Unless a written request for a hearing signed by or on behalf of the person named as respondent in the accompanying accusation is delivered or mailed to the agency within fifteen (15) days after the accusation was personally served on you or mailed to you, (here insert name of agency) may proceed upon the accusation without a hearing. The request for hearing may be made by delivering or mailing the enclosed form entitled ‘Notice of Defense,’ or by delivering or mailing a notice of defense as provided in § 9205 to: (insert here name and address of agency).
SOURCE: GC § 24111.