SFN 1784, Appeal Background Report 400-19-165-125

(Revised 6/1/10 ML #3218)

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The purpose of the SFN 1784 is to advise the Appeals Supervisor of the reason for an appeal and the program(s) being affected by the appeal.

 

This form is available through the Department of Human Services and may also be obtained electronically via E-Forms. (78kb pdf)

 

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