ADMINISTRATIVE PROCEDURES MANUAL
| ADDENDUM 109 C | FAIR HEARING REQUEST CANO |
SUBJECT |
ELEMENTS |
| RECORD TITLE | Fair Hearing Request |
| REQUEST DATE: | List date client request fair hearing. List which program(s) fair hearing is requested for. Document if the client is requesting continued benefits. |
| ISSUE: | Summarize the issue or reason for fair hearing request. |
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