Form 5.1	Appeal from Registrar—notice of appeal
Court Procedures Rules 2006
(see r 5012 (Appeals from registrar—starting appeal))
In the *[Supreme/Magistrates] Court of the Australian Capital Territory

No *[SC/MC]		of (year) (Court to complete)
On appeal from Registrar (name of registrar)
(name)
Appellant

(name)
Respondent

1.	On (date), the Registrar (name of registrar) made the following decision:
	(state the decision)
2.	The appellant appeals from *[all/the following part of] the decision.
	(if appeal from only part of decision, state the part appealed from)
3.	The appellant *[will/will not] seek to put further evidence before the Court.
4.	The orders sought are:
	(state orders sought)

Date:
(signature of appellant/appellant’s solicitor)
(name of appellant/appellant’s solicitor)

Notice of hearing
The hearing will be held as follows:
Time: (date and time to be entered by Court)
Place: Knowles Place, Canberra City ACT

*omit if, or whichever is, inapplicable