File Number

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	ACT CIVIL AND ADMINISTRATIVE TRIBUNAL

APPLICATION FOR REVIEW OR DIRECTION
		
	*Guardianship and Management of Property Act 1991		

I wish to apply for a Review/Direction* by the ACT Civil and Administrative Tribunal (* delete whichever does not apply)

DETAILS OF PROTECTED PERSON
Miss
Mrs/Ms	
Mr
Other
_____________________________________________________________________
		(Given Names)				 (Surname)

Current Address 

_____________________________________________________________________

__________________________________________________Postcode__________

Telephone (H)__________ (W) _____________ Date of Birth ____/____/____

EMAIL ________________________________

What disability/condition does the person have? 

_____________________________________________________________________

Is there a current order appointing a guardian for the person? If so, please provide details (if available):

GT Order No. __________________  Date of Order _____/_____/_____

Name, address and telephone details of Guardian(s) or Manager(s):

Name
	_______________________________________________________________

Address of Guardian and/or Manager
_____________________________________________________________________

							cont. over page
Telephone___________________________________________________________
									
EMAIL ________________________________

WHY DO YOU WANT THE ACT CIVIL AND ADMINISTRATIVE TRIBUNAL TO REVIEW OR MAKE A DIRECTION IN THIS MATTER? (if insufficient space please attach page)

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

DETAILS OF APPLICANT
Miss
Mrs/Ms	
Mr
Other
_____________________________________________________________________
		(Given Names)				 (Surname)
			
Current Address 

_____________________________________________________________________

__________________________________________________Postcode__________

Telephone (H)_______________________  (W) _____________________________ 

EMAIL ________________________________Date of Birth ____/____/____

Relationship to Protected Person ____________________________________

Signature _____________________________________  Date ____/_____/____