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OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE Website: www.otda.state.ny.us/oah OFFICE OF ADMINISTRATIVE HEARINGS FAX to: (518) 473-6735 Telephone #: 1-800-342-3334 FAIR HEARING REQUEST FORM ? FAX

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What is fair hearing request form?

The fair hearing request form is a document that individuals can fill out to request a fair hearing related to a specific issue or decision made by a government agency or organization.

Who is required to file fair hearing request form?

Any individual or their authorized representative who wants to challenge a decision made by a government agency or organization can file a fair hearing request form.

How to fill out fair hearing request form?

To fill out a fair hearing request form, you need to provide your personal information, details of the decision you are challenging, reasons for your disagreement, and any supporting documents or evidence. The specific instructions for filling out the form may vary depending on the agency or organization.

What is the purpose of fair hearing request form?

The purpose of the fair hearing request form is to allow individuals to formally request a fair hearing to challenge a decision made by a government agency or organization.

What information must be reported on fair hearing request form?

The fair hearing request form typically requires the individual to provide their name, contact information, details of the decision being challenged, reasons for disagreement, and any supporting documents or evidence.

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