Transcription of RESPONSE TO DISABILITY ACCOMMODATION REQUEST
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RESPONSE TO DISABILITY ACCOMMODATION REQUEST
CS-1669 REV 7/2020 Michigan Civil Service Commission400 South Pine Street, Box 30002 Lansing, Michigan 48909 AUTHORITY: Article 11, 5, MichiganConstitution of 1963, Civil ServiceCommission Rule 1-8, and CivilService Regulation TTOO DDIISSAABBIILLIITTYY AACCCCOOMMMMOODDAATTIIOONN RREEQQUUEESSTTThis form must be completed after an employee has filed a DISABILITY ACCOMMODATION REQUEST Form. The departmentalAccommodation Coordinator (or other designated official) must complete Part A and send a copy to the requestingemployee. (Civil Service Regulation requires the ACCOMMODATION Coordinator to issue a written RESPONSE withineight weeks after receiving a completed DISABILITY ACCOMMODATION REQUEST Form from an employee.)PART A: ACCOMMODATION COORDINATOR S RESPONSE TO REQUEST FOR ACCOMMODATION1. ACCOMMODATION Coordinator s Name2. Coordinator s Title3. Department/Agency4. Date REQUEST Received5. Employee s Name6. Employee s Identification Number7.
RESPONSE TO DISABILITY ACCOMMODATION REQUEST INSTRUCTIONS FOR COMPLETING THE FORM PART A: To be completed by the departmental Accommodation Coordinator or designee. Questions Instructions Questions 1-6 Self-explanatory. Question 7 Describe your final decision on the employee’s written request for an
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