Stay of Agency Enforcement Application - Indiana

ADMINISTRATIVE-LEVEL STAY GUIDE — NOT FOR EVERY ORDER

This file addresses a stay requested from an Indiana administrative law judge while
administrative review is pending. It is not a petition for a stay of a final order under
IC 4-21.5-3-31 and is not a court stay under IC 4-21.5-5-9. Classify the order before
selecting a statute.

Indiana Administrative Stay Application

1. Order-category gate

Agency: [________________________________]

Order: [________________________________]

Order date: [__/__/____]

Service date under IC 4-21.5-3-2: [__/__/____]

Effective date stated or calculated: [__/__/____]

Administrative cause or reference number: [________________________________]

Select the provision that actually covers the order:

☐ IC 4-21.5-3-4(e) — an order listed in § 3-4, including specified licensing or
personnel decisions.

☐ IC 4-21.5-3-5(h) — an order listed in § 3-5, including covered licensing,
financial-assistance, tax/liability, status, or other nonsanction decisions.

☐ IC 4-21.5-3-6(e) — an order listed in § 3-6, including specified sanctions or
terminations that become effective without a proceeding if review is not requested.

☐ IC 4-21.5-4-4 — an emergency or other temporary order issued without an
evidentiary proceeding; request the prompt hearing authorized by Chapter 4.

☐ Another agency-specific stay statute or rule: [________________________________]

☐ None applies — stop and identify the correct procedure.

Do not cite § 3-6 for every agency order. Do not cite § 3-7 as independent stay
authority; § 3-7 governs the petition for administrative review.

2. Review-petition prerequisite

For the administrative stay routes in §§ 3-4(e), 3-5(h), and 3-6(e), confirm the
underlying petition for review was timely filed under § 3-7 or other controlling law.

Review petition filed with: [________________________________]

Review petition filing date: [__/__/____]

Review deadline: [__/__/____]

For most orders within IC 4-21.5-3-4, -5, or -6, § 3-7(a)(3)(A) requires filing
with the ultimate authority within 15 days after notice, unless another statute supplies a
longer period. Apply § 3-2's computation rules, including the three added days when notice
is served by U.S. mail.

Proof of timely filing: [________________________________]

☐ Copy of review petition attached.

☐ Proof of filing attached.

3. Administrative stay application

BEFORE THE [AGENCY / OFFICE OF ADMINISTRATIVE LAW PROCEEDINGS]

Administrative Cause No.: [________________________________]

Application for Stay of Effectiveness

Applicant requests a stay under [IC 4-21.5-3-4(e) / -5(h) / -6(e) / OTHER] of
the following part of the agency's order dated [__/__/____]:

[____________________________________________________________]

1. Applicant filed the required petition for administrative review on [__/__/____].

2. Applicant is a party or is a person with a pending petition for intervention as required
   by the selected stay provision because:

[____________________________________________________________]

3. The selected statute applies to this order because:

[____________________________________________________________]

4. The order is scheduled to become effective, or became effective, on [__/__/____].

5. The specific facts and law supporting a stay are:

[____________________________________________________________]

[____________________________________________________________]

6. The evidence supporting those facts is:

7. Applicant requests a stay with this scope and these conditions:

[____________________________________________________________]

8. Applicant requests the preliminary hearing required by the selected provision as soon
   as practicable.

Requested relief

Applicant requests that the ALJ:

1. Schedule the preliminary hearing;
2. Stay the identified part of the order pending administrative review;
3. State the facts and law supporting the stay ruling; and
4. Grant any other relief authorized by the controlling law.

Applicant / Counsel: [________________________________]

Signature: [________________________________]

Date: [__/__/____]

4. Burden and evidence preparation

The person seeking a stay bears the burden of proof under §§ 3-4(e), 3-5(h), and
3-6(e). Those provisions do not state a universal irreparable-harm, likelihood-of-success,
balance-of-harms, and public-interest test. Address the facts and legal standard required by
the order-specific and agency-specific law; do not paste a federal four-factor test into every
application.

☐ Complete order and review-rights notice

☐ Petition for administrative review and filing proof

☐ Affidavit or declaration if required by agency rule

☐ Documents supporting the requested scope and conditions

☐ Witnesses needed for preliminary hearing

☐ Agency-specific rule or scheduling order

5. Emergency or temporary order route

When an agency issues an order under IC 4-21.5-4-2(a)(1) without notice or an
evidentiary proceeding, a party may request a hearing under § 4-4. The agency must set
the matter for an evidentiary hearing as quickly as practicable, and the ALJ determines
whether the order should be voided, terminated, modified, stayed, or continued.

Emergency-order hearing request:

Applicant requests a hearing under IC 4-21.5-4-4 concerning the order issued on
[__/__/____] and requests that the ALJ [void / terminate / modify / stay] the order
for these reasons:

[____________________________________________________________]

6. Service and filing record

Follow IC 4-21.5-3-1, the order, and the agency's rules.

7. Proposed administrative order

☐ Stay granted in full.

☐ Stay granted only as to: [________________________________]

☐ Stay denied.

Conditions: [________________________________]

Facts and law supporting ruling:

[____________________________________________________________]

Administrative Law Judge: [________________________________]

Date: [__/__/____]

Sources and References

• Indiana Code 2026, IC 4-21.5-3
• Indiana Code 2026, IC 4-21.5-4