Appendix 4.15-1 Illustration for ORAP 4.15 — Petition for Judicial Review (Other Than Workers' Compensation Cases)
Appendices
Rule Text
Illustration for ORAP 4.15
(Other than Workers' Compensation Case)
IN THE COURT OF APPEALS OF THE
STATE OF OREGON
| [The title should be set up, to the | ) | [Agency Name] |
| extent possible, as it was before the | ) | |
| agency, showing the parties with | ) | No. ______________ |
| their appropriate appellate designations] | ) | |
| ) | CA A ____________ |
PETITION FOR JUDICIAL REVIEW
Petitioner seeks judicial review of the final order of the _______________ in case number ______, dated _____________.
The parties to the judicial review proceeding before the Court of Appeals are:
| Petitioner(s) | Respondent(s) |
____________________________________________________________________________
____________________________________________________________________________
The name, bar number, address, telephone number, and email address of the attorney(s) for each party represented by an attorney is:
Name & Bar Number _____________________________ Representing __________________
Address ________________________________________ Telephone Number ______________
Email Address __________________________________
Name & Bar Number _____________________________ Representing __________________
Address ________________________________________ Telephone Number ______________
Email Address __________________________________
The name, address, and telephone number of each self-represented party is:
Name ____________________________________
Address___________________________________ Telephone Number ___________________
Email address
□ For self-represented parties: Please check here if you consent to receiving notices from the appellate court by email.
□ For self-represented parties: Please check here if you consent to receiving the agency record by Secure File Transmission Protocol (SFTP).
A. Attached to this petition is a copy of the order, rule or ruling for which judicial review is sought. If a copy of the order, rule or ruling is not attached, the nature of the order for which review is sought is ________________.
B. Petitioner was a party to the administrative proceeding which resulted in the order for which review is sought.
[or]
Petitioner was denied status as a party to the administrative proceeding that resulted in the order for which review is sought.
[or]
Petitioner is adversely affected or aggrieved by the order as set forth in an affidavit attached to this petition.
| C. | Petitioner is not willing to stipulate that the agency record may be shortened. |
[or]
Petitioner is willing to stipulate that the agency record may be shortened and designates these parts of the record to be included in the record:______________________________.
DATED this _____ day of ____________, ______.
_______________________________ Attorney for Petitioner
[Sign and print/type name, bar number, address, telephone number, and email address]
CERTIFICATE OF SERVICE
I certify that on [date] , I served a true copy of this petition for judicial review on:
| ______________________________ | ______________________________ |
| ______________________________ | ______________________________ |
| ______________________________ | ______________________________ |
| [State agency and address] | Attorney General of the State of Oregon |
| Office of the Solicitor General | |
| ______________________________ | 400 Justice Building |
| 1162 Court Street NE |
| ______________________________ | Salem, Oregon 97301-4096 |
[Other party(ies) or attorney for other party(ies)]
by [specify method of service]:
| __ | United States Postal Service, ordinary first class mail |
| __ | United States Postal Service, certified or registered mail, return receipt requested |
| __ | hand delivery |
| __ | other (specify) __________________________________ |
CERTIFICATE OF FILING
I certify that on [date] , I filed the original of this petition for judicial review with the [Supreme Court or Court of Appeals] by [specify method of filing]:
__ United States Postal Service, ordinary first class mail
__ United States Postal Service, certified or registered mail, return receipt requested __ hand delivery
__ other (specify) __________________________________
____________________________________ [Signature of petitioner or attorney]
____________________________________ [Typed or printed name of petitioner or attorney]