REQUEST FOR STATEWIDE ELIGIBLE LIST
REQUEST FOR STATEWIDE ELIGIBLE LIST
New Jersey Civil Service Commission
STATEWIDE INITIATIVES & INTERGOVERNMENTAL SERVICES●PO BOX 313, TRENTON, NJ 08625●TELEPHONE (609) 292-9184
INSTRUCTIONS: Complete the Appointing Authority portion of this form to request a copy of the Statewide Eligible List, also known as the Rice Bill List, as established by NJSA 40A:14-180 for law enforcement officers; NJSA 40A:14-9.9 for Firefighters; and NJSA 40A:14-182 for Federal Firefighters. Once completed, please mail this form to the address listed above or fax to (609) 984-1910.
|APPOINTING AUTHORITY USE ONLY |
|Jurisdiction: |Jurisdiction Code: |
|Address: |
|City: |State: |Zip Code: |
|Type of List Requested: |
|Law Enforcement Officer Correctional Officer Municipal Firefighter Federal Firefighter |
|Contact Person: |
|Contact Telephone #: |Contact Fax #: |
|Contact Email: |
|Comments: |
| |
|AA Signature: |Date: |
|AA Name (Please Print): |
|CIVIL SERVICE COMMISSION USE ONLY |
|SLGO Tracking #: |
|List ID #: |List Date: |
|Comments: |
|Action Completed by: |Date: |
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