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<br />writing with the Chief of the WID Office. The request for review should contain the <br />following information: <br /> <br />a. Full name, address, and telephone number of the party requesting the review <br />b. Full name, address, and telephone number of the other party <br />c. A copy of the decision <br />d. Brief statement of reasons for review or the section of the L WIA decision to be <br />reviewed including regulatory and statutory citations <br />e. A statement of the relief sought. <br />3. Complainant Responsibility <br /> <br />It is the responsibility of the complainant to include in the request for review a written <br />statement setting forth the facts presented at the LWIA hearing which support the <br />requested relief. <br /> <br />The Chief, WID, shall mail a copy of the request for review to the other party and to the <br />LWIA. It shall be the responsibility of the LWIA to submit the complete record including a <br />typed record of the hearing to the Chief, WID, within ten (10) days. <br /> <br />B. Conduct of Hearings. <br /> <br />1. Request for Hearing at the State Level <br /> <br />If no decision has been issued at the LWIA level or the State has determined an audit <br />disallowance or imposed sanctions, the complainant may request a hearing. The <br />hearing officer will then issue a recommended decision to the State's Review Panel for <br />final determination. <br /> <br />2. Filing for Request for Review <br /> <br />The request for a State hearing shall be filed within ten (10) days after LWIA should <br />have issued a decision or ten (10) days after the issuance of the audit disallowance or <br />sanction. The request shall be filed directly with the Chief of the WID in writing and <br />should include the following: <br /> <br />a. Full name, address, and telephone number of the LWIA <br />b. Name, address, and telephone number of the LWIA <br />c. Copies of complaints made at LWIA level from which no decisions were <br />issued or sanctions and imposed. <br />d. A statement of basis for the request for hearing. <br />3. Evidentiary Hearing <br />Upon receipt of the request for a State level hearing, a hearing before a designated <br />hearing officer will be scheduled. <br /> <br />13 <br /> <br />EXHIBIT C <br />