"Ada Request for Reasonable Accommodation Employee" - Florida

Ada Request for Reasonable Accommodation Employee is a legal document that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida.

Form Details:

  • Released on August 17, 2011;
  • The latest edition currently provided by the Florida Department of Juvenile Justice;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Florida Department of Juvenile Justice.

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Download "Ada Request for Reasonable Accommodation Employee" - Florida

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Attachment 2
FDJJ 1060 – 2
New 8/17/11
FLORIDA DEPARTMENT OF JUVENILE JUSTICE
Americans with Disabilities Act (ADA)
Request for Reasonable Accommodation
DJJ Employee
Date of Request:
Name of Employee:
Employee’s Job Title:
Office/Facility/Program Name:
Office/Facility/Program Address:
City:
State:
Zip Code:
Employee’s Supervisor Name:
Supervisor’s Telephone Number:
Disability(ies):
Limitation(s) identified:
Accommodation(s) requested:
Accommodation(s) granted:
Signatures:
Employee
Date
Supervisor
Date
Human Resources Bureau Chief
Date
Reset/Clear Form
Save As
Print Form
Email Form
Attachment 2
FDJJ 1060 – 2
New 8/17/11
FLORIDA DEPARTMENT OF JUVENILE JUSTICE
Americans with Disabilities Act (ADA)
Request for Reasonable Accommodation
DJJ Employee
Date of Request:
Name of Employee:
Employee’s Job Title:
Office/Facility/Program Name:
Office/Facility/Program Address:
City:
State:
Zip Code:
Employee’s Supervisor Name:
Supervisor’s Telephone Number:
Disability(ies):
Limitation(s) identified:
Accommodation(s) requested:
Accommodation(s) granted:
Signatures:
Employee
Date
Supervisor
Date
Human Resources Bureau Chief
Date
Reset/Clear Form
Save As
Print Form
Email Form