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Form OMHA-119 Withdrawal of Request for Administrative Law Judge (Alj) Hearing or Review of Dimissal
What Is Form OMHA-119?
This is a legal form that was released by the U.S. Department of Health and Human Services on March 1, 2017 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is form OMHA-119?A: Form OMHA-119 is used to withdraw a request for an Administrative Law Judge (ALJ) hearing or review of dismissal.
Q: Who can use form OMHA-119?A: Any individual or entity who has requested an ALJ hearing or review of dismissal can use form OMHA-119 to withdraw their request.
Q: What is the purpose of form OMHA-119?A: The purpose of form OMHA-119 is to formally withdraw a request for an ALJ hearing or review of dismissal.
Q: How do I use form OMHA-119?A: To use form OMHA-119, fill out the required information, sign and date the form, and submit it to the appropriate address or fax number provided on the form.
Q: Is there a deadline for submitting form OMHA-119?A: There is no specific deadline for submitting form OMHA-119, but it is recommended to submit it as soon as possible after deciding to withdraw the request for an ALJ hearing or review of dismissal.
Q: Are there any fees associated with form OMHA-119?A: No, there are no fees associated with form OMHA-119.
Form Details:
- Released on March 1, 2017;
- The latest available edition released by the U.S. Department of Health and Human Services;
- Easy to use and ready to print;
- Yours to fill out and keep for your records;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form OMHA-119 by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services.
