Article 1904 binational panel review pursuant to the north american free trade agreement




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ARTICLE 1904 BINATIONAL PANEL REVIEW
pursuant to the
NORTH AMERICAN FREE TRADE AGREEMENT


IN THE MATTER OF:




(Title of Panel Review)


Secretariat File No.


___________________

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)


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