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Five Year Review Extension Letter

Below is the five year review extension letter request template. To determine your extended five year review date request, take the rule's current five year review date and add up to 180 days to that date. For example, if the current five year review date is July 1st and you want to request a 60 day extension, your five year review date request would be August 30th. Please note if you missed your current five year review date, you must start the date count at the missed five year review date and not the date you are requesting the extension.

Please email your extension letter to Ian Dollenmayer, Executive Director, at ian.dollenmayer@jcarr.state.oh.us.

Note: If submitting a five year review extension request for multiple rules, all rules on the request must have the same originally scheduled review date and the same extended date.

Note: An automated date calculator is available to assist you in determining your extension calendar date.
Download Sample PDF

Ian Dollenmayer
Executive Director
Joint Committee on Agency Rule Review
77 South High Street, Concourse Level
Columbus, OH 43215

Mr. Dollenmayer:

The Ohio (Department, Board, Commission of_________________) hereby requests an extension of ____ (up to 180) days for the following rule(s) which were originally scheduled for five year review on (insert originally scheduled review date).

Rule # and Title
Rule # and Title
Rule # and Title
Rule # and Title

The new review date for these rules is __________________ .