Form 15A NOTICE OF APPEAL Court Use Magistrates Court of South Australia (Civil Division) Date Filed: Employment Agents Registration Act 1993 Date Posted: Section 15 Trial Court Action No Street Telephone Facsimile DX Address City/Town/Suburb State Postcode Email Address Applicant Full Name Address Street Telephone Facsimile DX (Registered Office, if Body Corporate) City/Town/Suburb State Postcode Email Address Solicitor for Applicant (name) Street Telephone Facsimile DX Address City/Town/Suburb State Postcode Email Address I hereby appeal to the Trial Court pursuant to s 15 of the Employment Agents Registration Act 1993, being a person aggrieved by a decision of the Director: to refuse to grant or renew a licence to refuse to transfer a licence to cancel a licence any other decision (please specify) Notice of the decision of the Director was served upon me on the day of 20 Date APPLICANT I certify that I have served a copy of this notice on the Chief Executive Officer, Department of Date REGISTRAR
Form 15A NOTICE OF APPEAL Magistrates Court of South Australia (Civil Division) Employment Agents Registration Act 1993 Section 15 Court Use Date Filed: Date Posted: Trial Court Action No Address Street Telephone Facsimile DX City/Town/Suburb State Postcode Email Address Applicant Full Name Address (Registered Office, if Body Corporate) Street Telephone Facsimile DX City/Town/Suburb State Postcode Email Address Solicitor for Applicant (name) Address Street Telephone Facsimile DX City/Town/Suburb State Postcode Email Address I hereby appeal to the Trial Court pursuant to s 15 of the Employment Agents Registration Act 1993, being a person aggrieved by a decision of the Director: to refuse to grant or renew a licence to refuse to transfer a licence to cancel a licence any other decision (please specify) Notice of the decision of the Director was served upon me on the day of 20 Date APPLICANT I certify that I have served a copy of this notice on the Chief Executive Officer, Department of Date REGISTRAR
Form%2015A%20-%20Notice%20of%20Appeal.docx