In all appeals arising under the discrimination provisions of the Washington Industrial Safety and Health Act, RCW 49.17.160, the notice of appeal should contain where applicable:

1. (1) The name, mailing address, telephone number, and email address of the employee who filed the complaint with the department and their representative, if any.
2. (2) The name, mailing address, telephone number, and email address of the cited employer or business and their representative, if any.
3. (3) A statement identifying the citation number, penalty assessment, or appropriate relief order being appealed. This requirement may be satisfied by attaching a copy of the citation, penalty assessment, or order of appropriate relief.
4. (4) The reason why the appealing party considers the citation, penalty, or appropriate relief decision to be wrong.
5. (5) A statement of facts in full detail in support of each stated reason.
6. (6) The specific nature and extent of the relief sought.
7. (7) The place, most convenient to the appealing party and that party's witnesses, where board proceedings are requested to be held.
8. (8) A statement that the person signing the notice of appeal has read it and that to the best of his or her knowledge the contents are true.
9. (9) The signature and date of the appealing party or the party's representative.

[Statutory Authority: RCW 51.52.020. WSR 22-19-009, § 263-12-05901, filed 9/9/22, effective 10/10/22.]