The Code on Social Security (Arunachal Pradesh) Rules, 2021
Form III
Official text
Open in the official PDF (p. 46)
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[See Rule 24]
Appeal to Employees' Insurance Court
To,
The Authority,
(Appointed under the Code on Social Security, 2020)
…………………………………………… (Address)
Sir,
I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , the undersigned, employee of . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and full address of the establishment).
*Feeling aggrieved by the order of ........................................................................... under sub section
7(a) of section 37 for the reasons attached hereto, prefer this second appeal under sub-section 7(b) of
section 37 and request that the said ........................................................................... be ordered
.........................................................
A copy of the order of .......................................................................................... in this behalf is enclosed.
Signature or thumb impression of the aggrieved person
Date : .......................
Signature of an Attester
(in case the person is not able to sign and
affixes thumb impression)