The Code on Wages (Lakshadweep) Rules, 2025
Form III
Official text
Open in the official PDF (p. 21)
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(See rule 40)
Appeal under Section 49(1) of the Code on Wages, 2019 Before the Appellate Authority
under the Code on Wages, 2019
A.B.C
Address…………………. APPELLANT
Vs.
C.D.E.
Address ……………………RESPONDENT
DETAILS OF APPEAL:
1. Particulars of the order against which the appeal is made:
Number and date:
The authority who has passed the impugned order:
Amount awarded:
Compensation awarded, ifany:
2. Facts of the case:
(Give here a concise statement of facts in a chronological order, each paragraph containing as
nearlyas possible a separate issue or fact).
3. Grounds for appeal:
4. Matters not previously filed or pending with any other Court or any Appellate
Authority:
The appellant further declares that he had not previously filed any appeal, writ petition or suit
regarding the matter in respect of which this appeal has been made, before any Court or any
other Authority or Appellate Authority nor any such appeal, writ petition or suit is pending
before any of them.
5. Reliefs sought:
In view of the facts mentioned above the appellant prays for the following relief (s): —
[Specify below the relief(s) sought]
6. List of enclosures:
1.
2.
Date :
Place: Signature of the appellant.
For office use
Date of filing or
Date of receipt by post Registration No.
AuthorizedSignatory