ESFA Mistaken Identity Form

ESFA MISTAKEN IDENTITY FORM
PLEASE NOTE:

Unless a RTO has indicated on the team sheet that a Participant has been mistakenly identified, your challenge will not be accepted.

See section 13.4 of ESFA's Competition Rules

If a Participant believes that they have been mistakenly identified as to committing an offence, the Participant of their Club must notify the ESFA by submitting the following:

COMPULSORY
A signed written statement by the Participant reported, stating that they were not responsible for the offence and identifying to the best of their knowledge, the Participant responsible;

AND(In addition)

OPTION 1
A signed written statement by the Participant who was responsible for the offence; OR

OPTION 2
A signed written statement from the Participant’s Club Official identifying, to the best of their knowledge, the name of the Participant who was responsible for the offence.

These forms must be submitted to the ESFA by 5:00pm the next working day following completion of the match.

Participant Challenging a Decision on the Basis of Mistaken Identity (Compulsory)
Your Details
Full Name*

First NameLast Name
FFA Number*
Your E-mail*
A copy of your submission will be emailed to this address.
Club Name*
Match Details
Opposition Club*
League
Date & Kick off time*

MonthDayYearHourMinutesAM/PM Option
Submission
I declare that the following Participant was responsible for the Offence:*

First NameLast Name
Please select the supporting statement*

Statement by participant responsibleStatement by a club representative
Name of participant responsible*

First NameLast Name
Email of participant responsible*
example@example.com
Name of club representative*

First NameLast Name
Role
Email of club representative*
example@example.com
Digital Signature*

I certify that the information entered above is true and correct and was entered by myself. I acknowledge that I may be charged with Misconduct if it is established that the contents of this statement are incorrect and amount to an abuse of process.
Submission Date*

DayMonthYear
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