San Manuel Tribal Court
San Manuel Indian Reservation
3214 Victoria Avenue
Highland, CA 92346
Phone: (909) 907-6920
NOTICE OF APPEAL
Appellant Dispute of Decision of the San Manuel Band of Mission Indians
Tribal Gaming Commission
Form approved by Judiciary Committee
NOA-001 • 12/20
*If you need more space, please check this box to indicate
an additional document is attached.
Page 1 of 2
1. Appellant Name and Email and Appellant Attorney Name and Title:
2. Appellant Address:
3. Appellant Telephone Number:
4. Agency Name:
San Manuel Band of Mission Indians Tribal Gaming
Commission
5. Date of Agency Decision:
6. Statement of Trial Court’s Jurisdiction:
This Notice of Appeal is being led pursuant to the jurisdiction of the San Manuel Tribal Court to resolve patron disputes regarding
decisions of the San Manuel Gaming Commission as set forth in 1) Section 10.0 of the Tribal-State Gaming Compact between the
State of California and the San Manuel Band of Mission Indians, effective April 10, 2017, as amended; 2) Section 7.12.23 of the San
Manuel Gaming Act of 1989, as amended; 3) San Manuel Band of Mission Indians Tribal Gaming Commission Regulation 009, as
amended; and 4) Title 4 of the San Manuel Rules of Court (Administrative Review Rules Attached).
7. Describe the Agency's Decision (or attach a printed copy to this form)
Please include a concise statement of the agency decision; include a copy of letter from agency:
8. Describe the Relief You are Seeking from the Tribal Court
Please include the nature of the relief being sought:
9. Describe the Reasons You are Appealing the Agency Decision:
