S):
Please indicate if you wish to
inspect the above captioned records or wish a copy of them:
Inspection Copy Both
Do you wish to have copies
certified? Yes No
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Date
Received
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Date
Response Due
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Date
Response Sent
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Date
Completed
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(Source: Amended at 20 Ill.
Reg. 7949, effective July 1, 1996)