Appeal decision details

Appeal Number

Enter the number of the appeal. This field is required.

Appeal Date

Enter the date the appeal was filed. Use the format MM/DD/YYYY. This field is required.

Appeal Type

Select the appeal type from the drop down

Appeal Decision

Select the final appeal decision. This field is required.

Appeal Decision Date

Select date of the appeal decision. Use the format MM/DD/YYYY. This field is required.

Appeal Officer

Enter the name of the appeal officer

Compliance Date

//SME: What's this?// Use for the format MM/DD/YYYY.

Comments

Enter any additional details about the appeal. You can enter up to 4,000 characters.