Get Fillable Ad 1164

Filling out the Fillable Ad 1164 form is an essential step for individuals seeking reasonable accommodation in the workplace. This guide provides clear instructions to help users complete the form accurately and efficiently in an online format.

Follow the steps to complete the Fillable Ad 1164 form online.

1. Select the ‘Get Form’ button to access the Fillable Ad 1164 form and open it in your preferred editor.
2. In the first section, enter the name of the individual requesting accommodation in the designated space.
3. Provide the agency and office details for the person submitting the request in the corresponding fields.
4. Check the appropriate box to indicate whether the reasonable accommodation request is approved or denied. If it is approved, include the name and title of the deciding official. If denied, attach the denial form AD-1164.
5. Record the date the accommodation was requested, as well as the date it was referred, if applicable.
6. Fill in the name and position of the individual to whom the request was made.
7. Indicate the date on which the accommodation was either approved or denied.
8. Enter the date when the accommodation was provided.
9. If applicable, provide an explanation for any delays in meeting the outlined time frames for reasonable accommodation procedures.
10. Clearly state the job held or the desired position by the individual requesting the accommodation, including occupational series and grade level.
11. Select the reason for needing the accommodation by checking the relevant box: application process, performing job functions or accessing the work environment, or accessing a benefit or privilege of employment.
12. List the types of accommodation requested in the specified section.
13. Detail the types of accommodation that were provided.
14. Indicate if medical information was required to process the request, and explain the reason.
15. If applicable, note any costs associated with the accommodation.
16. Mention any sources of technical assistance consulted during the process, such as a family member or rehabilitation counselor.
17. After completing all sections, review the form for accuracy, then save your changes, download, print, or share as needed.

Complete your Fillable Ad 1164 form online today to ensure your reasonable accommodation requests are processed effectively.