FORM 93A
rule 93.02 
IN THE [SUPREME COURT/
IN THE COURT OF APPEAL/
IN THE COURT OF CRIMINAL APPEAL]	    
OF THE NORTHERN TERRITORY 				
OF AUSTRALIA			    
AT [DARWIN OR ALICE SPRINGS]

File No. [file number] 
BETWEEN
THE KING
and
[Full name of offender applying for or subject to bail] 
[APPLICATION FOR BAIL / REQUEST FOR REVIEW OF BAIL 
DECISION]
[Full name of offender applying for or subject to bail]
of [address] is [charged with/has been convicted of] [description of offence].
I, [Full name of applicant /person making request] of [address]
request [identify Court] at Supreme Court Building [State Square, Darwin / 14 Parsons Street, Alice Springs]
to:
(a)	grant bail
Application for bail made at [Darwin / Alice Springs] on the [date] day of [month, year]; 
or
(b)	review under [cite provision of Bail Act 1982 under which review is sought] a decision of [name of Local Court Judge/ Supreme Court Judge] made at [Court] on [date of decision].
Application/ request for review made on the [date] day of [month, year]

Signature of [applicant / person making request]
______________________________________________________________
NOTICE OF HEARING
	
TO:	[Full name of offender applying for or subject to bail] 
	Director of Public Prosecutions
NOTE:  That the above matter has been listed for hearing at [Court], Supreme Court 
Building [State Square, Darwin / 14 Parsons Street, Alice Springs] on the [date] day 
day of [month, year] at [time] when all parties to the matter must attend.

Date: [date]
COURT OFFICER