ADMINISTRATIVE HEARING REQUEST PACKET
STATE OF WASHINGTON
ADJUDICATIVE PROCEEDING — RCW 34.05
PART I: COVER SHEET AND FILING INFORMATION
Case Information
| Field | Entry |
|---|---|
| Agency Case/Reference Number | [________________________________] |
| OAH Docket Number (if assigned) | [________________________________] |
| State Agency Issuing Action | [________________________________] |
| Agency Program/Division | [________________________________] |
| Date of Agency Action | [__/__/____] |
| Date Notice of Opportunity for Hearing Received | [__/__/____] |
| Filing Deadline (minimum 20 days from notice) | [__/__/____] |
| Date of This Filing | [__/__/____] |
Type of Agency Action Being Challenged
☐ Denial of License, Permit, or Certification
☐ Revocation of License, Permit, or Certification
☐ Suspension of License, Permit, or Certification
☐ Modification or Restriction of License, Permit, or Certification
☐ Denial of Benefits or Services
☐ Reduction, Suspension, or Termination of Benefits
☐ Imposition of Fine, Penalty, or Assessment
☐ Enforcement Action / Compliance Order
☐ Denial of Application
☐ Rate Determination or Adjustment
☐ Environmental Permit or Enforcement Action
☐ Unemployment Insurance Determination
☐ Industrial Insurance / Workers' Compensation Determination
☐ Other Agency Action: [________________________________]
Type of Proceeding
☐ Full Adjudicative Proceeding (RCW 34.05.413-.479)
☐ Brief Adjudicative Proceeding (RCW 34.05.482-.494)
☐ Unknown — to be determined by the agency
Petitioner / Applicant Information
| Field | Entry |
|---|---|
| Full Legal Name | [________________________________] |
| Title/Position (if applicable) | [________________________________] |
| Entity Name (if applicable) | [________________________________] |
| Entity Type | ☐ Individual ☐ Corporation ☐ LLC ☐ Partnership ☐ Government Entity ☐ Non-Profit ☐ Other: [____] |
| Street Address | [________________________________] |
| City, State, ZIP | [________________________________] |
| County | [________________________________] |
| Mailing Address (if different) | [________________________________] |
| Telephone Number | [________________________________] |
| Fax Number | [________________________________] |
| Email Address | [________________________________] |
| WA License/Registration Number (if applicable) | [________________________________] |
Attorney / Representative Information
| Field | Entry |
|---|---|
| Name | [________________________________] |
| WSBA Number | [________________________________] |
| Firm Name | [________________________________] |
| Street Address | [________________________________] |
| City, State, ZIP | [________________________________] |
| Telephone Number | [________________________________] |
| Fax Number | [________________________________] |
| Email Address | [________________________________] |
| Representation Type | ☐ Attorney ☐ Authorized Non-Attorney Representative ☐ Pro Se |
Respondent Agency Information
| Field | Entry |
|---|---|
| Agency Name | [________________________________] |
| Division/Program | [________________________________] |
| Contact Person | [________________________________] |
| Street Address | [________________________________] |
| City, State, ZIP | [________________________________] |
| Telephone Number | [________________________________] |
| Fax Number | [________________________________] |
| Email Address | [________________________________] |
PART II: APPLICATION FOR ADJUDICATIVE PROCEEDING
BEFORE THE [NAME OF AGENCY]
STATE OF WASHINGTON
In the Matter of:
[________________________________]
Agency Case No.: [________________________________]
APPLICATION FOR ADJUDICATIVE PROCEEDING
Pursuant to RCW 34.05.413
TO: [NAME OF AGENCY]
The undersigned Applicant, [________________________________] ("Applicant"), by and through [his/her/its/their] attorney, [________________________________], WSBA No. [____] (or appearing pro se), hereby applies for an adjudicative proceeding pursuant to the Washington Administrative Procedure Act, RCW 34.05, and respectfully states as follows:
Basis for Application
-
Agency Action Challenged: On or about [__/__/____], the [NAME OF AGENCY] ("Agency") issued [describe the specific agency action — e.g., a Notice of Denial, an Order of Revocation, a Determination regarding, a Notice of Intent to [revoke/suspend/deny/modify], etc.] ("Agency Action") pertaining to [________________________________].
-
Date of Notice: Applicant received notice of the Agency's action and of the opportunity to file an application for an adjudicative proceeding on [__/__/____].
-
Timeliness: Pursuant to RCW 34.05.413(2), the agency must allow at least twenty (20) days to apply for an adjudicative proceeding from the time notice is given of the opportunity to file. The notice was received on [__/__/____], making the minimum filing deadline [__/__/____]. This Application is timely filed on [__/__/____].
[If a different deadline applies under agency rules, state: The applicable filing deadline under [cite WAC provision] is [____] days, making the deadline [__/__/____].]
-
Statutory Authority for Hearing: Applicant is entitled to an adjudicative proceeding pursuant to:
- RCW 34.05.413 (commencement of adjudicative proceedings)
- RCW 34.05.410 (applicability of adjudicative proceedings)
- [________________________________] (specific enabling statute for the agency action at issue)
- [________________________________] (specific WAC provision, if applicable)
- [________________________________] (additional authority, if any) -
Statement of Reasons for Application: Applicant requests an adjudicative proceeding because: [________________________________].
-
Charges, Reasons, or Basis of Agency Action: The Agency's action is based upon the following stated reasons:
a. [________________________________]
b. [________________________________]
c. [________________________________]
d. [________________________________]
PART III: STATEMENT OF THE CASE
A. Parties
-
Applicant, [________________________________], is a [individual residing / corporation organized under the laws of Washington / limited liability company / partnership / other: ________________________________] with a principal place of [business / residence] located at [________________________________], County of [________________________________], State of Washington.
-
Respondent, [NAME OF AGENCY], is a state agency of the State of Washington, [created and existing under RCW Chapter ____ /] with offices located at [________________________________].
B. Factual Background
- [Provide a concise narrative of the factual background giving rise to the agency action being challenged. Include relevant dates, actions taken by both parties, communications exchanged, and the sequence of events leading to the agency's action.]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
- On or about [__/__/____], [describe the triggering event — e.g., Applicant submitted an application to the Agency for ____, the Agency initiated an investigation concerning ____, the Agency conducted a compliance review of ____, Applicant received a determination regarding ____, etc.].
[________________________________]
[________________________________]
[________________________________]
- On or about [__/__/____], the Agency [describe the agency's action — e.g., issued a Notice of Denial, served a Notice of Intent to Revoke, issued an Assessment, made a determination that ____, etc.].
[________________________________]
[________________________________]
[________________________________]
- The Agency's action was based upon the following stated reasons:
a. [________________________________]
b. [________________________________]
c. [________________________________]
d. [________________________________]
- Applicant contends that the Agency's action is [erroneous / outside the agency's statutory authority / unconstitutional / unsupported by substantial evidence / arbitrary and capricious / in violation of required procedures / other: ________________________________] for the reasons set forth herein.
C. Specific Agency Action Being Challenged
-
The specific agency action being challenged is: [________________________________].
-
A true and correct copy of the Agency's [notice / order / determination / decision] dated [__/__/____] is attached hereto as Exhibit A.
-
[If applicable: Applicant has previously [requested reconsideration / filed an internal appeal / sought informal review] on [__/__/____], which resulted in [________________________________]. Documentation is attached as Exhibit B.]
PART IV: JURISDICTIONAL STATEMENT
- Jurisdiction for this adjudicative proceeding is proper pursuant to:
a. RCW 34.05.410 — Provides that adjudicative proceedings are available in all cases of agency action where the agency is required by law to make a determination of the legal rights, duties, privileges, immunities, or other legal interests of specific parties.
b. RCW 34.05.413 — Governs the commencement of adjudicative proceedings. Provides that the agency shall allow at least twenty (20) days to apply for an adjudicative proceeding and that the application must contain specified information.
c. RCW 34.12.010 et seq. — Establishes the Office of Administrative Hearings (OAH) to conduct adjudicative proceedings assigned to it by agencies. [If applicable: The Agency has assigned this matter to OAH for hearing.]
d. [________________________________] — [Cite the specific enabling statute that requires or permits a hearing for the type of agency action at issue — e.g., RCW 50.32 (unemployment insurance), RCW 51.52 (workers' compensation), RCW 43.21B (environmental hearings board), RCW 18.____ (professional licensing), etc.].
-
Applicant has standing to apply for an adjudicative proceeding because [he/she/it] is a person whose legal rights, duties, privileges, or immunities are directly affected by the Agency's action.
-
This matter is ripe for adjudicative proceedings because the Agency has issued [a final order / a proposed action / a notice of intent / a determination] from which an adjudicative proceeding is available under the applicable statute.
-
Applicant has timely filed this Application within the period allowed by the Agency's notice and by RCW 34.05.413(2).
PART V: STATEMENT OF ISSUES
The following issues are presented for determination in this adjudicative proceeding:
Issue 1:
Whether the Agency's [describe the specific action — e.g., denial of Applicant's license, revocation of Applicant's certification, imposition of a penalty of $____, determination that Applicant is ineligible for ____] was [within the agency's statutory authority / supported by substantial evidence / consistent with applicable statutes and regulations / not arbitrary or capricious / in compliance with required procedures].
[________________________________]
Issue 2:
Whether the Agency [describe procedural or substantive issue — e.g., properly applied the standards set forth in RCW ____ or WAC ____, afforded Applicant the procedural protections required by law, considered all relevant evidence, violated Applicant's constitutional rights, etc.].
[________________________________]
Issue 3:
Whether [describe additional legal or factual issue — e.g., the evidence supports the Agency's finding that Applicant ____, the Agency's interpretation of RCW ____ or WAC ____ is correct, Applicant is entitled to the relief sought, etc.].
[________________________________]
Issue 4:
Whether [________________________________].
Issue 5:
Whether [________________________________].
(Applicant reserves the right to supplement this statement of issues as additional facts and legal issues become known through discovery and the course of proceedings.)
PART VI: STATEMENT OF FACTS
Applicant alleges the following facts in support of this Application:
Background Facts
-
[________________________________]
-
[________________________________]
-
[________________________________]
-
[________________________________]
-
[________________________________]
Facts Relating to Applicant's Compliance / Qualifications
-
[________________________________]
-
[________________________________]
-
[________________________________]
-
[________________________________]
-
[________________________________]
Facts Relating to the Agency's Action
-
[________________________________]
-
[________________________________]
-
[________________________________]
-
[________________________________]
-
[________________________________]
Facts Demonstrating Error in the Agency's Action
-
[________________________________]
-
[________________________________]
-
[________________________________]
-
[________________________________]
-
[________________________________]
Facts Relating to Harm and Prejudice
-
As a direct result of the Agency's action, Applicant has suffered and/or will suffer the following harm: [________________________________].
-
[________________________________]
-
[________________________________]
-
[________________________________]
-
[________________________________]
(Applicant reserves the right to supplement this Statement of Facts as additional facts become known through discovery and investigation.)
PART VII: LEGAL BASIS FOR CHALLENGE
Applicant challenges the Agency's action on the following legal grounds:
Ground 1: The Agency's Action Is Outside Its Statutory Authority
-
Under RCW 34.05.570(3)(b), an agency action may be reversed if the order is outside the statutory authority or jurisdiction of the agency. The Agency's action exceeds its authority because: [________________________________].
-
[________________________________]
Ground 2: The Agency's Action Is Not Supported by Substantial Evidence
-
Under RCW 34.05.570(3)(e), an agency action may be reversed if the agency's order is not supported by evidence that is substantial when viewed in light of the whole record before the court, including the agency record for judicial review, supplemented by any additional evidence received by the court. The Agency's action fails this standard because: [________________________________].
-
[________________________________]
Ground 3: The Agency's Action Is Arbitrary or Capricious
-
Under RCW 34.05.570(3)(i), an agency action may be reversed if the order is arbitrary or capricious. The Agency's action is arbitrary or capricious because: [________________________________].
-
[________________________________]
Ground 4: The Agency Committed an Error of Law
- Under RCW 34.05.570(3)(d), an agency action may be reversed if the agency has erroneously interpreted or applied the law. The Agency misinterpreted or misapplied the following statutes or rules:
a. [________________________________], in that: [________________________________].
b. [________________________________], in that: [________________________________].
- [________________________________]
Ground 5: The Agency Failed to Follow Required Procedures
-
Under RCW 34.05.570(3)(c), an agency action may be reversed if the order was made upon unlawful procedure. The Agency failed to follow the procedural requirements of [RCW ____ / WAC ____] in that: [________________________________].
-
[________________________________]
Ground 6: The Agency's Action Violates Constitutional Rights
-
Under RCW 34.05.570(3)(a), an agency action may be reversed if the order violates constitutional provisions on its face or as applied. The Agency's action violates Applicant's rights under [the Washington Constitution, Article ____, Section ____ / the United States Constitution, Amendment ____], specifically: [________________________________].
-
[________________________________]
Ground 7: Additional Legal Grounds
-
[________________________________]
-
[________________________________]
(Applicant reserves the right to assert additional legal grounds as the case develops.)
PART VIII: RELIEF REQUESTED
WHEREFORE, Applicant respectfully requests that the presiding officer and/or the Agency:
-
Grant this Application and schedule a full adjudicative proceeding in this matter in accordance with RCW 34.05.
-
Reverse, set aside, and vacate the Agency's [describe the specific action — e.g., denial, revocation, suspension, penalty, determination, etc.] dated [__/__/____].
-
Order the Agency to [describe the affirmative relief sought — e.g., grant Applicant's application for ____, reinstate Applicant's license/certification, restore Applicant's benefits, etc.].
-
Stay the Agency's action pending the completion of this adjudicative proceeding, as more fully set forth in Part IX below.
-
Award Applicant costs and reasonable attorney's fees pursuant to RCW 4.84.350 (Equal Access to Justice Act) and/or [other applicable authority], if applicable.
-
Grant such other and further relief as the presiding officer and/or Agency deems just and equitable.
PART IX: REQUEST FOR STAY OF AGENCY ACTION
Application for Stay Pending Adjudicative Proceeding
Applicant hereby requests that the Agency's action be stayed pending the completion of this adjudicative proceeding and the issuance of a final order.
Basis for Stay
-
Statutory Basis: Under RCW 34.05.467(1), the presiding officer may issue a stay or other temporary remedy during the pendency of an adjudicative proceeding if the presiding officer finds that the party requesting the stay is likely to prevail on the merits, that the party will suffer irreparable injury without the stay, and that the stay will not substantially harm other parties and is not adverse to the public interest.
-
Likelihood of Success on the Merits: Applicant has a reasonable likelihood of prevailing on the merits because: [________________________________].
-
Irreparable Harm: Applicant will suffer irreparable injury if the Agency's action is not stayed because: [________________________________].
-
No Substantial Harm to Other Parties: A stay will not substantially harm other parties to this proceeding because: [________________________________].
-
Public Interest: A stay would not be adverse to the public interest because: [________________________________].
Specific Stay Requested
Applicant requests that the following specific stay be entered:
[________________________________]
[________________________________]
[________________________________]
Duration of Stay
Applicant requests that the stay remain in effect until:
☐ The completion of the adjudicative proceeding and issuance of a final order
☐ Further order of the presiding officer or agency
☐ Other: [________________________________]
PART X: DISCOVERY REQUESTS
A. Request for Production of Documents
Pursuant to WAC 10-08-120 (or the agency's applicable discovery rules), Applicant requests that the Respondent Agency produce the following documents:
-
A complete copy of the administrative file and record relating to the Agency's action being challenged, including all documents, memoranda, correspondence, reports, and other materials considered by the Agency.
-
All internal memoranda, emails, notes, and communications relating to the Agency's investigation, review, or decision-making process concerning Applicant.
-
All inspection reports, investigation reports, audit reports, or compliance reviews relating to Applicant or the subject matter of this proceeding.
-
All policies, procedures, guidelines, manuals, and interpretive statements used by the Agency in making the type of determination at issue in this case.
-
All records of comparable cases in which the Agency has taken similar action against similarly situated parties.
-
All documents the Agency intends to introduce as evidence at the hearing.
-
The names and addresses of all witnesses the Agency intends to call at the hearing and a summary of their expected testimony.
-
[________________________________]
-
[________________________________]
-
[________________________________]
B. Interrogatories
Applicant propounds the following interrogatories to the Respondent Agency:
-
Identify all persons who participated in the investigation, review, evaluation, or decision-making process leading to the Agency's action challenged in this proceeding.
-
State the complete factual basis for the Agency's action, including all facts relied upon in making the determination.
-
Identify all documents, records, and other materials reviewed or relied upon by the Agency in reaching the action being challenged.
-
Describe in detail the procedures and standards applied by the Agency in reaching its determination.
-
State whether the Agency has taken comparable action against other similarly situated parties, and if so, identify those cases and describe the outcomes.
-
Identify all expert witnesses the Agency intends to call at the hearing, along with their qualifications and expected testimony.
-
[________________________________]
-
[________________________________]
C. Request for Subpoenas
Pursuant to RCW 34.05.446(2) and WAC 10-08-130 (or the agency's applicable rules), Applicant requests the issuance of subpoenas for the following witnesses and/or documents:
| No. | Witness / Entity | Type | Subject Matter |
|---|---|---|---|
| 1 | [________________________________] | ☐ Testimony ☐ Duces Tecum ☐ Both | [________________________________] |
| 2 | [________________________________] | ☐ Testimony ☐ Duces Tecum ☐ Both | [________________________________] |
| 3 | [________________________________] | ☐ Testimony ☐ Duces Tecum ☐ Both | [________________________________] |
| 4 | [________________________________] | ☐ Testimony ☐ Duces Tecum ☐ Both | [________________________________] |
| 5 | [________________________________] | ☐ Testimony ☐ Duces Tecum ☐ Both | [________________________________] |
Note: Under RCW 34.05.446(2), the presiding officer, at the request of any party, may issue subpoenas for the attendance of witnesses and for the production of documents. Subpoenas shall be served and enforced in the manner provided by the civil rules of superior court.
PART XI: WITNESS LIST
Applicant identifies the following witnesses who may be called to testify at the hearing:
Fact Witnesses
| No. | Witness Name | Address / Contact | Subject of Testimony |
|---|---|---|---|
| 1 | [________________________________] | [________________________________] | [________________________________] |
| 2 | [________________________________] | [________________________________] | [________________________________] |
| 3 | [________________________________] | [________________________________] | [________________________________] |
| 4 | [________________________________] | [________________________________] | [________________________________] |
| 5 | [________________________________] | [________________________________] | [________________________________] |
Expert Witnesses
| No. | Expert Name | Qualifications / Area of Expertise | Subject of Testimony |
|---|---|---|---|
| 1 | [________________________________] | [________________________________] | [________________________________] |
| 2 | [________________________________] | [________________________________] | [________________________________] |
| 3 | [________________________________] | [________________________________] | [________________________________] |
(Applicant reserves the right to supplement this witness list prior to and during the hearing.)
PART XII: EXHIBIT LIST
Applicant identifies the following exhibits that may be introduced at the hearing:
| Exhibit | Description | Date | Pages |
|---|---|---|---|
| A | Agency [Notice/Order/Determination/Decision] dated [__/__/____] | [__/__/____] | [____] |
| B | [________________________________] | [__/__/____] | [____] |
| C | [________________________________] | [__/__/____] | [____] |
| D | [________________________________] | [__/__/____] | [____] |
| E | [________________________________] | [__/__/____] | [____] |
| F | [________________________________] | [__/__/____] | [____] |
| G | [________________________________] | [__/__/____] | [____] |
| H | [________________________________] | [__/__/____] | [____] |
| I | [________________________________] | [__/__/____] | [____] |
| J | [________________________________] | [__/__/____] | [____] |
(Applicant reserves the right to supplement this exhibit list prior to and during the hearing.)
PART XIII: CERTIFICATE OF SERVICE
CERTIFICATE OF SERVICE
I, [________________________________], hereby certify that on this [____] day of [________________________________], [________], a true and correct copy of the foregoing Application for Adjudicative Proceeding, together with all exhibits and attachments, was served upon the following by the method(s) indicated:
Respondent Agency:
Name: [________________________________]
Division/Program: [________________________________]
Address: [________________________________]
City, State, ZIP: [________________________________]
☐ Personal Service
☐ Certified Mail, Return Receipt Requested (Tracking No.: [________________________________])
☐ First Class U.S. Mail, Postage Prepaid
☐ Facsimile (Fax No.: [________________________________])
☐ Electronic Mail (Email: [________________________________])
☐ Electronic Filing (OAH Participant Portal or agency e-filing system)
Agency Attorney / Assistant Attorney General (if known):
Name: [________________________________]
Address: [________________________________]
City, State, ZIP: [________________________________]
☐ Personal Service
☐ Certified Mail, Return Receipt Requested (Tracking No.: [________________________________])
☐ First Class U.S. Mail, Postage Prepaid
☐ Facsimile (Fax No.: [________________________________])
☐ Electronic Mail (Email: [________________________________])
Additional Party (if applicable):
Name: [________________________________]
Address: [________________________________]
City, State, ZIP: [________________________________]
☐ Personal Service
☐ Certified Mail, Return Receipt Requested
☐ First Class U.S. Mail, Postage Prepaid
☐ Facsimile
☐ Electronic Mail
Signature: [________________________________]
Name: [________________________________]
Date: [__/__/____]
PART XIV: VERIFICATION / DECLARATION
DECLARATION UNDER PENALTY OF PERJURY
I, [________________________________], declare under penalty of perjury under the laws of the State of Washington that the following is true and correct:
-
I am the Applicant in this matter [or: I am the [title] of [entity name], the Applicant in this matter, and am authorized to execute this Declaration on behalf of the Applicant].
-
I have read the foregoing Application for Adjudicative Proceeding, including all attachments and exhibits, and the statements of fact contained therein are true and correct to the best of my knowledge, information, and belief.
-
I understand that if any of the foregoing statements are willfully false, I may be subject to penalties for perjury under RCW 9A.72.
Signed at [________________________________] (city), Washington, on this [____] day of [________________], [________].
Signature: [________________________________]
Name (Printed): [________________________________]
Title (if applicable): [________________________________]
Note: Under Washington law, a declaration under penalty of perjury may be used in lieu of a notarized affidavit in most circumstances. RCW 9A.72.085. The declaration must state that it is certified or declared under penalty of perjury under the laws of the State of Washington, must be signed, and must include the date and place of execution.
NOTARIZED AFFIDAVIT (If Required by Agency)
STATE OF WASHINGTON
COUNTY OF [________________________________]
Before me, the undersigned authority, personally appeared [________________________________], who, being duly sworn, deposes and states that the facts set forth in the foregoing Application for Adjudicative Proceeding are true and correct to the best of [his/her] knowledge, information, and belief.
Signature: [________________________________]
Name (Printed): [________________________________]
Date: [__/__/____]
Sworn to and subscribed before me
this [____] day of [________________], [________].
[________________________________]
Notary Public in and for the State of Washington
Residing at: [________________________________]
My Commission Expires: [__/__/____]
(Notary Seal)
PART XV: SIGNATURE BLOCK
Respectfully submitted,
Signature: [________________________________]
Name: [________________________________]
WSBA Number: [________________________________]
Firm Name: [________________________________]
Address: [________________________________]
City, State, ZIP: [________________________________]
Telephone: [________________________________]
Fax: [________________________________]
Email: [________________________________]
Date: [__/__/____]
Attorney for Applicant [________________________________]
— OR, if Pro Se —
Signature: [________________________________]
Name: [________________________________]
Address: [________________________________]
City, State, ZIP: [________________________________]
Telephone: [________________________________]
Email: [________________________________]
Date: [__/__/____]
Applicant, Pro Se
PART XVI: FILING INSTRUCTIONS AND CHECKLIST
Filing Checklist
Complete the following checklist before submitting the application:
Document Preparation
☐ Application for Adjudicative Proceeding completed in full
☐ All fillable fields completed with accurate information
☐ Statement of the Case includes complete factual background
☐ Jurisdictional Statement identifies applicable statutes (RCW and WAC)
☐ Statement of Issues clearly identifies legal and factual questions
☐ Statement of Facts provides detailed, numbered factual allegations
☐ Legal Basis for Challenge identifies specific statutes, rules, and legal standards
☐ Relief Requested clearly and specifically stated
☐ Request for Stay completed (if applicable)
☐ Discovery Requests and subpoena requests prepared (if filing contemporaneously)
☐ Witness List prepared (preliminary)
☐ Exhibit List prepared with copies of referenced documents
☐ Certificate of Service completed
☐ Declaration under penalty of perjury executed (or notarized affidavit, if required)
☐ Signature block completed
Critical Deadline Verification
☐ Date of notice of opportunity to apply for hearing confirmed: [__/__/____]
☐ Filing deadline calculated (minimum 20 days from notice, per RCW 34.05.413(2), or as specified by agency rule): [__/__/____]
☐ This application is being filed on or before the deadline: ☐ Yes ☐ No
☐ IMPORTANT: Failure to file within the time limit results in DEFAULT and loss of the right to an adjudicative proceeding (RCW 34.05.440)
Copies and Attachments
☐ Original plus [____] copies prepared (check agency or OAH requirements)
☐ Copy of Agency Notice/Order/Determination attached as Exhibit A
☐ Copy of any prior correspondence with the Agency attached
☐ Supporting documentation organized and labeled
Filing Method
☐ Filing method confirmed: ☐ In Person ☐ U.S. Mail ☐ Certified Mail ☐ OAH Participant Portal ☐ Agency E-filing ☐ Fax
☐ Filing fee paid (if applicable): $[____]
☐ Filed with the correct agency or OAH office (as directed by the agency)
Service
☐ Copy served on the Respondent Agency
☐ Copy served on Agency Attorney / Assistant Attorney General (if known)
☐ Copy served on all other parties (if applicable)
☐ Proof of service retained
☐ Certificate of Service completed and filed
Post-Filing
☐ Confirmation of receipt obtained
☐ Determine whether the matter will be heard by OAH or by the agency
☐ Calendar prehearing conference date (when scheduled)
☐ Calendar discovery deadlines (when established)
☐ Calendar hearing date (when scheduled)
☐ Calendar 30-day judicial review deadline (from final order)
Filing Addresses
If Filing with the Agency:
Agency Name: [________________________________]
Filing Address: [________________________________]
City, State, ZIP: [________________________________]
Attn: [________________________________]
Phone: [________________________________]
Fax: [________________________________]
Email/E-filing: [________________________________]
If the Matter is Assigned to OAH:
Office of Administrative Hearings
Headquarters: P.O. Box 42488, Olympia, WA 98504-2488
Phone: (360) 407-2700
Fax: (360) 586-6563
Spokane Office: 16201 E. Indiana Ave., Suite 5600, Spokane Valley, WA 99216
Phone: (509) 456-3975
Fax: (509) 456-3980
OAH Participant Portal: https://secureaccess.wa.gov/
Website: https://oah.wa.gov/
PART XVII: WASHINGTON-SPECIFIC PRACTICE NOTES
A. Overview of Washington Administrative Hearing Process
-
Administrative Procedure Act (APA): Washington's Administrative Procedure Act, codified at RCW 34.05, governs all administrative proceedings before state agencies. The APA applies to all adjudicative proceedings unless a specific statute provides otherwise.
-
Adjudicative Proceeding Defined: Under RCW 34.05.010(1), an "adjudicative proceeding" means a proceeding before an agency in which an opportunity for hearing before that agency is required by statute or constitutional right before or after the entry of an order by the agency. This includes all cases of licensing and rate making in which an application is denied, or a license is revoked, suspended, or modified.
-
Office of Administrative Hearings (OAH): The OAH is an independent state agency created by RCW 34.12 to conduct hearings on behalf of other state agencies. OAH's mandate is that hearings shall be conducted "with the greatest degree of informality consistent with fairness and the nature of the proceeding." RCW 34.12.010.
-
OAH vs. Agency Hearings: Some agencies assign their adjudicative proceedings to OAH, while others conduct their own hearings using agency hearing examiners. The agency's enabling statute and regulations determine which body conducts the hearing.
B. Application and Filing Procedures
-
Filing Requirement (RCW 34.05.413): An agency may provide forms for and require that an application be in writing, filed at a specific address, in a specified manner, and within specified time limits.
-
Minimum 20-Day Filing Period: The agency must allow at least twenty (20) days to apply for an adjudicative proceeding from the time notice is given of the opportunity to file (RCW 34.05.413(2)). Agency rules may provide a longer period.
-
Default (RCW 34.05.440): Failure to file an application within the time limit constitutes a default and results in the loss of the party's right to an adjudicative proceeding. This is a critical deadline.
-
Contents of Application: Under RCW 34.05.413, the application must contain the information required by the agency's rules, typically including the applicant's name and contact information, identification of the agency action being challenged, and the reasons for the request.
C. Types of Adjudicative Proceedings
-
Full Adjudicative Proceeding: A full hearing with oral testimony, cross-examination, presentation of exhibits, and a formal record. This is the default type of proceeding under RCW 34.05.413-.479.
-
Brief Adjudicative Proceeding (BAP): Under RCW 34.05.482-.494, agencies may use a brief adjudicative proceeding when the issues can be resolved based on documents alone, without the need for a full hearing. A BAP is decided by the presiding officer based on written submissions. Parties receive written notice and may submit written evidence.
-
Conversion from BAP: A party in a brief adjudicative proceeding who is dissatisfied with the initial order may request a full adjudicative proceeding. The request must be made in accordance with agency rules.
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Emergency Adjudicative Proceedings: Under RCW 34.05.479, an agency may take emergency action without prior notice or hearing if immediate agency action is necessary for the protection of the public interest.
D. Hearing Procedures
-
Notice of Hearing (RCW 34.05.434): The agency must provide notice of the hearing, including the time, place, and nature of the proceeding; a statement of the legal authority and jurisdiction under which the hearing is to be held; the issues involved; and a reference to the particular sections of the statutes and rules involved.
-
Presiding Officer: Hearings are conducted by a presiding officer, which may be an Administrative Law Judge (ALJ) from OAH, an agency hearing examiner, or a member of the agency head. The presiding officer has authority to administer oaths, issue subpoenas, rule on evidence, regulate the course of the hearing, and issue initial orders or final orders (RCW 34.05.422, .425, .446, .449).
-
Evidence Rules (RCW 34.05.452): Evidence, including hearsay evidence, is admissible if in the judgment of the presiding officer it is of the kind on which reasonably prudent persons are accustomed to rely in the conduct of their affairs. The presiding officer has discretion to exclude evidence that is irrelevant, immaterial, or unduly repetitious. The Washington Rules of Evidence do not strictly apply.
-
Burden of Proof: The party asserting the affirmative of a factual issue bears the burden of proof. In license revocation and enforcement cases, the agency bears the burden. The standard is typically preponderance of the evidence.
-
Subpoenas (RCW 34.05.446(2)): Upon request of any party, the presiding officer may issue subpoenas for the attendance of witnesses and for the production of documents. Subpoenas are served and enforced in the manner provided by the civil rules of superior court.
-
Record: The presiding officer shall cause the hearing to be recorded by a method chosen by the agency. The recording or transcription is part of the record. Parties may request a transcription at their own expense.
E. Orders and Decisions
-
Initial Order (RCW 34.05.461): When the presiding officer is not the agency head, the presiding officer issues an "initial order." The initial order includes findings of fact, conclusions of law, and an order. The initial order becomes the final order unless a party petitions for administrative review or the agency head exercises review on its own initiative.
-
Review of Initial Order (RCW 34.05.464): Any party may petition the agency head for review of an initial order. The petition must be filed within the time specified in the initial order, typically twenty-one (21) days. The agency head may affirm, modify, or reverse the initial order, or remand the matter.
-
Final Order: The agency head's order on review, or the initial order if no petition for review is filed and no review is taken, becomes the final order of the agency.
F. Brief Adjudicative Proceeding (BAP) Details
-
Applicability (RCW 34.05.482): Agencies may use BAPs when the applicable statute or rule does not require the agency to give notice and an opportunity to participate in a hearing and the issues can be resolved on the basis of the record.
-
Procedure: In a BAP, the presiding officer reviews the written record and documentary evidence. There is typically no oral testimony or live hearing. The parties may submit written statements, declarations, and documents.
-
Initial Order: The presiding officer issues a brief written initial order.
-
Review of BAP Order: A party may request a full adjudicative proceeding within twenty-one (21) days of the brief adjudicative proceeding initial order, unless otherwise provided by agency rule.
G. Judicial Review
-
Right to Judicial Review (RCW 34.05.510): A person who has exhausted all administrative remedies available within the agency is entitled to judicial review of a final agency order.
-
30-Day Filing Deadline: A petition for judicial review must be filed within thirty (30) days after service of the final order (RCW 34.05.542(2)).
-
Where to File: The petition for judicial review must be filed in the superior court of Thurston County or in the superior court of the county where the petitioner resides or has a principal place of business (RCW 34.05.514).
-
Standard of Review (RCW 34.05.570(3)): The court may grant relief from an agency order only if it determines that a person has been substantially prejudiced by the order and that the order is:
- (a) In violation of constitutional provisions;
- (b) In excess of the statutory authority or jurisdiction of the agency;
- (c) The result of unlawful procedure;
- (d) An erroneous interpretation or application of the law;
- (e) Not supported by substantial evidence when viewed in light of the whole record;
- (f) Arbitrary or capricious; or
- (g) Outside the range of discretion delegated to the agency. -
Stay Pending Judicial Review: Under RCW 34.05.550, a party may apply to the reviewing court for a stay of the agency's final order pending judicial review.
-
Attorney's Fees: Under the Washington Equal Access to Justice Act (RCW 4.84.350), a qualifying party may be awarded reasonable attorney's fees if the party prevails and the agency's action was not substantially justified.
H. Important Washington Timelines
| Action | Deadline | Authority |
|---|---|---|
| Apply for adjudicative proceeding | At least 20 days from notice (agency may provide longer) | RCW 34.05.413(2) |
| Default for failure to apply | Upon expiration of application period | RCW 34.05.440 |
| Notice of hearing | Reasonable notice before hearing | RCW 34.05.434 |
| Petition for review of initial order | Typically 21 days (check initial order) | RCW 34.05.464 |
| Review of BAP initial order | 21 days (unless agency rule differs) | RCW 34.05.491 |
| Petition for judicial review | 30 days after service of final order | RCW 34.05.542(2) |
| Stay pending judicial review | Filed with reviewing court | RCW 34.05.550 |
I. Common Washington Agencies and Hearing Bodies
| Agency | Common Case Types | Hearing Body |
|---|---|---|
| Employment Security Department (ESD) | Unemployment insurance | OAH (RCW 50.32) |
| Dept. of Labor & Industries (L&I) | Workers' compensation, safety | Board of Industrial Insurance Appeals (BIIA) |
| Dept. of Social and Health Services (DSHS) | Public assistance, child welfare | OAH |
| Dept. of Health (DOH) | Professional licensing | OAH |
| Dept. of Licensing (DOL) | Driver's license, business licensing | OAH |
| Dept. of Ecology | Environmental permits, enforcement | Pollution Control Hearings Board (PCHB) |
| Dept. of Revenue (DOR) | Tax determinations | Board of Tax Appeals |
| Dept. of Children, Youth & Families (DCYF) | Child care licensing, child welfare | OAH |
| Office of Insurance Commissioner | Insurance regulation | OAH |
| Utilities and Transportation Commission | Utility rates, transportation | UTC ALJs |
| Other: [________________________________] | [________________________________] | [________________________________] |
NOTE: Always verify the current filing address, required forms, hearing body, and any agency-specific filing requirements before submitting. Addresses and procedures may change.
PART XVIII: APPENDIX — RELEVANT STATUTORY PROVISIONS
Washington Administrative Procedure Act — RCW 34.05 (Selected Provisions)
RCW 34.05.010 — Definitions
(1) "Adjudicative proceeding" means a proceeding before an agency in which an opportunity for hearing before that agency is required by statute or constitutional right before or after the entry of an order by the agency. Adjudicative proceedings also include all cases of licensing and rate making in which an application for a license or rate change is denied, or a license is revoked, suspended, or modified, or in which the granting of an application is contested by a person having standing to contest under the law...
RCW 34.05.413 — Commencement — When Required
(1) In a matter involving an adjudicative proceeding, an agency or a party to a proceeding, as provided by agency rule, may commence the proceeding...
(2) The agency shall allow at least twenty days to apply for an adjudicative proceeding from the time notice is given of the opportunity to file such an application...
RCW 34.05.434 — Notice of Hearing
In an adjudicative proceeding, the agency shall serve or provide notice of hearing that includes the following: (a) The names and mailing addresses of all parties to whom notice is being given and, if known, the names and addresses of their representatives; (b) The time and place of the hearing; (c) A statement of the nature of the proceeding; (d) A statement of the legal authority and jurisdiction under which the hearing is to be held; (e) A reference to the particular sections of the statutes and rules involved; (f) A short and plain statement of the matters asserted by the agency...
RCW 34.05.440 — Default
(1) If a party fails to attend or participate in a prehearing conference, hearing, or other stage of an adjudicative proceeding, the presiding officer may serve upon all parties a default or dismissal order, which shall include a statement of the grounds for the order...
(2) Failure of a party to file an application for an adjudicative proceeding within the time limit or limits established by statute or agency rule constitutes a default and results in the loss of that party's right to an adjudicative proceeding...
RCW 34.05.449 — Orders
(1) An order shall include a statement of findings and conclusions, and the reasons and basis therefor, on all the material issues of fact, law, or discretion presented on the record, including the remedy prescribed and, if applicable, the action taken on a petition for a stay of effectiveness...
RCW 34.05.452 — Evidence — Subpoenas
(1) Upon proper objection, the presiding officer shall exclude evidence that is excludable on constitutional or statutory grounds or on the basis of evidentiary privilege recognized in the courts of this state...
(3) Evidence, including hearsay evidence, is admissible if in the judgment of the presiding officer it is the kind of evidence on which reasonably prudent persons are accustomed to rely in the conduct of their affairs...
RCW 34.05.570 — Judicial Review — Standard of Review
(3) The court shall grant relief from an agency order in an adjudicative proceeding only if it determines that:
(a) The order, or the statute or rule on which the order is based, is in violation of constitutional provisions on its face or as applied;
(b) The order is outside the statutory authority or jurisdiction of the agency conferred by any provision of law;
(c) The agency has engaged in unlawful procedure or decision-making process, or has failed to follow a prescribed procedure;
(d) The agency has erroneously interpreted or applied the law;
(e) The order is not supported by evidence that is substantial when viewed in light of the whole record before the court...
(f) The agency action is a clearly unwarranted exercise of discretion;...
(i) The order is arbitrary or capricious...
Office of Administrative Hearings — RCW 34.12 (Selected Provisions)
RCW 34.12.010 — Purpose
There is hereby established an office of administrative hearings. Hearings shall be conducted with the greatest degree of informality consistent with fairness and the nature of the proceeding...
RCW 34.12.020 — Definitions
..."Hearing" means an adjudicative proceeding within the meaning of RCW 34.05.010(1) conducted by a state agency under RCW 34.05.413 through 34.05.476...
Sources and References
- Washington Administrative Procedure Act, RCW 34.05: https://app.leg.wa.gov/rcw/default.aspx?cite=34.05
- Office of Administrative Hearings, RCW 34.12: https://app.leg.wa.gov/rcw/default.aspx?cite=34.12
- Washington Office of Administrative Hearings: https://oah.wa.gov/
- OAH About Page: https://oah.wa.gov/about-oah/about-office-administrative-hearings
- Model Rules of Procedure, WAC 10-08: https://app.leg.wa.gov/wac/default.aspx?cite=10-08
- Washington State Legislature: https://leg.wa.gov/
- Ballotpedia — Washington APA: https://ballotpedia.org/Washington_Administrative_Procedure_Act
- RCW 34.05.570 (Judicial Review): https://law.justia.com/codes/washington/title-34/chapter-34-05/section-34-05-570/
This template is provided by ezel.ai for informational purposes only. It does not constitute legal advice and should not be used as a substitute for consultation with a qualified attorney licensed in Washington. Administrative hearing procedures vary significantly by agency and case type. Always verify current statutes, rules, and filing requirements before submitting any documents.
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