Appeal issue grid
Use one copy for each issue listed on the determination or hearing
notice.
- Issue:
_________________________________________________________ - Jurisdiction:
__________________________________________________ - Procedural stage:
______________________________________________ - Governing authority verified from:
______________________________ - Party with burden:
_____________________________________________
| Element or factor | Favorable fact | Supporting evidence/witness | Adverse or disputed fact | Opposing evidence | Missing proof/action |
|---|---|---|---|---|---|
One-sentence case theory
Strongest opposing point
Direct response supported
by evidence
Finding requested
Jurisdiction field
Add the state, agency, tribunal, official terminology, burden,
evidence rule, appeal deadline shown on the notice, and current source
used. This worksheet does not calculate or verify a deadline.
Local-use note: Complete or save this worksheet on your own
device or on paper. It is not submitted through uiappeals.com/.