The official seal and emblem of the Tribunal shall be such as the Central Government may specify.
FORM [See rule 5(1)] MEMORANDUM OF APPEAL UNDER SECTION 14 OF THE CONTROLV OF NATIONAL HIGHWAYS (LAND AND TRAFFIC) ACT, 2002 (13 OF 2003) For use of Tribunal’s office Date of filing...............................
‘ Date of receipt by post........................
Registration No. ......... ’. ..........
p ..............
Signature Registrar In the National Highways Tribunal ................._....Appellant .....................Respondent(s) Details of appeal:
1. Particulars of the appellant:
(i) Name of the appellant
(ii) Name of father/husband
(iii) Address of appellant
(iv) Address for service of all notices.
2. Particulars of the respondent or respondents including address of service:
3. Particulars of the order against which the appeal is filed. The appeal is against the following order:—
(i) Order No.
(ii) Date
(iii) Passed by
4. Jurisdiction of the Tribunal.—The appellant declares that the matter of the appeal falls within the jurisdiction of the Tribunal.
1,.
10‘
11.
The National Highways Tribunal (chodurp) Rules, 2003 Limitation—1'hé appellant further declares that the appPeal is within the Limitahon prescribed under section 19 of the Control of National Highways (Land and Traffic) Act, 2002 (13 of 2003) ’ . Facts of the case and Mders passed in actians talent by the Highway Administrations n! the officev authorized on its behalf, as the ms: may be—The facts of the case are given below (Give here a concise statement of facts and grounds or appeal against the specific order passed or action taken by the Highway Administréliiin or an officer authorized on its behalf as the case may be in a dlronologifld. order, each paragraph containing as neatly as possible a separate issue, fact or otherwise) Relief: sought—yin View of the facts mentioned in paragraph five above, the appellant prays for the tollawing reliefs (specify below the relief sought explaining the grounds for rehab) and the legal provisions (it any) relied upon.
Interim order, If prayed fan—Pmding final decision of the appeal, the appellant seeks issue of the following interim order:— (Give here the nature of the interim order prayed for with reasons) Matter not pending with any other court, etc—The appellant further declares that the matter regarding which this appeal has been made is not pending belure any court of law or any other authority or any othertribunal Details of indnwAp indefi'in duplicate mntaining the details otthe daaunents to be reliedrppqn‘is enclosed.
List of enclosures:
VERIFICATION a. (namein fullm block letters) son/daughter/wite of Stu-i.
do hereby verify that the contents of paras 1 to 11 are true to my personal knowledge and belief and that I have not suppressed any material facts.
Place ,.
Date To.
Signature of thesapplit‘ant The Registrar,