This form is for use in the AAT’s General Division, Freedom of Information Division, National Disability Insurance Scheme Division, Security Division, Small Business Taxation Division, Taxation & Commercial Division and Veterans’ Appeals Division. 
You can use this form to withdraw an application. When the AAT receives the form, the application is taken to be dismissed under section 42A(1B) of the Administrative Appeals Tribunal Act 1975. The AAT will close the file. An application that has been dismissed by withdrawal may be reinstated only if it was dismissed in error.
SECTION 1  Application	
AAT File Number	

Names of the parties to the application
(Applicant, Respondent and any Other Party)	

	
		
SECTION 2  Notice of Withdrawal	

1.	I am the Applicant or represent the Applicant in this application.
2.	I notify the AAT that the application is withdrawn.

SIGNATURE	
Signature	

	Date	dd   /    mm      /  yyyy	

                      ________________________

                      PRINT NAME

HOW DO I SUBMIT THIS FORM?
You can send us your form by email, post or fax, or deliver it to a registry.
		
Email:	generalreviews@aat.gov.au
		
Post:	AAT, GPO Box 9955, Your capital city. 

Northern Territory residents should write to Adelaide 
   
Norfolk Island residents should write to Sydney	

In person or by fax:		
Adelaide 
Level 2
1 King William St
ADELAIDE SA 5000	Brisbane
Level 6
295 Ann St
BRISBANE QLD 4000	Canberra
Level 8
14 Moore St
CANBERRA ACT 2601
	Hobart
Commonwealth Law Courts
39–41 Davey St
HOBART TAS 7000	
Fax (08) 8128 8099	Fax (07) 3052 3001	Fax (02) 6243 4600	Fax (02) 9276 5597	
Melbourne
Level 4
15 William St
MELBOURNE VIC 3000	NORFOLK ISLAND
Supreme Court of 
Norfolk Island
KINGSTON 
Norfolk Island 2899	Perth
Level 13
111 St Georges Terrace
PERTH WA 6000	Sydney
Level 6
83 Clarence St
SYDNEY NSW 2000	
Fax (03) 9454 6998	TEL +61 2 9391 2400
FAX +61 2 9283 4881	Fax (08) 6222 7299	Fax (02) 9276 5599	

If you want more information or assistance, call us on 1800 228 333 (calls are free from landline phones, however calls from mobiles may be charged). Residents of northern NSW (postcodes 2460–2490) will be connected to the Brisbane registry, and residents of the Northern Territory will be connected to the Adelaide registry. Our staff can give you information about procedures but cannot give you legal advice.
Non-English speakers can call the Translating and Interpreting Service on 131 450 and ask them to call the AAT.
From Norfolk Island and overseas please call +61 2 9391 2400.
If you are deaf or have a hearing or speech impairment, contact us through the National Relay Service. For more information visit www.relayservice.gov.au
Website : www.aat.gov.au