* - Denotes required field
*Reason For Telephone Request
I understand that I must immediately FAX any
documents or written materials I want the Referee to consider at the
hearing to 860-754-5059 (if scheduled in Middletown) or 203-437-3440
(if scheduled in Waterbury) and must mail copies to the other
parties at the address(es) shown on the hearing notice.
I understand it is my responsibility to call
the Appeals Division at 860-754-5020 (if scheduled in Middletown) or
866-291-3921 (if scheduled in Waterbury) fifteen (15) minutes before
the hearing and provide a number for the Referee to contact me.
The Appeals Division will NOT call me unless I first
register my appearance. I understand that I may lose the appeal if I
fail to call in as instructed and participate in the hearing.