FORM J
(subregulation 20(2))
APPLICATION TO TRIBUNAL FOR REVIEW
(Title)

1.	I (here insert name and address of applicant – where the applicant is a corporation, the corporation’s name should be inserted here, not the name of an officer of the corporation) hereby apply to the Australian Competition Tribunal pursuant to section 101A of the Competition and Consumer Act 2010 for a review of the giving of notice under subsection 93(3)/subsection 93(3A) (here delete whichever is not applicable) of that Act to (here state name of corporation to which, or person to whom, notice was given) by the Australian Competition and Consumer Commission on the 	
	                               day of    	           			20	    
	(Commission file no.                                     ).

2.	(a)	That notice was/was not (here delete whichever is not applicable) given to the 
		person making this application.
(b)	(To be completed if applicant for review was not corporation to which, or person to whom, that notice was given).  My interest in the determination is as follows:

(Here set out particulars of the matters by reason of which the applicant will seek to satisfy the Tribunal that, for the purposes of subsection 101A of the Act, he has sufficient interest.)

3.	I am dissatisfied with the giving of the notice by the Commission because:

4.	Particulars of the facts and contentions upon which I intend to rely in support of the application for review, and a statement of the issues as I see them, are attached.

5.	My address for service for the purpose of regulation 21 of the Competition and Consumer Regulations 2010 is (here insert address in Australia at which documents may be served for the purpose of the proceedings).

Dated this						day of 				20	.

Signed by/on behalf of the applicant

……………………………………..
(Signature)

……………………………………..
(Full Name)

……………………………………..
(Where applicant is a corporation, state position occupied in corporation by person signing.  If signed by solicitor for applicant this fact should be stated.)

History
Form J amended by SR No 248 of 1995, reg 8.18, effective 17 August 1995; 
SR No 330 of 1995, reg 10.1 and 10.2, effective 6 November 1995;
SR No 20 of 1996, reg 10.3, effective 31 January 1996; SR No 280 of 2010, Sch 1, 
effective 1 January 2011 (as amended by SR No 337 of 2010).