2 Ill. Adm. Code 1901.APPENDIX A
A Request for Public Records
Section 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