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REQUEST FOR FAIR HEARING Fill out this form ONLY if you disagree with a decision concerning your benefits. If you disagree with the action of the local department, you are entitled to discuss it with
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What is if you disagree with?
If you disagree with a decision or action taken, you can file an appeal or dispute.
Who is required to file if you disagree with?
Anyone who disagrees with a decision or action taken may file an appeal or dispute.
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You can fill out the necessary forms provided by the relevant authority and submit them along with any supporting documentation.
What is the purpose of if you disagree with?
The purpose of filing an appeal or dispute is to seek a review or reversal of the decision or action that you disagree with.
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You must report details of the decision or action you are disagreeing with, reasons for your disagreement, and any supporting evidence.
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