(PF12) NOTICE OF APPEAL OF A DECISION OF A GPT

NOTICE OF APPEAL OF A DECISION OF A GPT
(SECTION 9.6)
Prescribed Form 12
MEMBER DETAILS
Full Name*

First NameLast Name
FFA Number
If applicable.
Member*
E-mail Address*
A copy of your submission will be emailed to this address.
DECISION OF GENERAL PURPOSES TRIBUNAL
Date of GPT Determination*

DayMonthYear
Copy of the decision of the GPT*

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REPRESENTATION
Do you wish to be represented by a support person of the Club? *

YesNo
Please provide name and contact details of Club representative
Do you wish to be represented 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 10.1 of the Football NSW Grievance and Disciplinary Regulations (Regulations). The Appeals Tribunal will only hear a matter in the following circumstances:

(a) An appeal of a decision made by the GPT pursuant to section 9.2 of the Regulations (charges of Misconduct and Disrepute); and

(b) An appeal of a decision made by the GPT pursuant to section 9.3 of the Regulations (Grievances) subject to section 10.5 of the Regulations.

Further, the Participant must satisfy one or more grounds of appeal set out in section 10.3 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 jurisdiction of a Body or a Member Appeals CommitteeThe decision of a Body or a Member Appeals Committee was affected by actual biasThe decision was one that was not reasonably open to a Body or a Member Appeals Committee having regard to the evidence before the Body or the Member Appeals CommitteeSeverity, only where the decision of a Body or a Member Appeals Committee imposed a sanction of at least:i) a Fixture Suspension of six (6) or more Fixtures; orii) a Time Suspension of three (3) or more months; oriii) a fine of three thousand dollars ($3000) or more; oriv) a bond to be of good behaviour of three thousand dollars ($3000) or morev) a dedcution, loss or ban on accuring six (6) or more competition points; orvi) exclusion, suspension or expulsion of a Club or Team from a competition; or.vii) relegation to a lower division; orleniency, but only in the case of an appeal brought by Fotball NSW or an appeal allowed by the Executive pursuant to section 9.2(h)
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 7 working days of the issuance of the decision of the GPT.

2. Please lodge a fee of $750 together with this Form. Payment can be made by direct debit into Football NSW’s bank account. Bank: National Aust Bank Ltd, Account Name: Football NSW Limited, BSB: 082-356, Account Number: 14-055-1058. Please include the GPT reference number when making payment and provide proof of payment to tribunal@footballnsw.com.au.

3. Participants should read and consider sections 9, 10 and 13 of the Regulations prior to submitting this Notice to Football NSW.

4. If Football NSW does not receive a properly completed Notice by the time specified in paragraph 1 together with proof of payment of the $750 fee, you are deemed to have waived your right to appeal the decision of the GPT.

5. Capitalised words used in this document are defined in the Regulations.

6. Where the documents to be provided under section exceed fifty (50) pages in total, the Member must deliver to the offices of Football NSW four (4) hard copies of those documents by the date prescribed therein.
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
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