2021 PDFNL Notice of Report

2021 AFL Notice of Report
Competition *
Match Date *

Day Month Year
Home Team *
Away Team *
Played At *
I hereby report the following Player / Official *

First Name Last Name
Number *
Club *
Reportable Offences - Direct to Tribunal

REPORTABLE OFFENCES THAT MUST BE HEARD AT THE TRIBUNAL (UMPIRE TO TICK ONE APPROPRIATE BOX). (ANY PLAYER / OFFICIAL REPORTED FOR THE FOLLOWING OFFENCES SHALL APPEAR BEFORE THE LEAGUE TRIBUNAL)
Note:– misconduct covers offences not covered specifically under other laws, e.g. urinating in view of spectators, exposing themselves in front of spectators, etc.

Select ONE option below, if applicable (Set Penalty options are listed further down). Multiple offences require multiple forms to be submitted

	Tribunal
22.2.2 (a) Intentionally or carelessly:- (ii) kicking another person
22.2.2 (a) Intentionally or carelessly:- (iii) kneeing another person
22.2.2 (a) Intentionally or carelessly:- (vi) bumping or making forceful contact to an opponent from front-on when that player has their head down over the ball
22.2.2 (a) Intentionally or carelessly:- (vii) head-butting or making contact with another person using the head
22.2.2 (a) Intentionally or carelessly:- (viii) making unreasonable or unnecessary contact with the eye region of another person;
22.2.2 (b) eye-gouging another person
22.2.2 (c) stomping on another person
22.2.2 (d) intentionally making contact with, or striking, an Umpire
22.2.2 (e) attempting to strike an Umpire
22.2.2 (f) spitting on or at an Umpire
22.2.2 (i) unreasonable or unnecessary contact with an Umpire
22.2.2 (l) spitting on or at another person
22.2.2 (cc) engaging in any act of misconduct or serious misconduct

Reportable Offences - 1 Week Set Penalty or Direct to Tribunal

REPORTABLE OFFENCES THAT MAY BE HEARD AT THE TRIBUNAL (UMPIRE TO TICK ONE APPROPRIATE SET PENALTY BOX OR TRIBUNAL BOX)(ANY PLAYER REPORTED FOR THE FOLLOWING OFFENCES MAY APPLY TO ACCEPT THE RELEVANT SET PENALTY)

Select ONE option below, if applicable (2 week set penalty options are listed further down). Multiple offences require multiple forms to be submitted.If you have ticked the above section (DIRECT TO TRIBUNAL), DO NOT TICK HERE.

	1 Week	Tribunal
22.2.2 (a) Carelessly:- *(i)striking another person
22.2.2 (a) Carelessly:- *(ix) making unreasonable or unnecessary contact with the face of another person
22.2.2 (a ) Carelessly:- *(x) scratching another person
22.2.2 (a) Carelessly:- *(xi) tripping another person whether by hand, arm, foot or leg
22.2.2 (k) disputing the decision of an Umpire
*22.2.2 (m) attempting to strike another person
*22.2.2 (o) attempting to trip another person whether by hand, arm, foot or leg
*22.2.2 (q) engaging in a Melee
*22.2.2 (s) wrestling another person
*22.2.2 (t) pinching another person
*22.2.2 (u) engaging in an act of staging
*22.2.2 (v) using abusive, insulting, threatening or obscene language
*22.2.2 (w) use of an obscene gesture
*22.2.2 (x) engaging in Time Wasting
*22.2.2. (y) interfering with a player kicking for goal
*22.2.2 (z) intentionally shaking, climbing or otherwise interfering with a goal or behind post
*22.2.2. (bb) wearing boots, jewellery and equipment prohibited under Law 9

Reportable Offences - 2 Week Set Penalty or Direct to Tribunal

REPORTABLE OFFENCES THAT MAY BE HEARD AT THE TRIBUNAL (UMPIRE TO TICK ONE APPROPRIATE SET PENALTY BOX OR TRIBUNAL BOX)(ANY PLAYER REPORTED FOR THE FOLLOWING OFFENCES MAY APPLY TO ACCEPT THE RELEVANT SET PENALTY)

Select ONE option below, if applicable (Direct to Tribunal and 1 week set penalty options are listed above). Multiple offences require multiple forms to be submitted. If you have ticked either DIRECT TO TRIBUNAL or 1 WEEK SET PENALTY, DO NOT TICK HERE.

	2 Weeks	Tribunal
22.2.2(a) Intentionally :- *(i) striking another person
22.2.2 (a) Intentionally or Carelessly:- *(iv) Charging another person
22.2.2 (a) Intentionally or Carelessly:- *(v) Engaging in rough conduct against an opponent
22.2.2 (g) behaving in an abusive, insulting, threatening or obscene manner towards, or in relation to, an umpire
22.2.2 (h) using abusive, insulting, threatening or obscene language towards, or in relation to, an umpire
22.2.2 (j) carelessly making contact with an umpire
22.2.2 (n) attempting to kick another person
22.2.2 (p) Making unreasonable or unnecessary contact with an injured player
22.2.2 (r) instigating a Melee
22.2.2 (aa) Failing to leave the Playing Surface when directed to do so by an Umpire

NB: * indicates offences where reprimands may be applied by tribunal

NOTE: If the reported player has been previously suspended or reprimanded in the current or the preceding season the player shall not be able to apply for the set penalty until offered by the League Secretary / General Manager. The League Secretary / General Manager is the only person empowered to decide after studying a player’s tribunal history whether a player can accept the minimum prescribed penalty or will be required to attend the Tribunal Hearing. If a player wishes to accept the minimum set penalty the club secretary must contact the League Secretary / General Manager, no later than 12 noon on the first working day immediately following the match for approval. If the report is not requested to be heard by a tribunal by any party noted below (umpire/offended player(s)/club secretary/official) the player is automatically to be given the prescribed set penalty.
Umpire to Complete
I was the officiating (Field / Boundary / Goal) *
During the (Qtr) *
The above name player/offical was reported for (charge selected above, not details of incident) *
Player Offended against *
Club *
Number *
Umpires Name *
Email *
example@example.com
Signed Umpire, (if facility to sign is available)

Clear
REPORTED PLAYERS CLUB SECRETARY / OFFICIAL

Club Secretary is to act for and on behalf of the player. Under no circumstances is the charged player to approach the umpire.
Reported Player / Official Club Secretary/Official to Choose

The player / official wishes to apply for set penalty as outlined The player / official requests the case be heard by the Independent Tribunal The player / official will decide prior to 9 am Monday
Reported Player / Official Club Secretary / Official Name *
Reported Player / Official Club Email Address *
Reported Player / Official Club Secretary / Official to acknowledge that the report has been read out

Acknowlegement
Reported Player / Official Club Secretary / Official to sign

Clear
Date

Day Month Year
OFFENDED AGAINST PLAYER / OFFICIAL CLUB
The offended against player / official requests the case to be heard by the Independent Tribunal

Yes No Will notify PDFNL by 9 am Monday
Offended against Player / Official Club Secretary/Official Name

First Name Last Name
Offended against Player / Official Club Email Address
Offended against Player / Official Club Secretary / Official to sign

Clear
Date

Day Month Year
Should be Empty:

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2021 AFL Notice of Report

Reportable Offences - Direct to Tribunal

Reportable Offences - 1 Week Set Penalty or Direct to Tribunal

Reportable Offences - 2 Week Set Penalty or Direct to Tribunal

Umpire to Complete

REPORTED PLAYERS CLUB SECRETARY / OFFICIAL

OFFENDED AGAINST PLAYER / OFFICIAL CLUB