Remonstrators Objection Petition For Intervention And A Request For Appeal Hearing
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Remonstrators Objection Petition For Intervention And A Request For Appeal Hearing Form. This is a Indiana form and can be use in Alcohol And Tobacco Commission Statewide.
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STATE OF INDIANA
BEFORE THE INDIANA ALCOHOL & TOBACCO COMMISSION
IN THE MATTER OF
THE PERMIT OF:
x
x
x
Name of Permit
d/b/a
Address
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PERMIT NO. ______________
REMONSTRATOR’S OBJECTION, PETITION FOR INTERVENTION
AND A REQUEST FOR APPEAL HEARING
COMES NOW __________________________, and pursuant to 905 IAC 1-36-2, hereby
moves the Alcohol & Tobacco Commission (“Commission”) for permission to intervene in this
cause as a remonstrator. In support of this petition, remonstrator would show the Commission
the following:
1. This matter concerns a NEW APPLICATION/RENEWAL OF AN EXISTING PERMIT
/ TRANSFER OF OWNERSHIP / TRANSFER OF LOCATION (SELECT THE APPLICABLE)
for a permit.
2. This matter was heard by the __________________ County Local Alcoholic Beverage Board
(“Local Board”) on the ______ day of ____________________, 20___, at which time the Local
Board voted to recommend approval of the permit.
3. Remonstrator was present at the Local Board hearing and identified himself/herself to the
Local Board and stated his/her name, address, and/or telephone number for the record.
4. The Commission adopted the Local Board’s recommendation on the ____ day of ___________,
20____, and issued the permit.
5. Remonstrator received notice of the Commission’s action on the _____ day of ____________,
20____.
State Form 54361 (7-10)
American LegalNet, Inc.
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6. Remonstrator objects to the Commission’s decision and will be aggrieved or adversely affected
by the Commission’s decision on the grounds that it is:
SET FORTH DETAILS ON WHY THE LOCAL BOARD’S DECISION WAS
WRONG AND WHAT EVIDENCE, IF ANY, WAS OFFERED IN SUPPORT
OF THIS POSITION, see 905 IAC 1-27
7. Remonstrator will be personally aggrieved or adversely affected if the permit is granted because:
EXPLAIN HOW YOU WILL BE PERSONALLY AFFECTED BY THE
ISSUANCE OF THIS PERMIT.
Wherefore, the Remonstrator, ______________________________, prays the Commission
for permission to intervene in this matter and objects to the Commission’s actions and requests an
appeal hearing before the Commission, and for any and all other just and proper relief.
Respectfully submitted,
__________________________________________
(Signature)
__________________________________________________
(Name)
__________________________________________________
(Address)
__________________________________________________
(Telephone Number)
State Form 54361 (7-10)
American LegalNet, Inc.
www.FormsWorkFlow.com
