Transcript Receipt Form {ICTR}

ILLINOIS WORKERS' COMPENSATION COMMISSION 100 W. RANDOLPH ST. #8-200 CHICAGO, IL 60601 _________________________________ Petitioner Case # ______ WC _________ v. _________________________________ Respondent Commissioner ____________________ Return date ____________________ TRANSCRIPT RECEIPT FORM The Illinois Workers' Compensation Commission acknowledges receipt of the arbitration transcript for this case. _________________________ Signature of IWCC employee Attention, parties. When you authenticate the transcript and return it to the Docket unit, please submit it with two copies of this completed form. If you mail the transcript in, please include a self-addressed stamped envelope. One copy will be datestamped and returned to you. ICTR 1/08 American LegalNet, Inc. www.FormsWorkflow.com