Appellant’s Notice
(Criminal Costs Appeal to a
Costs Judge) / For Court use only
SCCO Ref No
Date filed
Section 1 / Details of the case in which you are appealing

Part 76 of The Criminal Procedure Rules

Court
Name of the case / R v
Case no.
Details of the Appellant Name

Address (including postcode)

Tel No.
Fax
DX
E mail
Ref.
Do you wish to attend the hearing of the appeal? / YES / NO
Section 2 / Details of the decision under appeal
Name and address of the Determining Authority
(the appellant must send a copy of this Notice to the Determining Authority)
Date of written reasons
Section 3 / Extensions of Time
Do you need an extension of time to pursue the appeal? / YES / NO

If yes, please set out the grounds relied on

Section 4 / Grounds of appeal

Please identify (briefly) the items in the written reasons which you wish to appeal and the grounds of appeal in relation to each such item

(if necessary, continue on a separate page)
Section 5 / Supporting documents

To support your appeal you should file with this notice all relevant documents listed below. To show which documents you are filing, please tick the appropriate box.

a copy of the solicitor’s bill or counsel’s fee claim (as appropriate) with any supporting submissions

a copy of the original determination and redetermination

a copy of the appellant’s representations on redetermination

a copy of the written reasons by the determining authority

a copy of the representation order and any authorities granted under it

relevant supporting papers

I confirm that a copy of this notice has been served on the determining authority

Statement of truth
I believe (The appellant believes) that the facts stated in this notice are true.
Full name
Name of appellant’s solicitor’s firm
signed / position or office held
Appellant (‘s solicitor) / (if signing on behalf of firm or company)