ARTICLE 1904 BINATIONAL PANEL REVIEW
pursuant to the
NORTH AMERICAN FREE TRADE AGREEMENT
IN THE MATTER OF:
Secretariat File No.
___________________
(Title of Panel Review)
REQUEST FOR PANEL REVIEW
Pursuant to Article 1904 of the North American Free Trade Agreement, panel review is
hereby requested of the final determination referenced below. The following information is
provided pursuant to Rule 34 of the NAFTA Article 1904 Panel Rules:
1. _________________________________________________________
(The name of the Party or the interested person filing this request for panel review)
2. _________________________________________________________
(The name of counsel for the Party or the interested person, if any)
3. _________________________________________________________
_________________________________________________________
_________________________________________________________
(The service address, as defined by Rule 3 of the NAFTA Article 1904 Panel Rules,
including facsimile number, if any)
4. _________________________________________________________
(The telephone number of counsel for the Party or the interested person or the telephone
number of the interested person, if not represented by counsel)
5. _________________________________________________________
(The title of the final determination for which panel review is requested)
6. _________________________________________________________
(The investigating authority that issued the final determination)
7. _________________________________________________________
(The file number of the investigating authority)
8a) _________________________________________________________
(The citation and date of publication of the final determination in the Federal Register,
Canada Gazette or Diario Oficial de la Federación); or
b) _________________________________________________________
(If the final determination was not published, the date notice of the final determination
was received by the other Party)
9. Yes ___________
No ___________
Non-Applicable___________
(Where a Notice of Intent to Commence Judicial Review has been served, is the sole
reason for requesting review of the final determination to require review by a panel?)
10. The Service List, as defined by Rule 3 of the NAFTA Article 1904 Panel Rules, is
attached.
___________
Date
__________________
Signature of Counsel
(or interested person, if
not represented by counsel)