State of Connecticut

Attachment to MEMORANDUM NO. 2003-12

REQUEST FOR INFORMATION
EMPLOYEES RETURNING TO STATE SERVICE
FROM ACTIVE MILITARY SERVICE

 

Employee Name: ___________________________________________________________ 

Employing Agency: _________________________________________________________

Agency Contact Person: _____________________________________________________

Date of Return to State Service: _______________________________________________

 

SEND TO: Office of the State Comptroller
Policy Services Division
55 Elm Street, Room 219
Hartford, Connecticut 06106
Attn: Christine Grodzki
Fax #: (860) 702-3441

Return to Memorandum 2003-12

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