Request for departmental action fee transmittal form 2011-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Request Information' section. Enter the project location, including street address, city/town, and zip code. Ensure you also provide the check number and fee amount.
3. Next, identify the person or party making the request. Fill in their name, mailing address, city/town, state, phone number, and fax number if applicable.
4. Complete the applicant's information as shown on the Notice of Intent or related forms. Include their name, mailing address, city/town, state, phone number, and fax number if applicable.
5. In the instructions section, select one of the options for departmental action requests. Attach a separate sheet detailing any objections to the determination or order being appealed.
6. Finally, ensure that copies of this form and payment are sent to the appropriate DEP Regional Office by certified mail or hand delivery.

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