Judicial Review Application Form

Judicial Review Application Form
Submit your application to request a judicial review of a public body decision. Please complete all required sections accurately.
Applicant's Full Name
First NameLast Name
Applicant's Email Address
example@example.com
Applicant's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Applicant's Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you represented by a legal representative?
Legal Representative's Name (if applicable)
First NameLast Name
Legal Representative's Contact Email (if applicable)
example@example.com
Decision Being Challenged (Public Body/Authority Name)
Date of Decision Being Challenged
MonthDayYear
Date
Reference Number or Case Number (if applicable)
Briefly describe the decision you are challenging and why you believe it is unlawful or unfair.
Grounds for Judicial Review (select all that apply)
Other
What outcome are you seeking from this judicial review?
List of Supporting Documents (please list the documents you will upload below)
Upload Supporting Documents (PDF, DOC, JPG, PNG)
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Applicant's Signature
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Should be Empty: