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CLARK COUNTY CIVIL LAW RESOURCE CENTER

330 SOUTH THIRD STREET, SUITE 1105

LAS VEGAS, NV 89101

702-455-1854

INSTRUCTIONS FOR PREPARING THE

STATEMENT OF INTENT TO PARTICIPATE IN PETITION

FOR JUDICIAL REVIEW — NRS 130-150

THIS PACKET CONTAINS

INSTRUCTIONS AND SAMPLE FORMS ALONG WITH THE

FOLLOWING BLANK DOCUMENTS

1. Civil Cover Sheet

2. Petition for Judicial Review

3. Certificates of Mailing

4 Cover Sheet for Respondent’s Answering Memorandum of

Points and Authorities

READ ALL THE MATERIALS CONTAINED IN THIS PACKET BEFORE FILLING IN

ANY PORTION OF THE DOCUMENTS. USE BLACK INK AND TYPE OR PRINT

CLEARLY WHEN FILLING OUT DOCUMENTS. THE CLERK’S OFFICE WILL NOT

ACCEPT DOCUMENTS THAT ARE HARD TO READ.

FOR MORE INFORMATION ON DOCUMENT PREPARATION READ THE

“DOCUMENT PREPARATION PAMPHLET” ON THE COUNTY CLERK’S WEB

PAGE, ON-LINE AT:

WWW.CO.CLARK. NV.US/CLERK/FORMS.HTM

REVIEW THE CONTENTS OF THIS PACKET BEFORE FILLING OUT ANY OF THE

FORMS. YOU MAY NEED TO MAKE ADDITIONAL COPIES OF THE BLANK FORMS

BEFORE YOU START.

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IMPORTANT

THESE MATERIALS ARE NOT INTENDED TO SUBSTITUTE FOR THE ADVICE OF

AN ATTORNEY

The law allows you to represent yourself in a legal action. While there is no requirement

that you obtain a lawyer, the legal process is complex and very formal. It is strongly

recommended that you have a lawyer to consult with or represent you.

Private Counsel Is Always Recommended For Legal Matters

The information provided in this form packet is offered to assist you in representing

yourself in court if you do not have a lawyer. If you represent yourself (appear before

the court “pro se” or “pro per”), you must follow the same rules that a lawyer must

follow. Law prohibits courthouse employees from giving legal advice.

You are responsible for knowing the law that applies to your case and the rules of the

court. This information is contained in the Nevada Revised Statutes and Nevada Rules

of Civil Procedure, which are available at the Clark County Law Library. Basic law, court

rules, and statutes are also available on the Internet at: www.leg.state.nv.us.

When you represent yourself, you are responsible for filing and serving the correct court

documents within the required time. You must also make sure that the documents are

complete before they are signed and filed. Failure to comply with any of the court

requirements may cause you to lose important legal rights.

Additional information is available at the Clark County webpage on the Internet at:

www.co.clark.nv.us.

This packet was prepared for educational and information purposes only. It

contains general information and is not intended to apply to any specific situation

or as legal advice.

THIS INFORMATION IS PROVIDED AS A COURTESY ONLY. THE COURT, SELF-

HELP CENTER, NON-PROFIT ORGANIZATION OR LAW LIBRARY THAT MAY

PROVIDE THIS INFORMATION SHALL NOT BE LIABLE FOR ERRORS

CONTAINED HEREIN OR FOR DIRECT, INDIRECT, SPECIAL OR

CONSEQUENTIAL DAMAGES IN CONNECTION WITH THE FURNISHING OF THIS

MATERIAL.

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PETITION FOR JUDICIAL REVIEW

NRS 233B.130-150

NRS 233B. 130—I 50 describes the procedure for requesting judicial review of an

administrative agency’s final decision in a contested case.

A person who is a party to the administrative proceeding and disagrees with the final

decision of the agency may ask the court to review the record of that proceeding. You

must be on the record as a petitioner or respondent in the administrative proceeding in

order to petition the court for judicial review.

PROCEDURE

Petitions for judicial review must name the agency and all other parties of record to the

proceeding as respondents. You must file the petition in the district court in the county

where the proceeding occurred or the county in which you live within 30 days of

receiving the final decision of the agency. (If you are no longer within the state, you

must file in the district court in and for Carson City.) The agency and every other party

to the proceeding must receive a copy of the petition within 45 days of filing the petition

with the clerk of the court.

You should attach a copy of the administrative agency’s final decision to the filed

petition.

Within 20 days after receiving the petition, the agency and all other parties to the

proceeding must file notice of their intent to participate in the judicial review process.

The agency will submit the entire record of the proceedings for the court’s review within

30 days of receiving the petition. (The parties may agree to shorten the record of the

proceedings submitted to the court. Upon request, the court may also agree to extend

the time for submitting the record.)

A request for judicial review is an appeal of the agency’s administrative decision. The

court will look at the record of the administrative proceeding when making its decision.

Upon a showing of good cause, the court may order the agency to receive additional

evidence and reconsider its decision before continuing the judicial review process. If the

agency modifies its decision and you want to continue the judicial review process, the

court will consider the modified decision as the final decision.

Appeals are generally decided upon the record below (lower court or administrative

agency decision) and legal arguments submitted by the parties in the form of a

memorandum of points and authorities. There is no jury. If the appeal concerns

irregularities in procedure that do not appear on the record, the court may receive

evidence limited to those irregularities.

You will have 40 days after notification that the court has the record of the proceeding to

file your memorandum of points and authorities with the Clerk’s Office and to serve the

document on all other parties to the proceeding. A blank cover sheet for your

memorandum is included in this packet.

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The respondents have 30 days from receipt of your memorandum to file an answering

memorandum of points and authorities with the Clerk’s Office and to serve the

document on all other parties to the proceeding.

You may file a reply memorandum with the Clerk’s Office within 30 days of receiving the

respondent’s memorandum of points and authorities. You must also serve the

document on all other parties to the proceeding within this period. A blank cover sheet

for a reply memorandum is also included in this packet.

If you want to request a hearing, you must file your request within 7 days of the date

your reply memorandum is due to the court. Rule 2.16 of the Eighth Judicial District

Court Rules covers hearing requests.

STANDARD OF REVIEW

The court will not reverse or set aside the decision of an administrative agency unless

there were procedural or legal errors, abuse of the agency’s discretion or, the decision

exceeds the agency’s authority. NRS 233B. 135 (3) lists the reasons the court may find

an administrative agency’s decision invalid in whole or in part. You should review this

statute before you submit a request for judicial review.

As the petitioner, you must prove that the administrative agency’s final decision is

invalid.

MOTIONS

During the petition for judicial review process, you may need to ask the court to issue an

order. The most common requests are for an Order to Shorten Time and an Order to

Stay the administrative decision during the judicial review proceeding. You must use a

motion to make requests of the court after you file the petition for judicial review. The

Civil Law Resource Center may have booklets and form packets to assist you in

preparing your documents.

ORDER GRANTING JUDICIAL REVIEW

The Civil Law Resource Center has a form packet to assist you in preparing the court

order should the court grant your request for judicial review.

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PREPARING YOUR DOCUMENTS

All papers presented to the court clerk for filing must be flat, unfolded, firmly bound

together at the top and on standard quality white paper, 8 1/2 x 11 inches in size.

Papers must be two-hole punched at the top. You must stamp or print “ORIGINAL” on

the top of the first page of each original document in the space between the punched

holes. If the document contains more than one page, you must staple the pages

together in the upper left corner.

You may use the blank petition contained in this packet to submit your request to the

court. Simply fill in the appropriate information in the space provided; print clearly and

use black ink. If you chose to type your own documents use the exact format shown for

the blank documents. Use numbered legal pleading paper where indicated.

Petition and Acknowledgement

The petition is a formal request for the court to review the final decision of the

administrative agency. The upper left-hand portion of the petition must contain the

document code (PET) followed by your printed or typed name, complete address and

telephone number, above the words “IN PROPER PERSON” as shown on the sample

document.

The case caption — the part of the document that follows the name and location of the

court — must appear exactly as shown on the blank document in this packet. Print or

type your name in the space provided above the word “PETITIONER” Show the names

of all other parties to the administrative proceeding in the space above the word

“RESPONDENT.” The Clerk’s Office will provide a case number and assign a judicial

department when you file the petition with the court.

To complete the first paragraph of the blank petition contained in this packet, you must

print your name on the first line following the word “PETIONER.” On the second line,

list the name of the hearing officer and/or agency issuing the final decision. The third

line requires you to give the date of the decision.

On the first line in the second paragraph, you must tell the court which statute gives you

the right to appeal the agency’s decision through the courts. (The administrative agency

may provide this information when it gives you its final decision.) On the second line,

specify the type of case you are appealing.

The final paragraph provides space for you to tell the court, briefly, why you believe the

administrative agency’s final decision is invalid. You will have an opportunity to go into

more detail when you file your memorandum of points and authorities. Insert the name

of the hearing officer or agency in the space provided.

Print your name, complete address, and telephone number on the lines provided at the

bottom of the last page of the petition.

You must acknowledge your petition before a notary public. Complete the

acknowledgement form contained in this packet by inserting the date and your name in

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the spaces provided. Take the petition and acknowledgement to a notary public. Date

and sign the petition in the presence of the notary. The notary will complete the

acknowledgement process and sign that document.

Certificate of Mailing

You must provide the court with proof that you gave the other parties to the case a copy

of your documents. You do this by filing a certificate of mailing with the Clerk’s Office.

To complete the certificate of mailing attached to the petition you must insert the city or

town where you mailed a copy of the petition to all other parties in the administrative

proceeding. You must also list the name of each party and the address to which you will

mail the copy of the petition. Sign the document, print your name and insert the date

you mailed the copies of the petition in the spaces provided.

FILING AND SERVING YOUR PETITION

You must take the completed petition with a copy of the agency’s final decision,

acknowledgement and certificate of mailing to the Clerk’s Office. You will need one

original and two copies of each document. You must two-hole punch and identify the

original as described earlier in this packet.

You will also need the civil cover sheet included in this packet. To complete the cover

sheet, type or print your name, address and telephone number in the space provided in

Section I — Party Information. In Section Il, the “CIVIL PETITION FOR JUDICIAL

REVIEW” box indicates the nature of the filing. You should check the appropriate box

under this heading to indicate the type of decision you are appealing.

Take the completed documents to the Clerk’s Office located on the third floor of the

courthouse. A filing fee may be required. You may pay in cash, by check or money

order. You will need personal identification if you are paying by check.

At the filing counter, a clerk will assign a case number and judicial department. The

clerk will keep the original and one copy of the documents. The clerk will stamp and

return one copy to you. This is your “file-stamped” copy. You will need to make copies

of the file-stamped documents to mail to the other parties in the case. You must mail the

document to the other parties in the case, or their attorney, on the date indicated on the

certificate of mailing.

Keep one copy of the file-stamped documents for your records.

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MEMORANDUM OF POINTS AND AUTHORITIES

Rule 28 of the Nevada Rules of Appellate Procedure describes the format you must use

in preparing your memorandum of points and authorities. This document, also called a

brief, must contain a table of contents, statement of the issues, statement of the case,

your argument and a short conclusion. This is a very structured document. You should

read Rule 28 before you prepare your memo rand urn.

If you have not written a legal brief, you may find the Civil Law Resource Guide

Booklet #2— Writing a Memorandum of Points and Authorities Part II: Presenting

Your Argument on Appeal of assistance.

Memorandum Cover Sheet

The upper left-hand portion of the cover sheet must contain the document code (BREF)

followed by your printed or typed name, complete address and telephone number,

above the words “IN PROPER PERSON” as shown on the sample document.

The case caption — the part of the document that follows the name and location of the

court — must appear exactly as shown on the blank document in this packet. Print or

type your name in the space provided above the word “PETITIONER.” Show the

names of all other parties to the case in the space above the word “RESPONDENT.”

Insert the case and judicial department number assigned to the case by the Clerk’s

Office in the space provided.

Complete the cover sheet by inserting your name, complete address and telephone

number, above the words “IN PROPER PERSON” in the space provided in the lower

left-hand portion of the document. On the lower right-hand side of the document, insert

the name, complete address and telephone number of the respondent, or the

respondent’s attorney. If an attorney represents the respondent, insert the words

“ATTORNEY FOR THE RESPONDENT” on the following line. If an attorney does not

represent the respondent, insert the words, “RESPONDENT IN PROPER PERSON” in

the space provided.

Reply Memorandum Cover Sheet

The upper left-hand portion of the cover sheet for your reply memorandum must contain

the document code (To complete the blank document contained in this packet, follow

the instructions given for the memorandum cover sheet.

Certificate of Mailing

You must provide the court with proof that you gave the other parties to the case a copy

of your documents. You do this by filing a certificate of mailing with the Clerk’s Office.

To complete the certificate of mailing, insert the city or town where you will mail a copy

of your memorandum to all other parties in the case. Next, list the name of each party

and the address to which you will mail the memorandum. Sign the document, print your

name and insert the date you filed the coversheet and memorandum in the space

provided.

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FILING AND SERVING YOUR MEMORANDUM AND REPLY MEMORANDUM

You must take the completed memorandum coversheet and certificate of mailing, with a

copy of your brief attached, to the Clerk’s Office located on the third floor of the

courthouse. You will need one original and three copies of each document. You must

two-hole punch and identify the original as described earlier in this packet.

At the filing counter, a clerk will keep the original and one copy of the document. The

clerk will stamp and return two copies to you. These are your file-stamped copies. Give

the clerk one of your file-stamped copies. Ask the clerk to give the document to the

judge as a “courtesy” copy. Use the remaining file stamped copy to make additional

copies to mail to the other parties in the case that you listed on the Certificate of Mailing.

Keep one copy of the file-stamped document for your records.

Nevada AOC – Planning and Analysis Division Form PA 201

Rev. 2.3E

CIVIL COVER SHEET

County, Nevada

Case No.

(Assigned by Clerk’s Office)

I. Party Information

Plaintiff(s) (name/address/phone):

Attorney (name/address/phone):

IN PROPER PERSON

Defendant(s) (name/address/phone):

N/A

Attorney (name/address/phone):

N/A

II. Nature of Controversy (Please check applicable bold category and Arbitration Requested

applicable subcategory, if appropriate)

Civil Cases

Real Property Torts

Landlord/Tenant

Unlawful Detainer

Title to Property

Foreclosure

Liens

Quiet Title

Specific Performance

Condemnation/Eminent Domain

Other Real Property

Partition

Planning/Zoning

Negligence

Negligence – Auto

Negligence – Medical/Dental

Negligence – Premises Liability

(Slip/Fall)

Negligence – Other

Product Liability

Product Liability/Motor Vehicle

Other Torts/Product Liability

Intentional Misconduct

Torts/Defamation (Libel/Slander)

Interfere with Contract Rights

Employment Torts (Wrongful termination)

Other Torts

Anti-trust

Fraud/Misrepresentation

Insurance

Legal Tort

Unfair Competition

Probate Other Civil Filing Types

Summary Administration

General Administration

Special Administration

Set Aside Estates

Trust/Conservatorships

Individual Trustee

Corporate Trustee

Other Probate

Construction Defect

Chapter 40

General

Breach of Contract

Building & Construction

Insurance Carrier

Commercial Instrument

Other Contracts/Acct/Judgment

Collection of Actions

Employment Contract

Guarantee

Sale Contract

Uniform Commercial Code

Civil Petition for Judicial Review

Other Administrative Law

Department of Motor Vehicles

Worker’s Compensation Appeal

Appeal from Lower Court (also check

applicable civil case box)

Transfer from Justice Court

Justice Court Civil Appeal

Civil Writ

Other Special Proceeding

Other Civil Filing

Compromise of Minor’s Claim

Conversion of Property

Damage to Property

Employment Security

Enforcement of Judgment

Foreign Judgment – Civil

Other Personal Property

Recovery of Property

Stockholder Suit

Other Civil Matters

III. Business Court Requested (Please check applicable category; for Clark or Washoe Counties only.)

NRS Chapters 78-88 Investments (NRS 104 Art. 8) Enhanced Case Mgmt/Business

Commodities (NRS 90) Deceptive Trade Practices (NRS 598) Other Business Court Matters

Securities (NRS 90) Trademarks (NRS 600A)

Date

Signature of initiating party or representative

This form CANNOT be filled out

online.

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PET

Name

Address

City, State, Zip Code

Telephone number

IN PROPER PERSON

DISTRICT COURT

CLARK COUNTY, NEVADA

) Case No.:

Petitioner )

vs. ) Dept. No.:

)

Respondents )

PETITION FOR JUDICIAL REVIEW

COMES NOW the Petitioner, , a resident of Clark

County, Nevada, appearing in proper person in the above-entitled action, and hereby

petitions this Court for judicial review of the Decision and Order of the

dated , a copy of which is attached hereto as

Exhibit 1.

This Petition for Judicial Review is filed pursuant to ,

which provides for judicial review of contested cases

in accordance with the provisions of NRS 233B.

Petitioner alleges that the decision of was

The following forms can be filled

out online.

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DATED this day of , 20 .

Respectfully submitted,

IN PROPER PERSON

Name

Address

City, State, Zip Code

Telephone number

IN PROPER PERSON

///

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ACKNOWLEDGEMENT

STATE OF NEVADA )

) ss,

COUNTY OF CLARK )

On this day of , 20 , before me, the undersigned

Notary Public in and for said county and state, personally appeared

know to me or proved to be, the person described in and

who acknowledged to me that executed the foregoing instrument, and who

acknowledges to me that executed the same freely and voluntarily and for the

uses and purposes mentioned therein.

NOTARY PUBLIC

///

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CERTIFICATE OF MAILING

I HEREBY CERTIFY that on the date shown below, a true and correct copy of the

foregoing Petition for Judicial Review was mailed postage prepaid, in a sealed

envelope, at , Nevada, to the following interested parties:

DATED this day of , 20

By:

Signature

PRINT NAME

///

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BREF

Name

Address

City, State, Zip Code

Telephone number

IN PROPER PERSON

DISTRICT COURT

CLARK COUNTY, NEVADA

) Case No.:

Petitioner )

vs. ) Dept. No.:

)

Respondents )

PETITIONER’S OPENING BRIEF

NAME NAME

ADDRESS ADDRESS

CITY, STATE, ZIP CODE cITY, STATE, ZIP CODE

TELEPHONE NUMBER TELEPHONE NUMBER

PETITIONER,

IN PROPER PERSON

///

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CERTIFICATE OF MAILING

I HEREBY CERTIFY that on the date shown below, a true and correct copy of the

foregoing Petitioner’s Opening Brief was mailed postage prepaid, in a sealed envelope,

at , Nevada, to the following interested parties:

DATED this day of , 20

By:

Signature

PRINT NAME

///

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BREF

Name

Address

City, State, Zip Code

Telephone number

IN PROPER PERSON

DISTRICT COURT

CLARK COUNTY, NEVADA

) Case No.:

Petitioner )

vs. ) Dept. No.:

)

Respondents )

PETITIONER’S REPLY BRIEF

NAME NAME

ADDRESS ADDRESS

CITY, STATE, ZIP CODE cITY, STATE, ZIP CODE

TELEPHONE NUMBER TELEPHONE NUMBER

PETITIONER,

IN PROPER PERSON

///

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CERTIFICATE OF MAILING

I HEREBY CERTIFY that on the date shown below, a true and correct copy of the

foregoing Petitioner’s Reply Brief was mailed postage prepaid, in a sealed envelope, at

, Nevada, to the following interested parties:

DATED this day of , 20

By:

Signature

PRINT NAME

///

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