Administrative Hearing Request Packet - North Carolina
NORTH CAROLINA ADMINISTRATIVE HEARING REQUEST PACKET
Initial Route, Deadline, and Petition Draft
This packet does not create a hearing right. Start with the agency decision, governing program law, and current official instructions. Do not assume that Chapter 150B supplies the only deadline or that every matter begins with OAH Form H-06.
1. STOP-GATE: IDENTIFY THE HEARING AUTHORITY
1.1 Agency action and source record
| Required item | Verified entry | Source / reviewer |
|---|---|---|
| Petitioner legal name and status | [________________] | [________________] |
| Agency or board | [________________] | [________________] |
| Program / license / benefit / penalty | [________________] | [________________] |
| Agency action date | [__/__/____] | [________________] |
| Notice date | [__/__/____] | [________________] |
| Notice delivery method | [________________] | [________________] |
| Notice delivery / deposit date | [__/__/____] | [________________] |
| Agency file or reference number | [________________] | [________________] |
| Law creating the hearing right | [CITATION] | [OFFICIAL URL] |
| Law or notice setting the deadline | [CITATION / NOTICE PAGE] | [OFFICIAL URL] |
| Required recipient | [________________] | [________________] |
| Required form | [________________] | [________________] |
| Permitted filing method | [________________] | [________________] |
| Required pre-filing process | [________________] | [________________] |
| Filing fee / waiver route | [________________] | [________________] |
1.2 Contested-case fit
Section 150B-2 defines a contested case as a Chapter 150B proceeding resolving an agency-person dispute involving the person's rights, duties, or privileges. It excludes rulemaking, declaratory rulings, and the award or denial of a scholarship, grant, or loan.
☐ The matter fits the current contested-case definition.
☐ The petitioner is a “person aggrieved” substantially affected in person, property, or employment.
☐ Another review, grievance, rulemaking, declaratory-ruling, court, contract, or internal process applies instead: [________________].
1.3 Informal process
Section 150B-22 favors informal resolution before a contested case. Record any available process, but do not let an informal request consume the filing period. Section 150B-23(f) states that a later informal-settlement request does not suspend the petition period when no informal request was received before the agency issued its notice.
| Informal step | Date | Result | Effect on deadline verified? |
|---|---|---|---|
| [________________] | [__/__/____] | [________________] | ☐ Yes ☐ No |
2. SELECT THE CORRECT ROUTE
2.1 Article 3 — petition filed with OAH
Select only after confirming the agency-specific hearing authority:
☐ General Article 3 route. A petition, fee or waiver if required, certificate of service, and attachments will be filed with OAH.
☐ Specialized OAH form. Use the current official form for:
- personnel;
- child-support tax intercept, distribution, or credit reporting;
- special education or manifestation determination;
- contested tax;
- Child/Adult Care Food Program;
- agency failure to act; or
- another category identified on the current OAH forms page.
☐ Medicaid recipient appeal. Use the hearing-request form supplied by DHHS or the managed care organization, as the current OAH forms page directs.
☐ General Form H-06. Use only after excluding a specialized form.
2.2 Article 3A — agency or board route
Section 150B-38 applies Article 3A to the listed occupational-licensing, banking, insurance, State IT, building-code, and fire-marshal bodies. These cases ordinarily proceed through the agency's hearing notice and rules. Section 150B-40 permits the agency, in specified circumstances, to request an OAH administrative law judge; that does not convert the matter into the ordinary Article 3 H-06 intake route.
☐ Respondent is within § 150B-38.
☐ The agency notice, rules, response deadline, recipient, hearing officer, and venue are attached.
☐ General OAH Form H-06 is not being filed unless current authority expressly requires it.
2.3 Route decision
| Decision | Selection |
|---|---|
| Article | ☐ Article 3 ☐ Article 3A ☐ Other / uncertain |
| Initial recipient | [________________] |
| Official form | [________________] |
| Filing URL / address | [________________] |
| Service recipient | [________________] |
| Counsel approval | [NAME / DATE] |
3. DEADLINE CONTROL
3.1 Do not default blindly to 60 days
Section 150B-23(f) supplies a general 60-day limitation only when another state statute, federal statute, or federal regulation does not set the time for petitions against the specified agency. The agency's written notice must state the action and inform known aggrieved persons of the right, procedure, and time limit.
| Deadline input | Verified entry |
|---|---|
| Governing deadline source | [CITATION / NOTICE] |
| Trigger event | [PERSONAL DELIVERY / ELECTRONIC DELIVERY / USPS DEPOSIT / OTHER] |
| Trigger date | [__/__/____] |
| Calendar method and excluded days | [________________] |
| Extension order or special rule | [________________] |
| Counsel-calculated last timely date | [__/__/____] |
| Planned filing date | [__/__/____] |
| Safety margin | [____] days |
☐ The program-specific deadline is shorter than 60 days.
☐ The general § 150B-23(f) period applies after current-law review.
☐ Deadline remains uncertain. Treat as urgent and do not file from this draft without counsel.
4. FEE AND FORM CONTROL
4.1 Current fee
Section 150B-23.2 sets a $125 amount but authorizes OAH to establish a lesser fee by rule and requires waiver routes for in forma pauperis matters and mandated federal causes of action. The current official H-06 instructions and OAH fee page show multiple $0, $20, and $125 categories. Do not hard-code one amount for every petition.
| Fee issue | Verified entry |
|---|---|
| Current official fee category | [________________] |
| Amount | $[________________] |
| Official fee-page check date | [__/__/____] |
| Payment method | [________________] |
| Waiver / in forma pauperis form | [________________] |
| Clerk confirmation, if needed | [NAME / DATE / METHOD] |
4.2 Current form
| Form control | Verified entry |
|---|---|
| Form name / number | [________________] |
| Revision shown on form | [________________] |
| Download URL | [________________] |
| Download date | [__/__/____] |
| Specialized form excluded? | ☐ Yes ☐ No |
The official forms page identified Form H-06 for most general cases but directs specified categories to specialized forms. Attach the downloaded current official form; do not rely on an old local copy.
5. REPRESENTATION AND CONFIDENTIAL INFORMATION
5.1 Representation
☐ Individual petitioner appears without counsel.
☐ North Carolina counsel appears: [NAME / BAR NUMBER].
☐ Business entity files the current OAH Notice of Non-Attorney Representation form.
For a business entity, § 150B-23(a) permits only the listed officer, LLC manager or member-manager, W-2 employee with written authorization, or at-least-25% owner with written authorization. Prior written notice must be made under penalty of perjury on the OAH form.
| Non-attorney representative item | Verified entry |
|---|---|
| Representative | [________________] |
| Statutory capacity | [________________] |
| W-2 status, if used | [________________] |
| Ownership percentage, if used | [____]% |
| Written authorization attached | ☐ Yes ☐ No ☐ Not applicable |
| Current OAH form attached | ☐ Yes ☐ No |
5.2 Confidential-information screen
The current official H-06 instructions warn against including confidential identifying information unless law or order expressly requires it. Before filing, inspect the petition and every attachment for:
☐ Social Security or taxpayer-identification numbers.
☐ Driver-license, State-ID, or passport numbers.
☐ Bank, credit-card, debit-card, PIN, or password information.
☐ Medical, student, personnel, trade-secret, or other protected information requiring a separate rule or sealing analysis.
Redaction or omission must preserve information the governing law or official form actually requires.
6. FORM H-06 COMPANION DRAFT
Use this section only for a general Article 3 matter after Sections 1-5 are complete. Transfer the final content to the current official H-06 or a counsel-approved petition.
6.1 Caption and parties
County of petitioner's residence: [________________]
Petitioner: [FULL LEGAL NAME]
Respondent State agency or board: [FULL OFFICIAL NAME]
Agency case / notice number: [________________]
6.2 Facts showing harm and agency error
On [__/__/____], Respondent [DESCRIBE THE FINAL OR REVIEWABLE ACTION]. Petitioner received or was given written notice on [__/__/____] by [METHOD]. The notice is attached as Exhibit [____].
The action affects Petitioner's rights, duties, or privileges as follows:
[____________________________________________________________]
[____________________________________________________________]
The material facts are:
-
[____________________________________________________________]
-
[____________________________________________________________]
-
[____________________________________________________________]
-
[____________________________________________________________]
6.3 Section 150B-23(a) allegation matrix
Check at least one harm category and at least one agency-error category only when supported by specific facts.
Harm / substantial prejudice:
☐ Deprived Petitioner of property: [FACTS].
☐ Ordered Petitioner to pay a fine or civil penalty of $[________________].
☐ Otherwise substantially prejudiced Petitioner's rights: [FACTS].
Agency error:
☐ Exceeded authority or jurisdiction: [FACTS AND AUTHORITY].
☐ Acted erroneously: [FACTS AND AUTHORITY].
☐ Failed to use proper procedure: [FACTS AND AUTHORITY].
☐ Acted arbitrarily or capriciously: [FACTS].
☐ Failed to act as required by law or rule: [FACTS AND AUTHORITY].
6.4 Amount in controversy
Amount in controversy, if applicable: $[________________]
Method used to calculate the amount: [________________]
6.5 Requested determination
Petitioner requests a contested case hearing and the relief the administrative law judge is authorized to grant under the governing program law and current Chapter 150B provisions, specifically:
[____________________________________________________________]
This draft does not promise attorney fees, a stay, damages, an injunction, or another remedy without separately verified authority.
6.6 Signature
Date: [__/__/____]
Telephone: [________________]
Email: [________________]
Mailing address: [____________________________________________________________]
Printed name: [________________]
Capacity: ☐ Petitioner ☐ Attorney ☐ Authorized non-attorney representative
Signature: ______________________________________
7. CERTIFICATE OF SERVICE COMPANION
Section 150B-23(a) requires service on all other parties and, in a license dispute, the license holder, plus filing of a certificate of service with the petition. The current H-06 instructions direct the filer to use the agency notice or current process-agent information to identify the person served.
I certify that on [__/__/____], I served the Petition and listed attachments on:
| Recipient | Capacity | Address / email | Method | Completion date and evidence |
|---|---|---|---|---|
| [________________] | Respondent agency / process agent | [________________] | ☐ Email ☐ Fax ☐ Personal delivery ☐ First-class mail ☐ Overnight service ☐ e-OAH | [________________] |
| [________________] | License holder, if different | [________________] | [________________] | [________________] |
| [________________] | Other party | [________________] | [________________] | [________________] |
The agency notice's service instructions were followed: ☐ Yes ☐ No ☐ Not provided
Printed name: [________________]
Signature: ______________________________________
Date: [__/__/____]
8. FILING CONTROL
The current OAH filing page states that an original petition must be filed with OAH and a copy served on the opposing party. It currently permits unregistered filers to use U.S. Mail, fax, or email, while registered e-filers must upload a Word or PDF document through the e-filing system and may not use fax or email.
8.1 Filing route selected
☐ Registered e-filer — upload through the current OAH system.
☐ Unregistered filer — U.S. Mail.
☐ Unregistered filer — fax to the current Clerk's Office number confirmed on [__/__/____].
☐ Unregistered filer — email with a PDF or Word attachment to the current Clerk's address confirmed on [__/__/____].
☐ Personal delivery under current OAH instructions.
☐ Different agency or specialized-form route: [________________].
8.2 Receipt record
| Item | Record |
|---|---|
| Filing sent / delivered | [DATE / TIME / METHOD] |
| Fee or waiver included | [________________] |
| OAH or agency receipt | [________________] |
| File-stamped copy / confirmation | [________________] |
| Service evidence | [________________] |
| Follow-up required | [________________] |
Do not treat transmission alone as proof of filing. Retain the accepted receipt, file stamp, portal confirmation, readable fax confirmation, or other evidence required by the selected route.
9. ATTACHMENT AND FINAL REVIEW CHECKLIST
☐ Current agency decision or notice.
☐ Current official petition or hearing-request form.
☐ Additional fact pages, if needed.
☐ Governing program statute, rule, or notice establishing the hearing right and deadline.
☐ Filing fee or current waiver / in forma pauperis request.
☐ Certificate of service.
☐ Current non-attorney representation form and authorization, if applicable.
☐ Documents required by the agency notice or specialized form.
☐ Confidential-information review completed.
☐ Every date, agency name, party name, address, citation, and requested remedy checked.
☐ Filing and service receipts retained.
10. POST-FILING HANDOFF
This packet intentionally does not supply generic discovery requests, subpoenas, mediation papers, a stay motion, a prehearing order, or a judicial-review petition. After acceptance, use the assigned order, the current OAH or agency rules, the governing program law, and any specialized procedure to create those documents.
| Post-filing control | Entry |
|---|---|
| Case number | [________________] |
| Assigned ALJ / hearing officer | [________________] |
| Scheduling or hearing notice | [________________] |
| Governing procedural rules | [________________] |
| Response / appearance deadline | [__/__/____] |
| Prehearing statement deadline | [__/__/____] |
| Discovery authority and deadline | [________________] |
| Mediation / settlement order | [________________] |
| Hearing date and location | [________________] |
| Final-decision and review calendar | [________________] |
OFFICIAL CURRENT-SOURCE LINKS
- North Carolina General Statutes, Chapter 150B section PDFs: https://www.ncleg.gov/Laws/GeneralStatutes
- OAH hearing forms: https://www.oah.nc.gov/hearings-division/filing/hearing-forms
- OAH filing instructions: https://www.oah.nc.gov/hearings-division/hearing-process/filing-contested-case
- OAH filing-fee page: https://www.oah.nc.gov/hearings-division/filing/contested-case-filing-fees
- Current General Petition Form H-06 page: https://www.oah.nc.gov/documents/form-h-06-general-petition-form
About this template
- Last updated
- August 21, 2026
- Citations checked
- August 21, 2026
- Jurisdiction
- North Carolina
- Category
- Administrative Law
Legal authority
- N.C. Gen. Stat. § 150B-2 (contested case and person-aggrieved definitions)
- N.C. Gen. Stat. § 150B-22 (informal settlement and contested-case commencement)
- N.C. Gen. Stat. § 150B-23 (Article 3 petition, service, contents, representation, and timing)
- N.C. Gen. Stat. § 150B-23.2 (filing fee, lesser fee by rule, and waiver)
- N.C. Gen. Stat. § 150B-38 (Article 3A scope and agency hearing)
- N.C. Gen. Stat. § 150B-40 (Article 3A hearing and requested ALJ)
Administrative law covers how you interact with government agencies, from filing a comment on a proposed rule to appealing a denied license or benefit. Agency processes have their own forms, deadlines, and evidence standards that are different from what courts use. Getting the paperwork wrong usually means missing a deadline or losing the right to appeal, so precision in these documents matters as much as it does in a courtroom filing.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on August 21, 2026.
N.C. Gen. Stat. § 150B-2(2), (6) (checked August 21, 2026): "‘Contested case’ means an administrative proceeding pursuant to this Chapter to resolve a dispute between an agency and another person that involves the person's rights, duties, or privileges, including licensing or the levy of a monetary penalty. ‘Person aggrieved’ means any person or group of persons of common interest directly or indirectly affected substantially in his, her, or its person, property, or employment by an administrative decision."
N.C. Gen. Stat. § 150B-22(a)-(b) (checked August 21, 2026): "It is the policy of this State that any dispute between an agency and another person that involves the person's rights, duties, or privileges ... should be settled through informal procedures. If the agency and the other person do not agree to a resolution of the dispute through informal procedures, either the agency or the person may commence an administrative proceeding."
N.C. Gen. Stat. § 150B-23(a) (checked August 21, 2026): "A contested case shall be commenced by paying a fee in an amount established in G.S. 150B-23.2 and by filing a petition with the Office of Administrative Hearings ... The party that files the petition shall serve a copy of the petition on all other parties ... [and] shall file a certificate of service together with the petition."
N.C. Gen. Stat. § 150B-23(a) — petition allegations (checked August 21, 2026): "A petition ... shall state facts tending to establish that the agency named as the respondent has deprived the petitioner of property, has ordered the petitioner to pay a fine or civil penalty, or has otherwise substantially prejudiced the petitioner's rights and that the agency ... exceeded its authority or jurisdiction, acted erroneously, failed to use proper procedure, acted arbitrarily or capriciously, or failed to act as required by law or rule."
Draft your Administrative Hearing Request Packet - North Carolina in the editor
Answer a few questions, let the AI editor draft each section from your answers, review it, and download Word and PDF. $99 one time, or $249 per month for every document and every Ezel app.