NOTICE OF APPEAL OF A DECISION OF A DC

NOTICE OF APPEAL OF A DECISION OF THE JC
(SECTION 7.5)
Prescribed Form 11
MEMBER DETAILS
Full Name*

First NameLast Name
FFA Number*
Club Name*
E-mail Address*
A copy of your submission will be emailed to this address.
DECISION OF THE JUDICIARY COMMITTEE
Date of Notice of Suspension*

DayMonthYear
Date of decision in respect of your challenge*

MonthDayYear
Copy of Notice of Suspension*

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Copy of decision regarding your challenge*

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REPRESENTATION
Do you wish to be supported by a Board/Executive Committee person of the Club?*

YesNo
Please provide name and contact details of Club representative
Do you wish to be supported by a lawyer?*

YesNo
Please provide name and contact details of the legal representative
JURISDICTION
Does the Appeals Tribunal have jurisdiction to hear this matter?*

YesNo
The jurisdiction of the Appeals Tribunal is set out in section 9.1 of the CDSFA Grievance and Disciplinary Regulations (Regulations). The Appeals Tribunal will only hear an appeal in the following circumstances:

(a)       A decision was made by the Judiciary Committee pursuant to section 7.3 of the Regulations (mistaken identity in a Match Official Send-Off Report);

(b)      A decision was made by the Judiciary Committee pursuant to section 7.3 of the Regulations (mistaken identity in a Match Official Incident Report); or

(c)       A decision was made by the Judiciary Committee pursuant to section 7.4 of the Regulations (exceptional circumstances).

Further, the Participant must satisfy one or more grounds of appeal set out in section 9.2 of the Regulations.
Please state the grounds you wish to rely on.*

A party was not afforded a reasonable opportunity to present its caseLack or excess of jurisdictionThe decision of the Body was affected by actual biasThe decision was one that was not reasonably open to the Body having regard to the evidence before the BodySeverity, only where the decision of the Body imposed a sanction of at least:i) A Fixture Suspension of four (4) or more Fixtures; orii) A Time Suspension of three (3) or more months; oriii) A fine of one thousand five hundred dollars ($1500) or more; or"iv) A loss of six (6) or more competition points; orv) Expulsion from a competition.
Please provide relevant facts and legal arguments that relate to each of the grounds of appeal that you wish to rely on.
AFFECTED PARTY
Is there another party potentially directly affected by your appeal? *

YesNo
Please provide the name and contact details of the affected party.
RELIEF SOUGHT
Please describe the relief that you are seeking*
Notes:

1. Please submit this form within 2 working days of the issuance of the decision of the JC to the Individual/Club by the CDSFA.

2. Please lodge a fee of $275 together with this Notice. Payment can be made by cheque or direct debit into the CDSFAs bank account. Bank: Westpac Bank, Account Name: CDSFA Inc, BSB: 032082, Account Number: 113442. Please file receipt of payment into this account with the Tribunal Administrator at trent@footballcanterbury.com.au.

3. Participants should read and consider sections 7, 9 and 12 of the Regulations prior to signing and lodging this Notice to the CDSFA.

4. If the CDSFA does not receive a properly completed Notice by the time specified in paragraph 1 together with the $275 fee, you are deemed to have waived your right to appeal the decision of the JC.

5. Capitalised words used in this document are defined in the Regulations.
SUBMISSION
Your name*

First NameLast Name
Digital Signature*

I certify that the information entered above is true and correct and was entered by myself.
Submission Date*

DayMonthYear
Should be Empty: