Title: Rule 86.19(4)
Author: Chris Cox
Last saved by: Nelson Cu
Company: Office of Courts Administration

FORM

Order 82.04(1)
Order 82.05(2)

IN THE [COURT]			
OF THE NORTHERN TERRITORY
OF AUSTRALIA 

[Supreme Court File Number]

ON APPEAL FROM Judge [Name]

BETWEEN

							[FULL NAME OF APPELLANT]
							Appellant

								-v-

[FULL NAME OF RESPONDENT]
							Respondent

NOTICE OF APPEAL (CRIMINAL/CIVIL)

1.	The appellant appeals against [provide a brief but specific statement of the decision appealed against, including a statement whether the appeal is from the whole or part only of the decision, and if part only, a description of what part]. 

*[Where applicable] The appeal is against a finding of guilt by the [Court] at [place of trial] on [date] on a charge of [set out charge].

OR

*[Where applicable] The appeal is against a special finding referred to in section 410(a) of the Criminal Code by his/her Honour Justice [Judge] on [date] in which his/her Honour found [set out brief details of the special finding].

OR

*[Where applicable] The appeal is under section 410(b) of the Criminal Code Act 1983 with the leave of the Court, or upon the certificate of the Judge of the court of trial that it is a fit case for appeal, a copy of which is annexed and marked “[LETTER]”.

OR

*[Where applicable] The appeal is under section 410(c) of the Criminal Code Act 1983 with the leave of the Court against the sentence passed on the finding of guilt. 
OR

*[Where applicable] The appeal is under section 414(1) of the Criminal Code Act 1983. The appeal is from [the whole or part only of the decision and, if part only, a description of what part].

2.	*[Where applicable] The appeal is brought pursuant to leave granted on [date] by Judge [Name]. 

3.	*[Where applicable] Annexed and marked “[LETTER]” is [the formal order or other document comprising or setting out the decision being appealed against, and any written reasons for the decision]. 

GROUNDS OF THE APPEAL:

4.	The grounds of the appeal are: [set out brief but specific grounds]. 

JUDGMENT, RELIEF OR DECISION SOUGHT:

5.	[State the judgment, relief or decision that is sought by the appellant].  

To the respondent:  [address]

NOTE:	Before taking a step in the proceeding you must enter an appearance in the Registry.

The appellant’s address for service is: [address]

Dated:  [date]

								Signed:  

IN THE [COURT] 
OF THE NORTHERN TERRITORY
OF AUSTRALIA

 [Supreme Court File Number]

On appeal from Judge [Name]

	BETWEEN:

[FULL NAME OF APPELLANT]
Appellant

	and:

[FULL NAME OF RESPONDENT]
	Respondent

	______________________

NOTICE OF APPEAL (CRIMINAL/CIVIL)
						    ______________________