1. Date:
To:
2. Director Administrative Law Judge
From:
3. Last Name:
4. First Name:
5. Email Address:
6. Mailing Address:
7. Docket Number: Note the number on your Notice of Hearing. It will resemble the following format: 97A-1234-ROC
8. Motion and grounds (see OAH Rule R2-19-106) Rules
9. I have sent a copy of this motion to the following:
(include name address and method, e.g. mail, fax, e-mail, and the date sent.) (Party Addressee)
NOTE: Failure to send copies to all other parties may result in your motion not being acted upon.Rules
10. Placing a mark in the signature space below constitutes my certification
that I have read the document, that I have a good faith basis for submission of
the document, and that it is not filed for the purpose of delay or harassment.
Signature
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