ADMINISTRATIVE HEARING REQUEST PACKET
COVER LETTER, REQUEST, AND EVIDENCE CHECKLIST
Filing Overview
- Requester: [NAME/ENTITY], Contact: [ADDRESS/EMAIL/PHONE]
- Agency action/date: [DECISION/NOTICE], Docket/Ref: [ID]
- Deadline to request hearing: [DATE] (filed on/before: [DATE])
- Relief: [Hearing de novo / Review on record]; Stay requested: [YES/NO]
Packet Order (suggested)
1) Cover letter (this document).
2) Hearing request form (if agency provides) or request statement.
3) Copy of challenged notice/decision.
4) Statement of issues and brief factual summary.
5) Evidence/exhibit list (with copies if permitted at this stage).
6) Stay request (optional) with supporting facts.
7) Proof of service on agency counsel/official.
8) Any required fee/waiver.
Cover Letter Body (sample)
text
Date: [DATE]
[AGENCY NAME/HEARING OFFICE ADDRESS]
RE: Request for Administrative Hearing – [NAME/ENTITY], Docket/Ref: [ID]
Dear [Hearing Officer/Agency],
Pursuant to [CITE AGENCY AUTHORITY], we request an administrative hearing to contest the [DECISION/NOTICE] issued on [DATE]. The issues presented include: [LIST ISSUES]. A stay of enforcement is [requested/not requested] pending resolution. Supporting documents and proof of service are enclosed.
Respectfully,
[NAME/TITLE]
Practice Notes
- For Louisiana matters, confirm whether the hearing is before the agency, the Division of Administrative Law, or another forum, and follow the specific procedural rules under the Louisiana Administrative Procedure Act (La. R.S. 49:950 et seq.).