PETITION FOR JUDICIAL REVIEW OF ADMINISTRATIVE DECISION
CIRCUIT OR SUPERIOR COURT OF INDIANA
Case No.: _________________
[PETITIONER],
Petitioner,
v.
[RESPONDENT STATE AGENCY],
Respondent.
1. INTRODUCTION
This Petition seeks judicial review of Respondent's final decision dated [DATE] imposing [DESCRIBE PENALTY/ORDER] against Petitioner, pursuant to the Indiana Administrative Orders and Procedures Act (IC 4-21.5).
2. JURISDICTION AND VENUE
- Jurisdiction under the Indiana Administrative Orders and Procedures Act (IC 4-21.5) and applicable judicial review statutes.
- Venue is proper in this Court.
- This Petition is timely filed.
3. PARTIES
- Petitioner [NAME] is a [ENTITY TYPE] with its principal place of business at [ADDRESS].
- Respondent [AGENCY] is a state administrative agency.
4. EXHAUSTION OF ADMINISTRATIVE REMEDIES
- Petitioner participated fully in the underlying agency proceeding.
- All administrative remedies are exhausted.
5. STATEMENT OF FACTS
[Provide chronological narrative of proceedings.]
6. GROUNDS FOR RELIEF
- The Decision is not supported by substantial evidence.
- The Agency abused its discretion.
- The Agency committed errors of law.
- The Agency violated procedural requirements.
7. PRAYER FOR RELIEF
WHEREFORE, Petitioner respectfully prays:
A. For an order vacating the Decision;
B. For declaratory judgment that the Decision is void;
C. For injunctive relief;
D. For costs and reasonable attorney's fees;
E. For such other relief as the Court deems just.
8. VERIFICATION
I declare under penalty of perjury that the foregoing is true and correct.
Executed on [DATE], at [CITY, STATE].
___________________________________
[NAME]
9. SIGNATURE BLOCK
Respectfully submitted,
[LAW FIRM NAME]
Attorneys for Petitioner
By: ___________________________________
[ATTORNEY NAME]
Bar No. [####]
[ADDRESS]
[PHONE] | [EMAIL]
Dated: ____________________