Form CSC-13

DATE: _________________________________________
TO: Executive Officer, Civil Service Commission
25 Van Ness Avenue, Suite 720
San Francisco, CA 94102
FROM:

_________________________________________
(Name)
_________________________________________
(Department)
_________________________________________
(Address)
_________________________________________
(Telephone)
SUBJECT:

_________________________________________
(CSC Register No.)
_________________________________________
(Appellant's Name)
_________________________________________
(Tentative CSC Hearing Date)

The following action on the appeal/request cited above is requested:(check appropriate box)

Appeal not timely. Copy of documentation attached. Please notify appellant; close file.

Resolved administratively. Copy of documentation attached. Please notify appellant; close file.

Scheduling problem; tentative CSC date not feasible for the reasons given under "Other" and note approximate date of CSC meeting when you will be prepared to proceed. Reschedule CSC hearing date; notify appellant if required.

Other; describe: 

____________________________________________________________________________________

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(Please add additional pages if necessary)

cc: Human Resources Director
CSC-13 (5/01)