The California Department of Insurance's requirements for withdrawal as an insurer from California are set forth in California Insurance Code §§1070-1076. Use this form to confirm attendance for a scheduled Assessment Appeal hearing, request a postponement, or withdraw an appeal.Complete a request for withdrawal form. There is a standard form you must fill out with your name and contact information. Instead, the letter W (Withdrawal) will be recorded on the student's transcript. Billings for post-dispositional activities must be submitted within 60 days of the hearing with the exception of juvenile matters. When you appear for your Disability Retirement consultation, make sure you bring along the forms and that you have filled them out completely. As we move out of the PHE, you need to take action now to keep getting the same health care coverage. San Bernardino Meridian. Sch. School. Scn. Scenic. SCS. Subsistence camp site.