*This form is offered as a convenience. Please refer to our Administrative Guide at: https://www.in.gov/nrc/administrative-review/ for additional information
INSTRUCTIONS: Complete and file this form or file correspondence including all the information specified in this form to request administrative review. You may file electronically, at NRCAOPA@nrc.in.gov; deliver by hand or mail to: Natural Resources Commission, Division of Hearings, 100 N. Senate Avenue, Room N103, Indianapolis, IN 46204. You may attach documents with this form. You will receive a response at your preferred method of communication selected below.