FORM 114. PETITION FOR DECLARATORY JUDGMENT STATE OF MINNESOTA IN COURT OF APPEALS CASE TITLE: Petitioner, vs. Agency or Body, Respondent. PETITION FOR DECLARATORY JUDGMENT APPELLATE COURT CASE NUMBER: [TO BE ADDED BY CLERK] AGENCY OR BODY NUMBER: TO: The Court of Appeals of the State of Minnesota: The above-named petitioner hereby petitions the Court of Appeals pursuant to Minn. Stat. § 14.44 for a declaratory judgment determining the validity of a rule adopted by (agency) on (date), upon grounds that the rule (is unconstitutional/exceeds the statutory authority of the agency/was adopted without compliance with statutory rule-making procedures). DATED: NAME OF [PETITIONER] AND ATTORNEY (IF APPLICABLE), ADDRESS (INCLUDING ZIP CODE), TELEPHONE NUMBER, EMAIL ADDRESS (IF AVAILABLE) SIGNATURE [OF PETITIONER, OR ATTORNEY IF REPRESENTED] (The procedure for obtaining a declaratory judgment on the validity of an administrative rule from the Court of Appeals is set forth in RCAP 114. The rule prescribes the manner of obtaining review, contents of the petition, filing fees, and service requirements for obtaining review. A completed statement of the case must accompany the petition, RCAP 133.03.) American LegalNet, Inc. www.FormsWorkFlow.com