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Click ‘Get Form’ to open the oshab appeal form 100 in the editor.
Begin with Section A: Citation Information. Fill in your Case (Inspection) #, Issuance date, Employer name, Reporting ID#, and Date Citation Received. Ensure all details match your citation for accuracy.
Continue by providing your Employer contact information including address, primary and secondary phone numbers, and email address. Select your preferred method of service—either U.S. Postal Service or Email.
If applicable, complete Section B: Representative Information with details about your representative's firm name, contact information, and preferred method of service.
In Section C: Contact Information and Signature, indicate whether you are the employer or representative. Sign and date the form to confirm your understanding of responsibilities.
Finally, move to Section D: Appeal Information. Specify what you are appealing and check any relevant grounds for appeal. Provide any affirmative defenses if applicable.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (107 Votes)
2016	4.3 Satisfied (92 Votes)
2014	4.4 Satisfied (51 Votes)

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