FORM 3

NOTICE OF APPEAL
MAGISTRATES' COURT (FAMILY VIOLENCE PROTECTION) RULES 2018
MAGISTRATES’ COURT (PERSONAL SAFETY INTERVENTION ORDERS) RULES 2011

In the Magistrates’ Court at Case no Appeal no

This notice must be filed within 30 days after the day the relevant decision was made, outlining grounds of
factual, legal, or discretionary error. Lodging an appeal does not stay the operation of an order.

APPELLANT DETAILS

Name:

Address for service:

Email address:
Legal practitioner’s name
and address

RESPONDENT DETAILS

Name:

Address for service:

Email address:

To the Registrar of the Magistrates’ Court at:

To the Registrar of the Supreme/County* Court at:

And to the above-named respondent

DETAILS OF THE PROCEEDING APPEALED

Venue of the Magistrates’ Court appealed from:

Date order made:

Nature of proceeding:

GROUNDS OF APPEAL: (LEGAL, FACTUAL OR DISCRETIONARY ERROR)

(Please state reason/s and the grounds of your appeal)

The Appellant requests the Registrar of the Supreme/County* Court to list the appeal.

1
Signed: Date:

(Appellant)_____________________________

(Registrar)_____________________________Name___________________________________

DETAILS OF APPEAL

The appeal is to be heard by the Supreme/County* Court sitting at:

Date of Appeal (first listing- witnesses not required): Time: