Code of Federal Regulations Title 43. Public Lands:  Interior § 43.4.1164 Contents of application

(a) A statement of facts entitling that person to administrative relief;

(b) A request for specific relief;

(c) A copy of any notice or order sought to be reviewed;

(d) A statement as to whether the person requests or waives the opportunity for an evidentiary hearing;  and

(e) Any other relevant information.