UNCLASSIFIED//FOR OFFICIAL USE ONLY
UNCLASSIFIED//FOR OFFICIAL USE ONLY
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IBWC Form 394 (EEO)
05/2015 Previous Editions are Obsolete
3. Accommodation(s)
RESOLUTION OF REQUEST FOR REASONABLE ACCOMMODATION
1. Name of Individual Requesting Reasonable Accommodation
2. Type of Reasonable Accommodation Requested
Items 1-5 must be completed, Complete Item 6 if applicable.
1a. Date
6. Detailed Reason(s) for the Denial of Reasonable Accommodation (Must be specific, e.g., why accommodation is ineffective or causes undue
hardship):
7. If the deciding official offered an accommodation that is different from the one originally requested, explain: (a) the reasons for
the denial of the accommodation originally requested; and (b) why the alternative accommodation would be effective.
*If the approved accommodation is different from the one(s) originally requested, identify the alternative accommodation(s) in the Remarks block
4. If Alternative Accommodation Was Offered, Indicate Whether it Was
Accepted
Rejected
5. Request Denied Due to (Check all that apply)
Requestor does not have a Rehabilitation Act disability
Accommodation ineffective
Accommodation would cause undue hardship
Accommodation would require removal of essential function
Medical documentation inadequate
Accommodation would require lowering performance or production standard
Other (identify):
Denied
Approved but different from original request*
Approved as specifically requested
