additional staff support and 1 or 2 person cila request Preview on Page 1

Il4624424 2 2026

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  1. Click ‘Get Form’ to open the il4624424 2 in the editor.
  2. Begin by entering the individual's name, SSN, RIN, and address in the designated fields. Ensure all information is accurate as it is crucial for processing.
  3. In Section I, check all applicable boxes for the Additional Staff Support Request. Specify if this is an initial request or a renewal by selecting the appropriate option.
  4. For Section II, indicate whether you are requesting a one or two-person CILA with 24-hour shift staff supports. Select only one box that applies to your situation.
  5. Complete the signature fields at the bottom of the form. Ensure that both the requesting executive director/designee and receiving ISC agency sign and provide their email addresses.
  6. Review all entered information for accuracy before submitting. Once confirmed, save your document and proceed to submit it through your preferred method.

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