ATAR Appeal Form

ATAR Appeal

Section 1 - ATAR Registrant Details

First Name

Last Name

Date of Birth

LUI Number

Phone

ATAR Issue Year

Have you made an Application to QTAC?

Yes

QTAC Application Number

Section 2 - Add ATAR Appeal Authorisation

Do you wish to authorise someone else to act on your behalf in relation to this ATAR Appeal submission?

Yes

ATAR Appeal Authorisation Details

QTAC will not provide information about your ATAR Appeal submission to anyone except you or someone authorised to act on your behalf. Please be aware that the person given authorisation to act on your behalf:

Must be 18 years or older.
Will get access to the information in your ATAR account.
Will be able to correspond and communicate directly with QTAC about your ATAR Appeal.
Authorisation given by an applicant in their QTAC Application for someone to act on their behalf for their application does not apply to their ATAR Appeal, and vice versa.

First Name

Last Name

Date of Birth

Relationship to Applicant

Phone

Address

City

State/Province

Zip/Postal

Address

Section 3 - Description of the basis of the appeal

Additional documentary evidence can be included if more detail is required.

Description of the basis of the appeal

0 of 500 max characters

Max 500 Characters

Are you submitting additional documentary evidence?

Yes

Make sure your name and LUI is included on additional documents, for identification purposes.

To change your uploaded file before submitting your Appeal form, click on the file name already uploaded and reselect a new file. The original file will be replaced. You cannot remove a file once uploaded.

File Upload

Maximum file size: 12MB

Declaration

I declare that, to the best of my knowledge, the information supplied on this form is correct and complete in every particular. I acknowledge that I have read, understood, and agree to be bound by the policies, terms and conditions set forth in QTAC’s Privacy Policy and QTAC’s Refund Policy.

Payment

The ATAR Appeal fee is $39 (incl. GST).

Payment must be made when the Appeal Application is submitted. If the Appeal is successful the fee will be fully refunded.

Payment

If you are human, leave this field blank.

ATAR Appeal Form

Section 1 - ATAR Registrant Details

Section 2 - Add ATAR Appeal Authorisation

ATAR Appeal Authorisation Details

Section 3 - Description of the basis of the appeal

Payment

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