Originating Application for Review (Form 4)
Form 4 is the Originating Application for Review used in South Australian courts to seek review of a decision of a tribunal, agency or other decision maker. It is prescribed by the Uniform Civil Rules 2020.
Word document from South Australian Courts (CourtSA)'s website.
DraftOur fillable copy of this form has not been through editorial review yet. Check it against South Australian Courts (CourtSA)'s current form before you rely on it.
- Format
- Word (DOCX)
- Category
- Court form
- Form number
- Form 4
- Version
- v5f628a23
- Last verified
- 5 July 2026
Supreme Court of South Australia · District Court of South Australia · Magistrates Court of South Australia · Uniform Civil Rules 2020

For law practices: this form maps to the published matter-field vocabulary, so your practice management system fills it from your matter data - on your own machine. Practice management systems can fetch and assemble it through the document assembly API.
What Form 4 is for
Chapter 19 Part 14 of the Uniform Civil Rules 2020 (SA) applies to proceedings in which a statute gives the court jurisdiction to review an administrative decision or action, whether the statute calls it a review or an appeal; it does not cover Supreme Court judicial review, which is governed by Chapter 20 Part 6 (r 244.1). Rule 244.2(1) requires the proceeding to be started by an Originating Application in Form 4 (review) or Form 5 (appeal against administrative decision). In the Environment, Resources and Development Court, Form 4 is used where the statute calls the proceeding a review (r 362.1(4)) and for a building reference (r 363.2). The supporting affidavit must identify and exhibit evidence of the decision, exhibit any reasons, and set out the facts relied on for the review and any extension of time (r 244.2(2)). On the review the court may set aside, vary or substitute the decision and make costs and other orders (r 244.6).
When you need it
- A statute gives the court power to review an administrative decision and calls the proceeding a review.
- In the ERD Court, you are seeking review of an administrative decision or bringing a building reference (rr 362.1(4), 363.2).
- You seek review of a Registrar's decision on registration of a native title claim, which must be filed within 42 days of notification (r 372.10).
- Not for an appeal against an administrative decision (Form 5), a development appeal (Form 5G), Supreme Court judicial review, or an appeal from a court judgment (Form 181).
How to fill it in
- 1
Complete the heading and parties
Choose the court and name the parties. Join anyone with a direct interest in supporting the decision as a respondent, and the decision maker as an interested party, or as a respondent if it has a direct interest in supporting the decision (r 244.2(3)).
- 2
Describe the application
Give the matter type, a one-sentence summary of the decision under review, and the Act and section or other source of the court's jurisdiction.
- 3
Identify the decision
Give the date of the decision, the date you received notice of it, the tribunal, agency or decision maker, the individual decision maker if known, and any reference number.
- 4
Set out the orders challenged and the orders sought
List only the orders you want reviewed, then the orders you ask the court to make in addition to or in place of them, each in numbered paragraphs.
- 5
Grounds, time and hearing
Name the deponent and date of the supporting affidavit that sets out the grounds. If you need an extension of time, give the provision and grounds. If you want the review decided on written submissions only, give your reasons.
- 6
Mark the accompanying documents
The multilingual notice, supporting affidavit and a copy of the original decision (which may be exhibited to the affidavit) are mandatory. Add any notice for a party served interstate, in New Zealand or outside Australia.
Filing, lodging and service
- File through CourtSA or at a registry with the supporting affidavit. The court inserts the hearing date and time. A filing fee applies: check the fee schedule for the court.
- Serve the Originating Application documents on each respondent and interested party as soon as practicable (r 82.3).
- A respondent or interested party who wants to be heard must file a Response and any responding affidavit within 14 days after service (r 244.3; rr 83.1, 83.2).
- The Registrar may ask the decision maker to send the court the documents relevant to the review, including the decision and reasons (r 244.5).
- Time limits for seeking review are usually set by the statute you rely on. Check it, and seek an extension in the application if you are out of time.
Common mistakes
- Check what the statute calls the proceeding. In the ERD Court a review uses Form 4 and an appeal uses Form 5 (r 362.1).
- Exhibit the decision and any reasons to the supporting affidavit (r 244.2(2)); a missing copy of the decision is a common reason for delay.
- List only the orders you actually challenge. The court's orders on review are set out in r 244.6.
Frequently Asked Questions
What is the difference between Form 4 and Form 5 in SA?
Form 4 is used where the statute calls the proceeding a review; Form 5 where it calls it an appeal against an administrative decision (rr 244.2, 362.1). Both are originating applications under r 82.1.
Do I need to attach the decision?
Yes. The form lists a copy of the original decision as mandatory, and the supporting affidavit must identify and exhibit evidence of the decision and any reasons (r 244.2(2)).
What can the court do on a review?
Subject to the statute, it may set aside the decision, substitute the decision it considers should be made, vary it, order costs, or make other orders (r 244.6).
Checked against the official sources on 26 October 2026
- Uniform Civil Rules 2020 (SA) rr 82.1-82.3, 83.1, 83.2, 244.1-244.6, 362.1, 363.2, 372.10
- Courts Administration Authority - Uniform Civil Rules and Forms 2020
- Courts Administration Authority - Form 4 Originating Application for Review (Word)
- Courts Administration Authority - Fees
General information about the form, not legal advice about your matter. Rules and forms change: if anything here differs from the court or agency's current instructions, theirs apply.
Field map
6 boxes on the Originating Application for Review (Form 4) fill from your matter. 6 are for you to complete: ticks, signatures and anything that needs judgement.
- Client
- Client full name(s)
- Court
- Court file number
- Key Dates
- Current date
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