Petition for Review of Commonwealth Agency Adjudication - Pennsylvania

PETITION FOR REVIEW OF COMMONWEALTH AGENCY ADJUDICATION

Filing Gate

Use this form only for an appellate-jurisdiction petition for review of a Pennsylvania Commonwealth agency adjudication. Confirm that no statute assigns review to another court or provides a special deadline.

Pa.R.A.P. 1512(a)(1) ordinarily requires a petition for review of a quasijudicial order to be filed within 30 days after entry of the order. Special proceedings listed in Rule 1512(b) have different periods.

Caption

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

No.: [________________________________]

PETITION FOR REVIEW

Petitioner [________________________________] petitions for review of the order or determination identified below.

1. Jurisdiction

1. This Court has appellate jurisdiction under 42 Pa.C.S. § 763(a)(1) and [agency-specific authority, if any]: [________________________________].

2. Petitioner is aggrieved by the adjudication and has a direct interest within 2 Pa.C.S. § 702 because:

[____________________________________________________________]

2. Order or Determination Reviewed

3. The government unit is [________________________________].

4. The order or determination was entered on [__/__/____] in [agency docket number].

5. A copy of the order or determination is attached as Exhibit A.

6. The order or determination finally adjudicated:

[____________________________________________________________]

3. Timeliness

7. This petition is timely under Pa.R.A.P. 1512 because:

[____________________________________________________________]

4. General Statement of Objections

Pa.R.A.P. 1513(d) requires a general statement of objections. State each objection and identify where it was preserved before the government unit.

Petitioner contends that the adjudication should not be affirmed under 2 Pa.C.S. § 704 because:

☐ It violates Petitioner's constitutional rights.

☐ It is not in accordance with law.

☐ The agency violated applicable provisions of Subchapter A of Chapter 5 of Title 2.

☐ A necessary finding of fact is not supported by substantial evidence.

Supporting statement:

[____________________________________________________________]

Review is ordinarily confined to the record made before the government unit, and issues ordinarily must have been raised there, subject to the exceptions in Pa.R.A.P. 1551(a).

5. Relief Requested

Petitioner requests that the Court:

1. Accept jurisdiction over this petition;
2. Reverse, vacate, modify, or remand the adjudication as authorized by law;
3. Grant any stay or supersedeas requested by separate application;
4. Tax lawful costs; and
5. Grant other relief the Court may lawfully provide.

Notice to Participate

If other parties participated before the government unit but are not named in the caption, include the current notice to participate required by Pa.R.A.P. 1513(d).

Other parties before the government unit:

[____________________________________________________________]

Stay or Supersedeas

Under Pa.R.A.P. 1781(a), an application for a stay or supersedeas ordinarily must first be made to the government unit.

☐ No stay requested

☐ Application made to government unit on [__/__/____]

☐ Application denied or did not afford the requested relief

☐ Appellate application prepared with the required supporting facts and record materials

Signature

Pa.R.A.P. 1513(d) states that no verification is necessary for an appellate-jurisdiction petition for review.

Respectfully submitted,

Dated: [__/__/____]

Signature: ______________________________

Name: [________________________________]

Attorney ID, if applicable: [________________________________]

Address / Telephone / Email: [________________________________]

Proof of Service

I certify that on [__/__/____], a copy of this Petition for Review was served:

Signature: ______________________________

Filing Checklist

☐ Proper appellate court confirmed

☐ Thirty-day or special deadline confirmed

☐ Petition divided into numbered paragraphs

☐ Jurisdictional basis stated

☐ Government unit and proper parties named

☐ Order date and agency docket identified

☐ General objections stated

☐ Relief stated

☐ Order attached as Exhibit A

☐ Certificate required by Pa.R.A.P. 127 prepared

☐ Proof of service included

☐ Government unit and Attorney General served as Rule 1514(c) requires

Sources and References

• 2 Pa.C.S. Chapter 7, including §§ 702 and 704: https://www.legis.state.pa.us/cfdocs/legis/LI/consCheck.cfm?txtType=HTM&ttl=02&div=0&chpt=7
• 42 Pa.C.S. § 763: https://www.legis.state.pa.us/cfdocs/legis/LI/consCheck.cfm?txtType=HTM&ttl=42&div=0&chpt=7&sctn=63&subsctn=0
• Pa.R.A.P. 1512: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/210/chapter15/s1512.html
• Pa.R.A.P. 1513: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/210/chapter15/s1513.html
• Pa.R.A.P. 1514: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/210/chapter15/s1514.html
• Pa.R.A.P. 1551: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/210/chapter15/s1551.html
• Pa.R.A.P. 1781: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/210/chapter17/s1781.html