Request To Reconsider Form PDF Details

Have you ever experienced the unfortunate situation where funds were unexpectedly denied to your business? It can be an overwhelming and stressful experience that puts Financial Officers in a difficult position. Fortunately, when it comes to handling disapproved applications for funds or loans, there are ways to take matters into your own hands with a well-crafted Request To Reconsider Form. In this blog post we will explore what types of information need to be included in these forms, how they should be formatted properly and explain why professional language is essential for approval.

Form NameRequest To Reconsider Form
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesreconsideration, appealtribunal, Affix, Nebraska

Form Preview Example


DOCKET NO. ___________________

Attorney / Rep. Name

Company / Firm Name

Business Address

City, State, ZIP


Requesting Party:



Department of Labor


In the space provided below, briefly state why this appeal should be reconsidered:

Please Sign and Date Here:
















Date of Decision:


















Hearing Judge:


















Date Decision was entered:


















Date Decision was mailed:


















Is Request Timely?














(Affix Date Stamp Here)


Request is GRANTED:














Request is DENIED:


Not filed within 10-day reconsideration period

Good cause not provided
















Administrative Law Judge:





















For more information, you may visit the Tribunal’s website at

Please return the Request to Reconsider to: Nebraska Appeal Tribunal, P.O. Box 94600, Lincoln, NE 68509-4600.

You may also fax this to the Tribunal at: (402) 471-1734

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Part no. 1 of filling in Tribunals

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