Form 5.4	Supreme Court—notice of appeal
Court Procedures Rules 2006
(see r 5100 (Appeals to Supreme Court—starting appeal))
In the Supreme Court of the Australian Capital Territory
*[Criminal jurisdiction]
No SCA		of (year)
On appeal from (name of relevant court, tribunal, body or person)
(name)
Appellant

(name)
Respondent

1.	On (date), the (name of relevant court, tribunal, body or person) made the following order:
(state the order)
2.	The appellant appeals from *[all/the following part of] the order.
(if appeal from only part of order, state the part appealed from)
*3.	[The appeal is brought by leave of the Court given on (date).  A sealed copy of the order giving leave to appeal is attached.]
4.	The appellant *[will/will not] seek to put further evidence before the Court.
(if further evidence is sought to be put before the Court, state briefly the nature of the evidence and what is sought to be proved)
5.	The grounds of the appeal are:
(state briefly, but specifically, the grounds relied on in support of the appeal, including, in particular, any grounds on which it is claimed that there is an error of law in the order appealed from)
6.	The orders sought are:
(state orders sought)
(if r 5101 (3) applies)
7.	*[The appellant wants to present the appellant’s case in writing.]
(if the appellant is represented by a solicitor)

*Particulars of appellant’s solicitor
Solicitor’s full name:
(if the solicitor practises in a firm of solicitors)
*Solicitor’s firm:
Solicitor’s full business address:
Solicitor’s telephone no:
*Name, address and telephone no of solicitor’s agent:

Appellant’s address for service of documents
(set out appellant’s address for service)
(if represented by a solicitor the following information may be given)
*Document exchange box no:
(if postal address different from address for service)
*Postal address:
*Fax:
*Email address:
Date:
(signature of appellant/appellant’s solicitor)
(name of appellant/appellant’s solicitor)

Notice to respondent
To: (respondent’s name and address)
Before taking any other step in this proceeding, you must file a notice of intention to respond in the Court and serve a sealed copy of it on the appellant.
You do not need to file and serve a notice of intention to respond if you have already filed a notice of intention to respond to an application for leave to appeal, or for leave to appeal out of time, in the proceeding, and the information provided in the notice has not changed.

Settling appeal papers
A directions hearing for settling the appeal papers will be held as follows:
Time: (date and time to be entered by Registrar)
Place: Supreme Court, Knowles Place, Canberra City, ACT.
If you do not attend to settle the appeal papers, either in person or by your legal practitioner, directions may be given, and orders made, in your absence.
Note	Before the date set for settling the appeal papers, the appellant must prepare and file a draft index of the appeal papers (see r 5130).
Date:
(signature of Registrar)
Registrar

*omit if, or whichever is, inapplicable