Is your request for a permit related to COVID-19? Check YES or NO. If you check yes, upload supporting documents as directed by emergency rule effective 3/20/20.

The OFFICIAL name of the company.

If you have previously submitted an ODRISA permit application in this calendar year and were provided a reference number, please include the reference number here.

(Not A PO BOX)

Total number of persons employed by the company. (NUMBERS ONLY)

Date the permit starts.

Date the permit ends.

Select YES if this permit request encompasses more than 8 weeks OR if with this permit request you would exceed 8 weeks cumulatively with other permits you have requested in the current Calendar Year. If YES you must select one of the two options below AND upload an attachment explaining the request. If NO you are not required to select either option.

Please submit the anticipated number and title/skills of employees covered by this permit. If you require a permit for more than (4) titles/skills, please submit a second request.


I [OWNER/CONTACT] certify that all employees covered by this permit are in fact voluntarily working and no action will be taken to discipline any employee who chooses not to work on their day off as permitted by the Act (820 ILCS 140/1-9). I certify that all information provided and the statements made herein are true, correct, and complete.

    If your request is for more than 8 weeks you must submit an attachment explaining your request. Multiple files can be uploaded by holding down Shift or Ctrl while selecting.