SFN 162, Request for Hearing 400-28-165-20
(Revised 8/1/2023)
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SFN 162, Request for Hearing form is used when an applicant or caretaker chooses to request a fair hearing due to action taken regarding TANF benefits.
This form is available through the Department of Health and Human Services and may also be obtained electronically via E-Forms.
E-Forms are presented in Adobe Acrobat and require the Adobe Acrobat reader. If you do not currently have Adobe Acrobat reader installed, you may download a free copy by clicking the Get Adobe Reader icon below.