Form CSC-22

CIVIL SERVICE COMMISSION
CITY AND COUNTY OF SAN FRANCISCO

CIVIL SERVICE COMMISSION REPORT TRANSMITTAL (FORM 22)

Refer to Civil Service Commission Procedure for Staff - Submission of
Written Reports for Instructions on Completing and Processing this Form

1. Civil Service Commission Register Number: ___________ - ___________ - ___________
2. For Civil Service Commission Meeting of: ___________________________
3. Check One: Ratification Agenda
Consent Agenda
Regular Agenda
Human Resources Director_s Report
_________
_ ________
_ ________
_ ________
4. Subject:
5. Recommendation:
6. Report prepared by: _______________________Telephone number: ___________________
7. Notifications: (Attach a list of the person(s) to be notified in the format described in IV. Commission Report Format -A).
8. Reviewed and approved for Civil Service Commission Agenda:

Human Resources Director: __________________

Date: ________________

9.

Submit the original time-stamped copy of this form and person(s) to be notified
(see Item 7 above) along with the required copies of the report to:

Executive Officer
Civil Service Commission
25 Van Ness Avenue, Suite 720
San Francisco, CA 94102

10. Receipt-stamp this form in the _CSC RECEIPT STAMP_box to the right using the time-stamp in the CSC Office.

CSC RECEIPT STAMP

Attachment

CSC-22MTA (9/00)