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

Full name of applicant Minister:
Designation of Minister:
State or Territory:
Address:

1.	I apply to the Australian Competition Tribunal under subsection 44O(1) of the Competition and Consumer Act 2010 for a review of the decision of the Commonwealth Minister that the regime for access to the service described below *is/*is not an effective access regime for the service.
2.	I am the Minister who asked the National Competition Council for a recommendation under section 44M of the Act in respect of the service.
3.	Brief description of the service:
4.	Facts and contention on which I intend to rely:
5.	Issues as I see them:
6.	Address for service of documents:
(An address for service must comply with regulation 21 of the Competition and Consumer Regulations 2010).

Dated:						20			Signed:

(Signature)
* Delete if not applicable

History
Form JB inserted by SR No 20 of 1996, reg 10.4, effective 31January 1996; amended by SR No 280 of 2010, Sch 1, 
effective 1 January 2011 (as amended by SR No 337 of 2010).