Supreme Court Rules 1937—Form 6.16
(see o 86 r 72)
Application for reference appeal

In the Supreme Court of the Australian Capital Territory
Court of Appeal

ACTCA No		of (year)

Appeal from (Judge)
(SC No		of (year))

The Queen (the appellant)

and

(name of respondent)

Grounds
1
2
3
[etc]

Question[s] of law to be decided
[next par no]
[etc]

Written case
[if the Supreme Court Rules 1937, o 86 r 72 (2) applies] The applicant wants to present the applicant’s case in writing.

Date:

Signature of applicant:
Address for service:

Notice to interested party
[interested party’s name and address]

1  Entry of appearance
Before taking any further step in this application, you must enter an appearance in the registry.

2  Settling appeal papers
1	The appeal papers will be settled on [date] at [time] at [place]. [Registrar to insert date, time and place] 
2	If you do not attend to settle the appeal papers, either in person or by your lawyer, directions may be given, and orders made, in your absence. 

Date:

Registrar

Endnote
1	This form was originally in the Supreme Court Rules 1937.  Under the Court Procedures Act 2004 A2004-59, pt 8, the form became a form approved under that Act. 

©  Australian Capital Territory 2005