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Submission

1.       I am authorised to make this statement on behalf of the Club.

2.       I declare that there has been a case of mistaken identity in relation to the following Fixture:

Match Details

3.       I declare that the Participant referred to below was not responsible for the Offence reported by a Match Official.

4.       I declare that the Participant referred to below was responsible for the Offence reported by a Match Official and should be issued with a Notice of Suspension. 

5.       I declare that the information in this statement is accurate and to the best of my knowledge.

6.       I acknowledge that the Club and I may be charged with Misconduct if it is established that contents of this statement are incorrect and amount to an abuse of process. 

Notes:

1.      Please submit this form by 4pm the next working day after the issuance of the notification of the Incident Report to the Club by the CDSFA.

2.      Participants MUST submit Prescribed Form 07 at the same time as submitting this Form.

3.      Clubs should read and consider section 7.3 prior to signing and lodging this form with the Disciplinary Tribunal.

4.      If the CDSFA does not receive  properly completed forms by the time specified in paragraph 1, the Participant issued with the Notice of Suspension shall serve the Suspension.

5.      Capitalised words used in this document are defined in the Regulations.

Submitter Details