§1901.APPENDIX A. Request for Public Records

 

TO:   Freedom of Information Officer Illinois Health Facilities Authority 180 North Stetson Avenue, Suite 1100 Chicago, Illinois  60601			FROM:
				Name
				Address
				ZIP   (         )
				Telephone
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
FOR OFFICE USE ONLY:
Date Received				Date Response Due

 

(Source:  Amended at 20 Ill. Reg. 358, effective December 26, 1995)