Audio Recording Request

Save my progress and resume later | Resume a previously saved form

Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Your Email:

A Password:

Confirm Password:

This form IS NOT to be used when requesting a transcript in connection with a Petition to Review.

Hearing Date

Case Number

WC #-###-###-##

Claimant/Party's Name

Party Represented by Requestor

Judge

Hearing Location

Courtroom

Time Hearing Started

HH:mm (AM/PM)

Time Hearing Ended

HH:mm (AM/PM)

Does this request covers multiple days or are additional instructions are needed?

YesNo

Additional Document

Requests for transcripts will be forwarded to an outside transcription service for preparation. If requesting a transcript, you must provide the name and address of the transcriptionist or court reporter to whom OAC will send a copy of the recording.

I am requesting a copy of:

CD Recording of the hearing only.Written transcript of the hearing only. Both the CD recording and written transcript of the hearing.

Attach name and address of transcriptionist

Or fill out transcription contact information below:

Transcriptionist Name

Transcriptionist Address

Transcriptionist City, State, Zip

Transcriptionist Email/phone/fax

Signature

By signing this request, I acknowledge that the filing of this form with the Office of Administrative Courts DOES NOT constitute filing an appeal of this case. I further acknowledge that if this request is in conjunction with a Worker's Compensation Petition to Review of other form of Appeal that additional filing requirements may need to be met pursuant to any and all applicable rules of the agency/department involved.

First Name

Middle Initial

Last Name

Suffix

Attorney Registration Number

Company

Address

City

State

ZIP

#####

Phone Number

###-###-####

Email Address

Contact Preference

You have selected traditional mail as your preferred contact method. This may result in delay in receipt of any procedural or final order. If you accept these terms, please check the box below. If you do not, please change your contact preference to "Email."

I accept

Other Recipient

I hereby certify that I mailed or delivered the original of the Audio Recording Request to all parties at the addresses shown below: (A claimant must provide a copy to the employer and the insurer, or their attorney.):

First Name

Middle Initial

Last Name

Suffix

Company

Address

City

State

ZIP

#####

Phone Number

###-###-####

Email Address

Please type your name in the box below. By typing your name, you certify this information is accurate and certify that this will act as your binding electronic signature.

Date Mailed:

A $1.00 charge will be assessed for duplication of Audio Recordings to CD. This fee is waived for requests in connection with the filing of Exceptions in benefits cases. When the copy of the hearing is ready, the requester will be notified by phone or email. The Requester is responsible for arranging pick up of the recording. If the Requester wants the recording mailed to them, they must also submit a self-addressed envelope with sufficient postage affixed to it.

Save my progress and resume later | Resume a previously saved form

Need assistance with this form?