Osah Form 1 - Greab Application Form
ADVERTISEMENT
1OSAH FORM 1
This form is available online at
or by telephone request at (404)657-2800.
OSAH USE ONLY
AGENCY CODE
CASE TYPE
DOCKET NUMBER
COUNTY
JUDGE
DOCKET NUMBER
GREAB
GEORGIA REAL ESTATE APPRAISERS BOARD
NAME OF REFERRING AGENCY:
CHECK ONE:
DEN—Denial of License Application
SAN—Licensee Sanction
COUNTY OF NON-AGENCY PARTY’S RESIDENCE OR PRINCIPAL PLACE OF BUSINESS: __________________
DATE OF REQUEST FOR HEARING: _______________________
CONTACT PERSON IN REFERRING AGENCY
NAME:
TEL NO:
FAX NO:
POSITION
EMAIL:
CURRENT ADDRESS INCLUDING ZIP CODE
PAGER:
ATTORNEY FOR REFERRING AGENCY
ATTORNEY NAME:
TEL NO:
FAX NO:
EMAIL:
CURRENT ADDRESS INCLUDING ZIP CODE
GEORGIA BAR NO:
PAGER:
NON-AGENCY PARTY
(TO OSAH CLERK: IN DEN, PARTY IS APPLICANT)
NAME:
TEL NO:
FAX NO:
EMAIL:
CURRENT ADDRESS INCLUDING ZIP
PAGER:
NON-AGENCY PARTY’S ATTORNEY
(TO OSAH CLERK: IN DEN, PARTY IS APPLICANT’S ATTORNEY)
EMPLOYEE’S ATTORNEY NAME:
TEL NO:
FAX NO:
EMAIL:
CURRENT ADDRESS INCLUDING ZIP CODE
GEORGIA BAR NO:
PAGER:
:
PARTY REQUESTING THE HEARING
REFERRING AGENCY
NON-AGENCY PARTY
NON-AGENCY PARTY’S ATTORNEY
FOR PUPOSES OF THIS HEARING, THE PARTY INDICATED WILL BE
PETITIONER
RESPONDENT IN THIS MATTER.
:
DOCUMENT INITIATING THE HEARING
As “Attachment 1” to this form, attach the document initiating the hearing.
:
ISSUES TO BE RESOLVED
As “Attachment 2”, attach an outline of legal issues and factual matters to be resolved at the hearing
including specific statutes or rules to be applied at the hearing.
:
SPECIAL REQUIREMENTS
As “Attachment 3”, attach a sheet identifying any statutes or rule (state of federal) establishing any specific
time deadlines or procedures that are to be applied by OSAH in resolving the matter referred.
:
SERVICE OF DOCUMENTS
In addition to routine service on the agency’s attorney, the agency contact person requests the following:
No service of documents prior to certification of the file to the agency after a decision
service of all documents prior to certification of the file to the agency after a decision
service of a copy of the notice of hearing
service of a copy of a continuance
service of copy of any interim orders.
All documents will be mailed to the referring agency at the address indicated for the contact person to the contact person’s
attention unless written instructions provide an alternative place for service.
GREAB OSAH FORM 1 Revised 7/26/02
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal