Electronic Appeals Submission (EAS)
      
   




  

If the issue you are appealing is Other or Don't know, please explain: What issue are you appealing? If you are filing the appeal late, please state the reason. If No, why didn't you attend the hearing? If Yes, did you attend the hearing? If Yes, please enter the Appeal Number: Did you have a hearing scheduled with a judge? Document Date (mm/dd/yyyy) If you do not know what document you are appealing or other, please explain. What type of document are you appealing? Phone Type: Phone: Zip Code: State City: Address Line 2: Address Line 1: Last Name: First Name: text bullet              text bullet      Denotes Required Data SSN must be formatted 999-99-9999   text bullet Middle Initial:   Would you like to receive the judges decision by email instead of US Postal Service mail?           Why are you appealing?     SSN:   If Yes, specify language:







  If there is a hearing, it will be conducted in English. Do you need an Interpreter? If Yes, please enter email address             
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