The Central Government shall communicate, to the appellant and the National Authority, every order passed or an appeal either by hand delivery or by registered post free of cost.
(No.40020/14/2004-Ch.I) (R.I.Singh) Joint Secretary to the Govt. of India.
Dated June 13, 2005 Seal 6 F O R M A (See sub- rule (1) of rule 4) APPEAL UNDER SECTION 50 OF THE CHEMICAL WEAPONS CONVENTION ACT, 2000 Title of the Case I N D E X S.No. Description of documents relied upon Appeal Page No.
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Signature of the appellant For use in Office Date of filing or Date or receipt by post, Registration. No.
7 Signature of Officer Between -Applicant and - Respondent Details of appeal:
1. Particulars of the appellant:
(i) Name of the appellant:
(ii) Name of father / husband
(iii) Age of the appellant:
(iv) Office address-
(v) Address for service of notices
2. Particulars of the direction issued by the National Authority under section 10 of the Chemical Weapons Convention Act, 2000 against which appeal is made The appeal is against the following order ( i) Direction Order No.
(ii)`Date
(iii) Passed by
(iv) Subject in brief
3. Limitation:
The appellant further declares that the appeal is within the limitation period specified in rule 3 of the Chemical Weapons Convention (Appeal to the Central Government) Rules, 2004.
4. Facts of the case:
The facts of the case are given below:
8 (Give here a concise statement of facts in a chronological order, each paragraph containing as nearly as possible a separate issue, fact or other relevant information)
5. Details of the remedies exhausted:
The appellant declares that he has availed of all the remedies available to him, etc..
(Give here chronologically the details of correspondence made and the outcome of such correspondence with reference to the Annexure numbers).
6. Relief (s) sought In view of the facts mentioned in paragraph 4 above, the appellant prays for the following relief(s) (specify below the relief(s) sought explaining the ground for relief(s) and the legal provisions (if any) relied upon).
7. Interim order, if any prayed for:
Pending final decision on the appeal, the above-mentioned appellant seeks issue of the following interim order:
(Give here the nature of the interim order prayed for with reasons).
8. In the event the memorandum of appeal being sent by registered post, it may be stated whether the appellant desires to have oral hearing at the admission stage and if so he shall attach a self addressed post card / inland letter through which intimation regarding the date of hearing could be sent too him.
9. Particulars of Bank Draft in respect of fee of appeal:
1.Name of the Bank on which drawn 9
2.Demand Draft No.
10. List of enclosures:
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10 V E R I F I C A T I O N I, _______________________(name of the appellant / authorized signatory) S/o, D/o, W/o_______________ Age__________ working as _____________________________________in the office of _____________________________resident of ______________________ hereby verify that the contents of paras ______ to _______ are true to my personal knowledge and para _______ to______ believed to be true on legal advice and that I have not suppressed any material fact.
Signature of the appellant / Authorised signatory 11 F O R M B (See sub-rule(2) of rule 4) RECEIPT SLIP Receipt of the memorandum of appeal filed in the___________________________________ filed by Shri/Smt/Kum_____________________________________________ working as______________________________________________________ ________ residing at ___________________________________________is hereby acknowledged.
Joint Secretary (Chemicals) Department of Chemicals and Petrochemicals Government of India No.40020/14/2002-Ch.I R.I. Singh, Joint Secretary Date:
Seal: