[DRAFT] NOTICE OF APPEAL AND PETITION FOR ADMINISTRATIVE REVIEW
(Washington Administrative Procedure Act – Ch. 34.05 RCW)
[// GUIDANCE: This template is designed for use when appealing a final agency order to a Washington State administrative tribunal (e.g., Office of Administrative Hearings, Board of Industrial Insurance Appeals, Pollution Control Hearings Board, etc.). It assumes the Washington Administrative Procedure Act (“APA”) governs. Customize bracketed items and delete any unused sections before filing.]
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions
- Representations & Warranties
- Covenants & Restrictions
- Default & Remedies
- Risk Allocation
- Dispute Resolution
- General Provisions
- Execution Block
1. DOCUMENT HEADER
1.1 Title.
NOTICE OF APPEAL AND PETITION FOR ADMINISTRATIVE REVIEW OF FINAL AGENCY ORDER ISSUED BY [AGENCY NAME]
1.2 Parties.
a. Petitioner: [PETITIONER LEGAL NAME], a [Washington corporation/individual/other entity] (“Petitioner”).
b. Respondent: [AGENCY NAME], an agency of the State of Washington (“Agency”).
1.3 Recitals.
WHEREAS, on [DATE], the Agency entered a “Final Order” in Agency Docket No. [NUMBER] adverse to Petitioner; and
WHEREAS, Petitioner is aggrieved by the Final Order and seeks administrative appellate review pursuant to the Washington Administrative Procedure Act, ch. 34.05 RCW (“APA”); and
WHEREAS, Petitioner has satisfied all jurisdictional prerequisites, including exhaustion of administrative remedies under RCW 34.05.534 and timely filing under RCW 34.05.542(2);
NOW, THEREFORE, Petitioner submits this Notice of Appeal and Petition for Administrative Review (this “Petition”) and respectfully requests the relief set forth herein.
1.4 Effective Date & Jurisdiction.
This Petition is deemed filed on the date indicated in the Execution Block and is governed exclusively by Washington state administrative law.
2. DEFINITIONS
For purposes of this Petition, capitalized terms have the meanings set forth below:
“Agency Record” – The complete record of the Agency’s proceedings as defined in RCW 34.05.566.
“APA” – The Washington Administrative Procedure Act, ch. 34.05 RCW.
“Final Order” – The Agency’s written decision dated [DATE] in Agency Docket No. [NUMBER].
“Petitioner” – The party identified in Section 1.2(a).
“Respondent” or “Agency” – The entity identified in Section 1.2(b).
[// GUIDANCE: Add or delete defined terms as needed.]
3. OPERATIVE PROVISIONS
3.1 Statement of Jurisdiction.
This Tribunal possesses jurisdiction under RCW 34.05.514(1) because the Final Order constitutes an appealable “final agency action” within the meaning of RCW 34.05.570(3).
3.2 Timeliness & Venue.
a. Timeliness. This Petition is filed within thirty (30) days after service of the Final Order, satisfying RCW 34.05.542(2).
b. Venue. Venue is proper in [NAME OF ADMINISTRATIVE TRIBUNAL] pursuant to [APPLICABLE STATUTE/REGULATION].
3.3 Issues Presented for Review.
Petitioner seeks review on the following grounds permitted by RCW 34.05.570(3):
i. The Agency erroneously interpreted or applied the law;
ii. The Final Order is not supported by substantial evidence;
iii. The Agency’s decision is arbitrary or capricious;
iv. [ADD ADDITIONAL STATUTORY GROUNDS, IF ANY].
3.4 Relief Requested.
Petitioner respectfully requests that the Tribunal:
a. Reverse, vacate, or modify the Final Order;
b. Award reasonable attorney fees and statutory costs as authorized by RCW 34.05.570(4);
c. Grant such other and further relief as the Tribunal deems just and equitable.
3.5 Designation of Agency Record.
Pursuant to RCW 34.05.566(4), Petitioner designates the entire Agency Record, including all exhibits, transcripts, and pleadings, for purposes of this review.
3.6 Filing & Service.
Concurrent with filing, Petitioner shall serve copies of this Petition on the Agency and the Office of the Attorney General in accordance with RCW 34.05.542(4) and WAC 10-08-110.
4. REPRESENTATIONS & WARRANTIES
4.1 Authority.
Petitioner warrants that it has full legal capacity and authority to prosecute this appeal.
4.2 Exhaustion of Administrative Remedies.
Petitioner represents that all available intra-agency appeals have been exhausted in compliance with RCW 34.05.534.
4.3 Accuracy of Statements.
Petitioner warrants that, to the best of its knowledge after reasonable inquiry, all factual statements herein are true and correct and all legal arguments are warranted under existing law or a good-faith argument for its extension.
4.4 Survival.
The warranties in this Section 4 survive disposition of the Petition.
5. COVENANTS & RESTRICTIONS
5.1 Cooperation.
Petitioner covenants to cooperate with the Agency in compiling the Agency Record and to comply with all Tribunal scheduling orders.
5.2 Notice of Supplementation.
Petitioner shall promptly notify the Tribunal and the Agency of any material change in facts or law that may affect the merits of this Petition.
6. DEFAULT & REMEDIES
6.1 Events of Default.
a. Failure to Prosecute. Failure by Petitioner to appear at scheduled conferences or to file required briefs may result in dismissal under WAC 10-08-200.
b. Failure to Provide Record. Failure by the Agency to transmit the Agency Record within the time set by RCW 34.05.566(6) constitutes default.
6.2 Cure Periods.
The defaulting party shall have ten (10) days after notice of default to cure unless a shorter period is ordered for good cause.
6.3 Remedies.
Upon default, the Tribunal may impose any remedy authorized by the APA, including dismissal, reversal, sanctions, or assessment of fees and costs.
7. RISK ALLOCATION
7.1 Administrative Penalties.
Nothing in this Petition shall be construed to expand Petitioner’s liability beyond the administrative penalties, interest, or costs expressly authorized by governing law.
7.2 Costs of Appeal.
Each party shall bear its own costs absent a statutory or regulatory provision to the contrary or an express order of the Tribunal.
8. DISPUTE RESOLUTION
8.1 Governing Law.
This appeal is governed exclusively by Washington state administrative law, including the APA and applicable agency regulations.
8.2 Forum Selection.
All proceedings shall be conducted before [NAME OF ADMINISTRATIVE TRIBUNAL] (“Tribunal”), which has exclusive jurisdiction over this matter.
8.3 Arbitration.
Arbitration is not available for issues within the Tribunal’s statutory jurisdiction.
8.4 Jury Waiver.
Because this is an administrative proceeding, trial by jury is unavailable and hereby waived.
8.5 Injunctive Relief.
The Tribunal retains authority to stay the effectiveness of the Final Order or to grant other interim relief under RCW 34.05.550 pending final disposition.
9. GENERAL PROVISIONS
9.1 Amendments & Waivers.
This Petition may be amended only by leave of the Tribunal; waivers require written consent of the non-waiving party.
9.2 Assignment.
Petitioner may not assign its rights or obligations arising from this Petition without prior Tribunal approval.
9.3 Severability.
If any provision of this Petition is held invalid, the remaining provisions shall remain in full force to the maximum extent permitted by law.
9.4 Integration.
This Petition, together with the Agency Record and all pleadings filed herein, constitutes the entire statement of claims and relief sought by Petitioner.
9.5 Electronic Signatures & Counterparts.
This Petition may be executed in counterparts and by electronic signature, each of which shall be deemed an original.
10. EXECUTION BLOCK
Executed this ___ day of _, 20_, at _____, Washington.
PETITIONER:
[LEGAL NAME]
By: ______
Name: ______
Title: _________
Attorney for Petitioner (if any):
[ATTORNEY NAME], WSBA No. ______
[LAW FIRM NAME]
[ADDRESS]
[PHONE] | [EMAIL]
CERTIFICATE OF SERVICE
I certify that on the date stated above I served a true and correct copy of this Petition on:
1. [AGENCY NAME & ADDRESS]; and
2. Office of the Attorney General, [SECTION], P.O. Box 40100, Olympia, WA 98504-0100,
by [U.S. Mail/Hand Delivery/E-Service] as authorized by WAC 10-08-110.
[NAME], Declarant
[// GUIDANCE: Attach exhibits (e.g., copy of Final Order) as separate labeled documents. Verify service requirements for the specific tribunal and agency rules.]