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Ex Parte Communication Disclosure

Disclosure form documenting prohibited ex parte communications during formal agency proceedings under APA Section 557(d).

PDF TemplateUse the instructions below to complete this form

Instructions

Report the date, participants, and substance of the ex parte communication. Include any documents exchanged. File the disclosure in the public record of the proceeding. The presiding officer will determine appropriate remedial action. Failure to disclose may result in sanctions or reversal of the agency decision on judicial review.