STEWARDS DETERMINATION

MOTORCYCLING VICTORIA
Action Required

No Futher ActionOther
PO Box 3

Broadford

Vic 3658

Phone: 03 5784 2827
STEWARDS DETERMINATION
Promoter
Event
Venue
Date

DayMonthYear
Date
MA Permit No.
To (Competitor/ Entrant)
From (Steward)
The following determination is made
Determination made on:

DayMonthYear
Date
Details of Steward
Name
MA Licence number
Date

MonthDayYear
Date
Time
Signature

Clear
An appeal against this determination may be made to MA by stating the grounds of appeal and lodging a fee of $1,000 within 21 days from now.

Fines are to be paid to MA within 72 hours unless the Steward determines otherwise. Failure to comply will result in suspension of licence.

THE CONTROLLING BODY OF MOTORCYCLE SPORT IN VICTORIA
Should be Empty: