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Get Ok 13mp003e (h-2) 2002-2024

, Legal Division P.O. Box 53025 Oklahoma City, OK 73152 To be completed by the local office Case name Case number Hearing number Date of this request Dear Sir or Madam: REQUEST I hereby request that you review the Oklahoma Department of Human Services' decision made on my appeal for the following reasons: I understand that for my request to be considered, my request must be made in writing within 30 days of the date of the decision letter on my appeal. SIGNATURE A. If the request for directo.

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