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STATE OF WASHINGTONPhone: (360) 7257000 www.insurance.wa.govMIKE KILLER STATE INSURANCE COMMISSIONERFlLED December 29, 2017OFFICE Of l '1 OEC 2ci p J: '. ' 2INSURANCE COMMISSIONER HEARINGS UNITOFFICE
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Hearing Regarding Form A is a legal document filed to request a hearing for specific issues or concerns relating to a regulatory or administrative matter.
Individuals or entities affected by a regulatory decision, ruling, or action that they wish to contest are required to file Hearing Regarding Form A.
To fill out Hearing Regarding Form A, provide your contact information, details of the decision you are contesting, reasons for the hearing request, and any relevant supporting documents.
The purpose of Hearing Regarding Form A is to formally request a hearing where an individual or entity can present their case and seek a re-evaluation of a decision made by a regulatory authority.
The information that must be reported includes the names and addresses of the parties involved, a description of the issue being addressed, the specific regulatory provision being contested, and any supporting evidence.
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