Sample Administrative review application
This page links to an example of a completed form. This is the actual form with sample text added in each section.
You should make sure that your form relates to your circumstances. If you need more help to prepare your form, get legal advice.
Do not try to file this sample form.
This sample form is provided in Word 
format.
For more information about completing this form, see Instructions for completing an Administrative review application.
Case study – May McPhee
May McPhee has received an order for restitution in the amount of $1,500.
Two years ago, May and her friend Sammy went out to the pub and got drunk.They got into a fight with the victim. The victim was injured and claimed support from Victims Services.
Both May and Sammy were convicted for the offence. May was released from gaol and is living with her partner in a rental house. May is currently enrolled in a hairdressing course at TAFE. She is also attending weekly alcohol counselling to help her with her drinking problem. May is eager to put her life back on track and start a new life with her family. She is currently receiving Centrelink payments. May applied for an objection but it was refused.
May wants to apply for a review at NCAT.