Appeal (New Form)

Represented Entity

You indicated that you are submitting an appeal on behalf of another organization.
Other Organization*
Other Organization Primary Contact Information*

First NameLast Name
Represented Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Represented Organization Website
Comments - Represented Entity
Optional

Appeal Details

Please provide the following information in order for your appeal to be processed.
Appeal Title*
This is a short title you can give your appeal for reference. (e.g. ACME Appeal 1)
You will need to provide the following information:
1. Appeal Statement - Simple statement of the nature of the appeal.
2. Adverse Effects - What are the adverse effects that were caused by the action or inaction to the individual, the organization, or represented entity/orgization submitting the appeal? This should clearly state what adverse effects are, were, or will be if the appeal is not upheld.
3. Sections Violated - What are the specific sections of the code development procedures, standards development procedures, or guideline development procedures that were violated? This needs to be specific and not general ideas that do not reference the specific section(s) that were violated. If this is not provided the appeal will be returned without action.
4. Actons or Inactions - What specific actions or inactions are being appealed? Note that appeals for actions typically have a time limit associated so it is strongly recommended that you cite the date of the action taken if that is what being appealed.
5. Specific Actions to Mitigate - What would be an acceptable resolution to the appelant? This is important to help the secretariate and the appeals board understand what the appellant is seeking for an outcome. It also may be something that can resolved without going through the formal appeals process if it clearly understood what the desired resolution may be.
Appeal is related to:*

An Action TakenAn Inaction
Action Date*

MonthDayYear
This is the date of the action that is being appealed. Note that the appeal must be filed and appeal fee received within 30 days of the action that is being appealed. If the filing of the appeal and applicable appeal fees are not received within 30 days of the action it is no longer a valid appeal.
Appeal Statement?*
Adverse Effects?*
Section of the Council Policy / Procedures that were violated?*
Specific Action or Inaction that is at issue?*
Specific actions that would satisfy the concern?*
Previous efforts to resolve the objection(s) and the outcome?
Optional | Please explain any previous efforts to resolve the issue.
Supporting Materials

You can upload multiple files here. The total size of all the files cannot exceed 20 mb.
Cancelof

Attestations

The following attestations are required to submit the appeal
I am authorized by the organization identified that I represent to submit this appeal on their behalf.*

Yes
The information I have submitted is true and correct to the best of my knowledge.*

Yes
If there are appeals filing fees associated with this appeal, I understand that the appeal filing fee must be paid by the applicable deadline for the appeal to be processed.*

Yes
I understand that all appeal fees are non-refundable regardless of the appeal assessment and any appeal outcome.*

Yes
Appeal Fee Purchase Order Option
prevnext( X )
Appeal Fee This is the fee per appeal being filed
$500.00 Quantity

Total

$0.00
Waiver (Optional)

I am requesting a waiver of the associated appeal fees.I am requesting that the appeals fees be reduced.
Appeal Fee Waiver or Reduction Justification
By selecting the above you have requested the appeal fees be waived or reduced. Please provide details above explaining the amount you wish to be reduced and an explanation for the reduction or waiver of the applicable fees. Please provide sufficient explanation to justify the request and the exigent circumstances that should be considered by ICC. It is not typical practice to reduce or waive the appeal filing fee(s) and the applicant should NOT assume that the request to reduce or waive the fee(s) will be granted.
Please verify that you are human*
Should be Empty:

Appeal

Represented Entity

Appeal Details

Attestations