REQUEST FOR REVIEW OF FILE TO REMOVE LIMITATIONS ON LBS I

Oct 10, 2026

Form requesting an ISBE review to remove limitations on an LBS I Approval Certificate. Includes educator information fields, instructions for printing or typing, and sectioned prompts to correct overlooked records, list prior LBS I designations, provide new data (additional college work, Illinois Certification Testing System test completion, attached verification of teaching experience, and elapsed time since initial limited designation), and sign an affidavit under penalty of perjury. Also includes a regional superintendent signature area and ISBE internal use fields.

LanguageEnglish

CategoryExam

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

SECTION I: CORRECTION OF RECORDS

SECTION II: NEW DATA THAT WILL REMOVE LIMITATIONS

SECTION III: AFFIDAVIT

SECTION IV: REGIONAL SUPERINTENDENT

Use your "Mouse" or "Tab" key to move through the fields and check boxes. After completing last field, save document to hard drive to make future updates or click print button. !73-85! REQUEST FOR REVIEW OF FILE TO REMOVE LIMITATIONS ON LBS I 100 North First Street, E-240 Springfield, Illinois 62777-0001 EDUCATOR EFFECTIVENESS DEPARTMENT Note: City of Chicago residents should forward this form to the Educator Effectiveness Department, ISBE, 100 North First Street Springfield, Illinois 62777-0001. INSTRUCTIONS: Please print or type. If you have received an LBS I/Limited certificate or approval, you may use this form to request ISBE to review your file for additional documents that may have been missed during the conversion or to review new information that you are providing to remove limitations. This request should be filed through your Regional Office of Education. | NAME (Last, First, Middle, Maiden) | IEIN | BIRTHDATE (mm/dd/yyyy) | | --- | --- | --- | | ADDRESS (Street Number, City, State, ZIP Code) | TELEPHONE (Include Area Code) | EMAIL | This information is being filed to remove the limitations on an LBS I Approval Certificate SECTION I: CORRECTION OF RECORDS I previously held another credential or authorization, which was overlooked during the conversion, that qualifies me for an unlimited LBS I. (Where possible, please provide a copy of the credential or authorization indicated below. No additional changes will be made to your status if the files at ISBE do not support your claim.) A. I was given the following LBS I designations on my reprinted certificate: LD SED PH EMH TMH B. I hold the following: Category: LD SED PH EMH TMH Additional Certificate Approval C. This credential or authorization was granted to me in the following manner: On Month/Year Under the Name of In the County of D. My file at ISBE shows I have preparation to qualify me in the following area although I never applied for this approval or endorsement: | SECTION II: NEW DATA THAT WILL REMOVE LIMITATIONS
As set forth in the Certification Rules, I am providing the
following to remove the limitations placed on my LBS I Approval Certificate | | | | --- | --- | --- | | | A. I have completed additional college work in the characteristics and methods described atthe right. (Attach official transcripts showing the courses and credits. )
B. I have passed the subject matter knowledge test of the Illinois Certification Testing System listed at the right on the date noted.
C. I have passed the examination for Learning Behavior Specialist I in the Illinois Certification Testing System on the date to the right.
D. I have attached verification form (ISBE No. 73-83) showing that I have taught for three years in the area listed to the right.
E. Three years have passed since I began teaching in special education after receiving my LBS I/Limited designation. (Attach a letter verifying your special education teaching experience from your district superintendent and show dates. ) | Area:
Area: Date: Date:
Area:
Dates:
From: To: | | SECTION III: AFFIDAVIT
Under penalty of perjury, I swear that the above information is true, accurate, and complete.
Date Signature of Teacher | | | SECTION IV: REGIONAL SUPERINTENDENT (For City of Chicago: Chicago Public Schools Talent Office) Date Signature of Regional Superintendent Region | ISBE USE ONLY | | | --- | --- | | Consultant:
Remarks: | Date:
Approved Disapproved | ISBE 73-85 (5/23) Print Reset Form

FAQs

What is the purpose of this form?

To request ISBE to review a file so limitations on an LBS I Approval Certificate can be removed, including missing documents from the conversion or new information being provided.

What documents or evidence are requested to remove limitations?

The form requests attachments such as official transcripts for additional college work, verification of passing required Illinois Certification Testing System tests, an attached verification form (ISBE No. 73-83) for teaching for three years, and a letter verifying special education teaching experience with dates.

Which parts of the form require signatures?

The teacher signs the affidavit under penalty of perjury in SECTION III, and the regional superintendent (including Chicago Public Schools Talent Office for Chicago) signs in SECTION IV. ISBE also has an internal use area for consultant remarks and approval status.

Oct 10, 2026

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