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Fillable Printable De9403

Fillable Printable De9403

De9403

De9403

DE 9403 Rev. 1 (2-04)(INTERNET)Page 1 of 1CU
Conditional Withdrawal
I,, hereby withdraw my request for a
hearing to protest the Earning Withholding Order for Taxes of the Employment
Development Department (EDD). That request was dated .
I ask that my case be treated as an administrative complaint which may be resolved
informally without hearing. I understand that if I do not agree with the administrative
resolution, I may file a new request for a hearing.
DateSignature
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