Judicial review claim - criminal injuries compensation cases, England and Wales
| Published date | 21 March 2018 |
| Subject Matter | Administrative Appeals Chamber (Upper Tribunal) forms |
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UPPER TRIBUNAL ADMINISTRATIVE APPEALS CHAMBER
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For Upper Tribunal use only |
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Upper Tribunal Reference No. |
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Judicial Review claim form (Criminal Injuries Compensation Case) |
Date received
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Notes for guidance are available which explain how to complete the judicial review claim form. Please read them carefully before you complete the form. |
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Use black ink and complete the form in CAPITAL LETTERS Use another sheet of paper if there is not enough space for you to say everything. (Please put your full name at the top of the sheet.) |
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| SECTION 1 – IDENTIFICATION OF THE APPLICANT | ||||||||||||||||||||
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This application for judicial review is made by – (Please tick the appropriate box) |
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the claimant (i.e., the person who claimed criminal injuries compensation) |
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or |
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the Criminal Injuries Compensation Authority |
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SECTION 2 – DETAILS OF THE CLAIMANT |
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Claimant’s name |
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Address |
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Postcode |
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Telephone No. |
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Fax No. |
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E-mail address |
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Is the claimant represented? If so please give the representative’s details below. |
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Representative’s name |
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Address |
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Telephone No. |
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Fax No. |
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E-mail address |
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SECTION 3 – DETAILS OF THE DECISION TO BE JUDICIALLY REVIEWED |
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What was the date of the First-tier Tribunal's decision? (This will also be on the decision notice.) |
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What was the First-tier Tribunal's (and CICA’s) reference number? |
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If the decision was made at or following a hearing, where did the hearing take... |
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