Reporter Unable to Verify Illinois Driver’s License / Reporter Has an Out- of -state Driver’s License

Helping Families. Supporting Communities. Empowering Individuals.

Request for MIS Hardware, Software and Services

You can access this form by clicking on Request for MIS Hardware, Software and Services

Instructions to Complete the Request

Requester Block

  • Write name of staff person requesting/reporting in CIRAS.
  • Division - Leave Blank
  • Bureau/Facility - Leave Blank
  • Telephone No - Leave Blank
  • Contact - Give information for requestor/reporter name; address; city/zip; phone number.
  • State Fiscal Year - Insert current State Fiscal Year.

Recipient Block

Leave the entire block blank (that is Recipient through *Required Estimated Total Cost)

Narrative Description of Request Block

Write as applicable:

"Illinois driver's license will not verify," and then write license number

or

"Requestor has out-of-state license,"

and then write state and license number

Justification

Write in the Justification box: "DHS.G.CIRAS_ISCProviderExternalReporting, Required for reporting."

Page Two

All fields should be left blank.

Completion

Once completed, both pages of the form must be emailed to Sherry.Hinds@illinois.gov