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  • Ok 13mp004e (h-3) 2002

Get Ok 13mp004e (h-3) 2002-2026

5 Oklahoma City, OK 73152 To be completed by the local office Case name Case number Office name and number Date withdrawal requested I. WITHDRAWAL After discussing my situation with I wish to withdraw my request for a hearing before the Oklahoma Department of Human Services. I am withdrawing my request for the following reasons: II. SIGNATURE A. If the withdrawal of the hearing request is made by the client, this item is completed. Client s signature Date Witness if signed by mark: Sig.

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How to fill out the OK 13MP004E (H-3) online

The OK 13MP004E (H-3) form is used for withdrawing a request for a hearing before the Oklahoma Department of Human Services. This guide will provide clear, step-by-step instructions for completing this form online, ensuring users can navigate the process easily and effectively.

Follow the steps to fill out the OK 13MP004E (H-3) online.

  1. Locate and click the ‘Get Form’ button to access the OK 13MP004E (H-3) form online. This will allow you to open the form in an editable format.
  2. Fill in the 'case name' and 'case number' fields. This information is crucial to identify your specific request.
  3. Enter the 'office name and number' where your case is managed. This helps ensure that your withdrawal is processed through the correct local office.
  4. Provide the 'date withdrawal requested'. Be sure to enter the date you are submitting this withdrawal.
  5. In section I, clearly state your desire to withdraw your request for a hearing. After discussing your situation, explain the reasons for your withdrawal.
  6. In section II, if you are the client making the request, please provide your signature and the date of your signature.
  7. If applicable, if the withdrawal is made by someone acting on behalf of the client, fill in the client’s name and the signature of the person making the request.
  8. If the request has been signed by mark, make sure to have two witnesses sign. Include their signatures, addresses, city, state, and zip code.
  9. After completing all necessary sections, you can save your changes, download the completed form, print it, or share it as needed.

Complete your document online today for a smooth withdrawal process.

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