1. Name and Address of the Applicant_______________________________
2. Address of manufacturing unit:____________________________________
3. Name of the Insecticide________________________________________
4. Date of order appealed against ___________________________________
5. Date of communication of the order _______________________________
6. Whether the appeal is within limitation period_________________________
7. Particulars of the fee deposited________________________________
8. Relief claimed in appeal________________________________________
9. Address to which notice may be sent to the applicant
*Statement of Facts
*Grounds of Appeal
*(Please give each ground in a separate paragraph and number it).
I_____________S/o__________________the appellant, do hereby verify that what is stated above is true to the best of my knowledge and belief:
The appeal must be preferred in duplicate and must be accompanied by a copy of the order appealed against.
The form of appeal, ground of appeal and the form of verification must be signed in case of an individual by the individual himself or a person duly authorized by him; in case of Hindu undivided family by the karta, in case of a partnership company, by the magazine partner; in case of a company, by a person duly authorized by the Board of Directors and in any other case, by the person incharge or responsible for the conduct of the business.