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.
6) Stay request (optional).
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 Massachusetts matters, confirm whether the hearing is before the agency, the Division of Administrative Law Appeals (DALA), or another forum under the Massachusetts Administrative Procedure Act (M.G.L. c. 30A).