BLUE BADGE SCHEME - APPEALS FORM

BLUE BADGE SCHEME - APPEALS FORM

Right to Appeal (Stage 2)
Right to Appeal (Stage 2)

Stage 2: Appeal

If you have completed the Stage 1 review or had a face to face assessment and still wish to contest the decision, you can submit a Second Stage Appeal to the Blue Badge Appeal Panel. This appeal will examine whether the correct processes were followed during the initial assessment and the review.

Important Information:
- This form is for the Second Stage Appeal and can only be completed after the review stage has been concluded or if you have had a face to face assessment.
- You must submit your appeal within 4 weeks of receiving the review or face to face assessment decision.
- You may attend the appeal meeting with someone to support you. If you are unable to attend, you can appoint a representative to attend on your behalf, or the panel will proceed in your absence.
1. About You
Name*

First NameLast Name
Address*

Address 1

Address 2

CityState / Province

Post Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
2. Attending Panel Meeting
Please indicate whether you will attend the Panel in person:*

YesNo
Will you be bringing a friend or someone else with you:*

YesNo
If Yes - Please provide their full name:
If No, will you be sending someone else to speak for you:*

YesNo
If Yes - Please provide their full name:
If you need an Interpreter please tell us the language you speak:
Please inform us of any upcoming dates within the next 12 weeks when you are unable to attend the panel. Please specify dates and times below:
3. Reason for appealing
Please explain to the Panel why you are appealing. You can use the space on the page of this form or attach a letter or additional pages of your own.

The Panel will have access to all the information you previously submitted when you applied for a Blue Badge and when you requested a review of the decision.
Use this space
Once you submit this form our Democratic Services Team will contact you with further information about the Appeal panel.
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BLUE BADGE SCHEME - APPEALS FORM

Right to Appeal (Stage 2)

Stage 2: Appeal

1. About You

2. Attending Panel Meeting

3. Reason for appealing