APPEAL REQUEST FORM

Applicant Information Applicant Name Organization / Business Name LTP Verified™ Number (if applicable) Applicant Type ☐ Pageant System ☐ Business Primary Contact Email Phone Decision Being Appealed Please select the decision you are appealing. ☐ Initial Verification Denial ☐ Renewal Denial ☐ Gold Verified™ Denial ☐ Legacy Verified™ Denial ☐ Suspension ☐ Probation ☐ Revocation ☐ Other Date Decision Was Issued Grounds for Appeal Please select all that apply. ☐ Procedural Error ☐ Administrative Error ☐ Misinterpretation of Submitted Information ☐ New Information ☐ Other Statement of Appeal Please explain why you are requesting an appeal. (Attach additional pages if necessary.) Supporting Documentation Please indicate what documentation you are submitting. ☐ Additional Documents ☐ Updated Policies ☐ New Evidence ☐ Letters of Support ☐ Clarification of Previous Submission ☐ Other Requested Outcome Please indicate the outcome you are requesting. ☐ Reconsideration of Verification ☐ Reconsideration of Renewal ☐ Removal of Probation ☐ Reinstatement of Verification ☐ Other Certification I certify that the information contained within this appeal is true and accurate to the best of my knowledge. I understand that submitting false or misleading information may result in denial of this appeal and may affect future eligibility for LTP Verified™ accreditation. Applicant Name Signature Date For Official Use Only Date Appeal Received Received By Appeal Number Administrative Review Completed ☐ Yes ☐ No Date Accreditation Council Review Council Recommendation ☐ Uphold Original Decision ☐ Modify Decision ☐ Request Additional Information ☐ Return for Additional Review ☐ Other Comments Final Decision ☐ Appeal Approved ☐ Appeal Denied ☐ Deferred Pending Additional Documentation ☐ Other Decision Date Executive Director Signature Appeal Timeline Reminder Appeals must be submitted within 30 calendar days of the official decision. Applicants will receive written confirmation of receipt, and a final determination will generally be issued within 45 business days in accordance with Policy LTP-V-007-2026 (LTP Verified™ Appeals Policy).