Rule : Form 2: PETITION FOR DIRECT APPELLATE REVIEW OF ADMINISTRATIVE PROCEEDINGS

APPENDIX A: FORMS

216

PETITION FOR DIRECT APPELLATE REVIEW OF ADMINISTRATIVE PROCEEDINGS2

 

Court of Appeals for the _________ Section of Tennessee

                                                             No. _____________________

A. B., Petitioner

    v.                                                              Petition for Review

X, Y, Z Commission, Respondent

 A. B. hereby petitions the court for review of the order of the X, Y, Z Commission entered on the _____ day of _______, 20__.

                                          /s /_____________________

                                             _____________________

                                                               (Address)

 

Counsel for A. B.

 2 The copy of the Petition for Review filed with the clerk of the court of appeals shall include a list of the parties upon whom service of notice of docketing of the proceeding is required by Rule 12 of these rules.

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