APPENDIX A: FORMS
PETITION FOR DIRECT APPELLATE REVIEW OF ADMINISTRATIVE PROCEEDINGS2
Court of Appeals for the _________ Section of Tennessee
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__.
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.