NOTICE OF DISPUTE OR GRIEVANCE
1. APPLICANT DETAILS
Applicant Name:
Contact name and title: (NAME)
(if applicant is an entity) (TITLE)
Address for service (ADDRESS)
of notices: (SUBURB) (P/C)
Telephone:
Mobile:
Fax:
Email:
2. TYPE OF APPLICATION
Grievance to an Amateur Player De-registration
Grievance to a Professional Player De-registration
General Purposes Tribunal
Appeal Tribunal
Explanatory notes:
All Grievances in relation to Amateur and Professional player De-registrations shall be heard
by the General Purposes Tribunal
The General Purposes Tribunal determines Grievances and Disputes arising from any
breach of the FNSW Constitution, By-Laws or Regulations.
The Appeal Committee hears appeals from the Disciplinary Committee and General
Purposes Tribunal
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3. AFFECTED PARTY
Is there another party potentially directly affected by your application? Yes No
If your answer is yes, please name that party:
Name:
Contact name and title (NAME)
(if affected party is an entity) (TITLE)
Address for service (ADDRESS)
of notices: (SUBURB) (P/C)
Telephone:
Fax:
Email:
Explanatory Notes:
Your application for relief may have consequences for another party. For example, if you
allege your club should have been awarded 3 points for a match, the opposing club would
have a real interest in the hearing. FNSW is concerned to ensure such an affected party is
aware of your application and provided with an opportunity to be separately represented.
IF THERE ARE FURTHER PARTIES YOU WISH TO BE LISTED AS AFFECTED PARTIES,
PLEASE PROVIDE THEIR DETAILS ON A SEPARATE PAGE:
I have attached a further list of Affected Parties: Yes No
4. DATE DISPUTE OR GRIEVANCE AROSE
Insert date subject matter of Grievance arose:
Explanatory Notes:
Ordinarily, you must bring your application within 2 years of the date the Grievance arose
(see clause 23 of the Football Federation Australia Grievance Resolution Regulations).
Grievances in relation to Amateur and Professional Player de-registrations are required
within 7 days of notice of that de-registration being lodged with the Club/Player and FNSW.
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5. DETAILS OF GRIEVANCE
If this is an application to the General Purposes Tribunal (including Disputes / Grievances
lodged to a De-registration) briefly state the relevant facts and legal arguments in the space
below. You must include a clear statement of the issues you are submitting to the General
Purposes Tribunal for determination. If necessary, continue in an annexure:
If this is an application to the Appeal Tribunal provide details of the decisions appealed from.
Date of decision:
Decision made by:
Football NSW
Disciplinary Tribunal
General Purposes Tribunal
PLEASE ANNEX A COPY OF THE DECISION YOU ARE APPEALING FROM.
Briefly state your grounds of appeal, noting they must fall within the grounds specified in
Section 19.14 of the FNSW By-Laws. If necessary, continue in an annexure:
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6. RELIEF SOUGHT
Please describe the relief you are seeking from the Judicial Body. If necessary, continue in
an annexure:
7. URGENCY
Are there grounds for suggesting that these proceedings should be heard on an urgent
basis? For example, is there an upcoming match that requires these proceedings to be
finalised beforehand, or any other reason for urgency?
Yes No
If yes, please describe below the basis for the urgent hearing of the matter and the
requested timeframes:
8. TIMEFRAMES AND COSTS
The FNSW By-Laws provides for detailed time frames and costs for Appeals Tribunals and
General Purposes Tribunals, including costs associated with legal representation and
attendance costs at Tribunals.
Lodgment of notices of dispute / grievance / is 7 days from receipt of the de-registration
request.
Lodgment of a notice to appeal to a determination of first instance is 7 days from receipt of
that notice.
Fees applicable to the various Tribunals are:
Appeals Tribunal $750
General Purposes Tribunal $300
General Purposes Tribunals: De-registrations
A notice of response from FNSW to an applicant who has had a notice of grievance / dispute
lodged against their Amateur / Professional De-Registration incurs a $50 fee.
Lodgment of Notice of dispute / grievance incurs a $100 fee.
Response from FNSW to Notice of dispute / grievance incurs a $50 fee.
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9. INSTRUCTIONS FOR LODGING APPLICATION
A cheque for the full amount of the application fee as listed above must be lodged at the time
of making this application.
You should address any correspondence, applications or other general queries to the
Competitions Manager at the address below:
Football NSW
PO BOX 6146
Baulkham Hills BC NSW 2153
Ph: (02) 8814 4409
Fax: (02) 8814 4483
10. SIGNATURE OF APPLICANT
I warrant that the information contained in this Application Form is true and correct.
Signed:
Date:
Position:
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