17
Rules of the Sports Tribunal of New Zealand
Application for Anti-Doping
Rule Violation Proceedings
1. Details of the Applicant
Name
Postal Address
Contact Person for this application
Name
Position
Telephone (Wk) Mobile
Facsimile (Wk)
Email
2. Details of the Athlete
Please provide the last known contact details of the person against whom you allege may have or has
committed an Anti-Doping Rule Violation (“the Athlete”).
Name
Postal Address
Telephone (Wk) (Hm)
Facsimile (Wk) Mobile
Email
3. Details of Representative
Please insert the details of your legal representative or other person, if any, who will be representing the
Applicant in these Proceedings.
Name of Representative
Firm/Company
Postal Address
Contact Person for this application
Name
Position
Telephone (Wk) Mobile
Facsimile (Wk)
Email
FORM 1
TITLE FIRST NAME SURNAME
STREET SUBURB
CITY
POSTCODE
TITLE FIRST NAME SURNAME
STREET SUBURB
CITY
POSTCODE
TITLE FIRST NAME SURNAME
STREET SUBURB
CITY
POSTCODE
TITLE FIRST NAME SURNAME
Rules of the Sports Tribunal of New Zealand
18
4. Jurisdiction
Give details of the basis of the Tribunal’s jurisdiction.
5. Alleged Anti-Doping Violation
(a) Give details of the alleged anti-doping violation.
(b) Give details of the article or rule in the WADA Code, Sports Anti-Doping Rules or other relevant
constitutional or regulatory provision which the Athlete has allegedly infringed.
(c) Summarise the evidence which will be produced in support of the alleged violation (the summary
will not preclude further evidence being brought in accordance with any direction given by
the Tribunal). If the basis of the allegation is a positive test result provide a copy of the documents
evidencing that result.
19
Rules of the Sports Tribunal of New Zealand
7. Result Sought
Please supply the outcome sought in accordance with the applicable doping rules/policies.
8. Information about Athlete’s Sporting Activities
(a) Do you know if the athlete plays or otherwise participates in other sports, apart from the sport to
which the alleged anti-doping violation applies? Yes No
If so please provide details of those sports below:
(b)
If known, please provide details of the athlete’s sporting commitments over the next 6 months below:
(c)
Please provide any other information you think may be relevant about the athlete’s sporting activities:
6. Provisional Suspension
(a) Has the NSO (if the applicant is not the NSO) had its attention drawn to the provisional
suspensions provisions of the Doping Rules? Yes No
(b) Is the Applicant applying for the Athlete to be provisionally suspended? Yes No
If answer to (b) above is yes and Applicant is applying for provisional suspension, please also complete
and fi le Form 6 Application for Provisional Suspension in Anti-Doping Rule Violation Matter.
Rules of the Sports Tribunal of New Zealand
20
Filing and Service Instructions
1. This application should be signed and fi led with the Registrar of the Sports Tribunal at the
address given below.
2. The application should be accompanied by the prescribed fi ling fee (if any) together with a copy
of the applicable constitution, rules or policies which give the Applicant the basis for bringing
the allegations.
3. Where possible, a summary of the evidence to be brought in support of the allegations and a
copy of documents evidencing a positive test return should be attached.
4. The Applicant is to personally serve a copy of this application and attachments on the Athlete
as soon as practical after the original has been fi led with the Tribunal and will forthwith after
service forward to the Tribunal Notice of Service on the form attached.
The Registrar
Sports Tribunal
PO Box 3338
WELLINGTON
Ph: 0800 55 66 80
Fax: 0800 55 66 81
Email: info@sportstribunal.org.nz
Web: www.sportstribunal.org.nz
TITLE FIRST NAME SURNAME
DAY / MONTH / YEAR
Authority
Name
by signing this application certifi es that the signatory is authorised to sign this application on behalf of
the Applicant.
Signed
Position Date
21
Rules of the Sports Tribunal of New Zealand
Notice of Service
(to be attached to Form 1)
I,
hereby certify that on the day of 20
I personally served upon the Athlete named in the attached application a true copy of the Application and
supporting documents.
Attached hereto is a copy of the Application and supporting documents which I served on the Athlete.
I have initialled each page of the Application form and supporting documents as evidence that these are true
copies of the documents so served.
Dated the day of 20
Signed
TITLE FIRST NAME SURNAME
DAY MONTH YEAR
DAY MONTH YEAR
Rules of the Sports Tribunal of New Zealand
22
Notice to be Endorsed
on Application Served on Athlete
To
Address
This is a copy of the application fi led by the Applicant with the Sports Tribunal.
The Tribunal has an obligation to promptly hear this application. Your rights are:
(a) To defend the application.
(b) To admit the violation but advise you wish to participate in a hearing to make submissions on any
penalty which may be imposed; or
(c) to admit the violation and advise you do not wish to participate in a hearing and understand that a
penalty will be determined by the Tribunal based on the application.
You must by 5.00pm on a date not later than seven working days from the service of this notice on you
complete, sign and return the attached Form 2 if you wish either to defend the Application or to admit the
violation but to participate in the hearing to consider the penalty. If you do not take such action the Tribunal
has the right to hear and determine the application in your absence and impose a penalty on you.
If you need more time to complete and return the attached form, you should immediately apply to the Registrar
for an extension of time.
A copy of the relevant Rules of the Tribunal is enclosed for your information. If you have questions regarding
this matter, please contact the Registrar on 0800 55 66 80 or email on info@sportstribunal.org.nz.
STREET SUBURB
CITY
POSTCODE
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