Form 6. Notice of Action

A.R.S. § 12-904(B), JRAD Rule 4(f) Distribution: Clerk of Superior Court--Original Administrative Agency--1 Each party--1 Attorney or Party Name State Bar No. (if any) Law Firm Name (if any) Complete Mailing Address Telephone Number Email Address Attorney for __________ (party name) OFFICE OF ADMINISTRATIVE HEARINGS OR NAME OF AGENCY ) Appellant, ) Case No. __________ ) vs. ) NOTICE OF ACTION ) (COMMENCEMENT OF THE APPEAL) ) Appellee. ) ) [Appellant] gives notice pursuant to A.R.S. § 12-904(B) that Appellant has filed an action pursuant to the Judicial Review of Administrative Decisions Act, A.R.S. §§ 12-901 to--914 to appeal the decision of [name of agency] dated [date entered]. DATED this ___ day of __________, 20 ___ Signature of Attorney or Self-Represented Party Copy of the foregoing [mailed/delivered] this _____ day of __________, 20 ___, to: [Attorney or Party Name] by: ______________________________