[Translator’s notes appear in square brackets]

[Personal information has been redacted.]


In the Name of God


Judicial System

Court of Administrative Justice

Petition Form

Number: ------

Priors at Branch ------


Respected plaintiff! Have you filed a complaint with the Court of Administrative Justice before?  No

Details About the Plaintiff: Name: Sohrab; Surname: Laghaie; Father’s Name: Laghaollah; National ID Number: [redacted]; Date of Birth: [redacted]; Citizenship: Iranian; Occupation: Optician

Details about the Legal Representation: Name of Corporation/Establishment/Organization -----; Corporate Registration Number ------; Names and Surnames of Individuals Holding Rights Signature ------; Mailing Address: Mazandaran, [redacted]; Mobile number: [redacted]; Email: ------

Defendant: The Public Places Supervision Office, Town of Qaemshahr

Subject of Grievance and Claim: Cease and desist order and enforcement of Amendment 1, Article 10, of the Law of the Court as stated in the petition

Number and Date of Decision/Judgment Being Contested: ------

Attachments and Documents: ------

Details of the Complaint:

Esteemed Head of the Court of Administrative Justice

With greetings and respect, I convey the following. According to Article 173 of the Constitution, and in accordance with Item 10 of the Court of Administrative Justice Code of Procedure approved on 25 Mordad 1393 [16 August 2014], and relying on the documentation provided, I hereby submit my petition that you issue an order to consider my complaint. This is because the actions of the defendant are against our religion and law. Despite that the attached business permit, which is valid until 10 Mehr 1396 [2 October 2017], is a legal permit, and I was engaged in conducting my business and earning a living at that shop, the respected department has sealed my shop for the last four years. This has caused severe financial and emotional damage to me and my family. Therefore, based upon Amendment 1, Article 10, of the Law of the Court, as well as ceasing the order to close, I request that you issue an order to compensate the damages. Please issue the necessary instructions for appropriate action to be taken.

With expressions of respect,



Plaintiff/Attorney/Legal Representative



Notary Name: ----- Surname: ------ Signature has been verified.