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Office of the Revisor of Statutes

APPELLATE PROCEDURE

FORM 114 - PETITION FOR DECLARATORY JUDGMENT

STATE OF MINNESOTA

IN COURT OF APPEALS

CASE TITLE:
Petitioner,PETITION FOR DECLARATORY JUDGMENT
vs.COURT OF APPEALS NUMBER:
Agency or Body,
Respondent.AGENCY OR BODY NUMBER:
TO:The Court of Appeals of the State of Minnesota:

The above-named petitioner hereby petitions the Court of Appeals pursuant to Minnesota Statutes, section 14.44, for a declaratory judgment determining the validity of a rule adopted by (agency) on (date), upon the grounds that the rule (is unconstitutional/exceeds the statutory authority of the agency/was adopted without compliance with statutory rulemaking procedures).

DATED:
NAME, ADDRESS, ZIP CODE, AND TELEPHONE NUMBER OF PETITIONER: (ATTORNEY REGISTRATION LICENSE NUMBER IF REPRESENTED BY COUNSEL)
_
SIGNATURE

(The procedure for obtaining a declaratory judgment on the validity of an administrative rule from the Court of Appeals is set forth in Rule 114, Rules of Civil Appellate Procedure. The rule prescribes the manner of obtaining review, contents of the petition, filing fees, and service requirements for obtaining review. An original and one copy of a completed statement of the case must accompany the petition.)

(Added effective January 1, 1999.)