Application For Hearing On
Adverse Ruling Relating To
Approval To Operate
Drug Abuse Treatment And/Or
Preventive Education Programs
TO: New York State Drug Abuse Control Commission
Albany, New York 12203
PLEASE TAKE NOTICE that in accordance with the provisions of Chapter XXV of 14 NYCRR
2020.11
___________
(Voluntary Agency) hereby requests a hearing on the adverse ruling issued in the name of the Commission, dated ________, and relating to approval to operate a drug abuse treatment and/or preventive education program.
Dated: ________
____________
(Voluntary Agency)
____________
(Address)
N.Y. Comp. Codes R. & Regs. tit. 14, Appendices, app 112