Fill out an Effective Date Change Request Form if you're applying for a change in coverage start date or a change in coverage termination date. The agency must act within 10 days of the change report date to effect the benefit change and issue the notice of adverse action. â—‹.The permit applicant shall request the extension in writing no more than 30 days prior to the expiration of the issued permit. How do you write a vacate letter? Form to Accompany Miscellaneous Filings, Form. In this article, we explain why you may write a letter to inform your employer you want to change from a fulltime to a parttime position. This packet provides general guidance about writing a motion. A representative will be available to assist you Monday through Friday, 8 a.m. Note: The following sample pages say to "write" on the legal forms. Nevada Revised Statute 118A.