Locker Request

Date______________

Please be advised that I am submitting a formal request for a locker(s).

Employee Name_____________________ Employee #_________________________

Current Assignment_______________________

Request at location (s)

Cicero, Illinois_______________________________

Savanna, Illinois______________________________

Eola, Illinois_________________________________

LaCrosse, Wisc______________________________

This request is made in accordance with Pooled Caboose Agreement

Cicero-Savanna Line Freight Pool dated and signed December 11,

1970 and/or Interdivisional Pool Agreement signed and dated June 28,

1972

Signed____________________

Savanna/LaCrosse

Please forward this request to Terminal Supt. Tim Merriweather via fax 708-924-5424

Retain this copy and receipt of successful transmittal for your records.

Eola

Please forward this request to Terminal Division Trainmaster R. Mc Mahan via fax 630-692-6406.

Retain this copy and receipt of successful transmittal for your records.

 ***Submit a copy of this request with, all penalty claims for non-compliance.