(Here mention the grounds on which the appeal is made):

(i)

(ii)

(iii) 3. Relief sought:

(i)

(ii)

(iii) 4. Prayer:

(a) In the light of what is stated above, the appellant respectfully prays that the order/ decision of the respondent be quashed/set-aside.

(b) The policy/guidelines/regulation framed by the respondent be quashed/ modified /annulled to the extent ..................................................

(c) .........................................................................................