STATE OF CALIFORNIA Department of Industrial Relations Occupational Safety and Health Appeals BoardPlease mail all correspondence to: 2520 Venture Oaks Way, Suite 300 Sacramento, CA 95833Clear FormOSHAB.
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How to fill out the CA OSHAB Appeal Form 100 online
Filing an appeal using the CA OSHAB Appeal Form 100 is an important step in contesting citations related to occupational safety and health. This guide will help you navigate the process of completing the form online, ensuring all necessary sections are filled accurately and efficiently.
Follow the steps to complete the CA OSHAB Appeal Form 100 online.
- Click ‘Get Form’ button to access the CA OSHAB Appeal Form 100 online and open it in the editor.
- In Section A, enter the citation information. This includes the inspection number, issuance date, employer details, reporting ID, and date the citation was received. Make sure to provide accurate information as per the citation.
- If you have a representative, fill out Section B with their information, including firm name and contact information. If you do not have a representative, you can skip this section.
- In Section C, select your role by indicating whether you are the employer, representative, or another party. Sign the form and provide your printed name and title.
- Proceed to Section D to describe the appeal information. Select the type of appeal and specific grounds for your appeal, ensuring to check all applicable boxes regarding your reasons.
- If applicable, list any affirmative defenses you plan to raise, and provide a short statement explaining these defenses if necessary.
- Remember to complete page 2 of the form for each citation or item being appealed, as required.
- Once all sections are filled out and reviewed, you can save your changes, download the completed form, print it, or share it if needed.
Take action now by completing the CA OSHAB Appeal Form 100 online.
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