Rule Form III Form III
- Chapter
- Annexures · Forms and Appendices
- Text as on
- As notified 08 May 2026
FORMDefined in rule 2(k): form means the forms appended to these rules III (See sub rule (1) of rule 50)
APPEALDefined in rule 2(a): appeal means an appeal under sub section (1) of section 49 UNDER SECTION 49(1) OF THE CODEDefined in rule 2(g): Code means the Code on Wages, 2019 (29 of 2019) ON WAGES, 2019 BEFORE THE APPELLATE AUTHORITYDefined in rule 2(b): appellate authority means the appellate authority appointed by the Central Government under sub section (1) of section 49 UNDER THE CODEDefined in rule 2(g): Code means the Code on Wages, 2019 (29 of 2019) ON WAGES, 2019 A.B.C Address................................................................................................... ... ......................APPELLANT
Vs. C.D.E. Address....................................................................................................................... RESPONDENT
DETAILS OF APPEALDefined in rule 2(a): appeal means an appeal under sub section (1) of section 49:
1. Particulars of the order against which the appealDefined in rule 2(a): appeal means an appeal under sub section (1) of section 49 is made : Number and date : The authorityDefined in rule 2(d): authority means the authority appointed by the Central Government under sub section (1) of section 45 who has passed the impugned order: Amount awarded: Compensation awarded , if any :
2. Facts of the case : (Give here a concise statement of facts in a chronological order, each paragraph containing as nearly as possible a separate issue or fact).
3. Grounds for appealDefined in rule 2(a): appeal means an appeal under sub section (1) of section 49 :
4. Matters not previously filed or pending with any other Court or any Appellate AuthorityDefined in rule 2(b): appellate authority means the appellate authority appointed by the Central Government under sub section (1) of section 49: The appellant further declares that he had not previously filed any appealDefined in rule 2(a): appeal means an appeal under sub section (1) of section 49, writ petition or suit regarding the matter in respect of which this appealDefined in rule 2(a): appeal means an appeal under sub section (1) of section 49 has been made, before any Court or any other AuthorityDefined in rule 2(d): authority means the authority appointed by the Central Government under sub section (1) of section 45 or Appellate AuthorityDefined in rule 2(b): appellate authority means the appellate authority appointed by the Central Government under sub section (1) of section 49 nor any such appealDefined in rule 2(a): appeal means an appeal under sub section (1) of section 49, 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: Signature of the appellant.
1. Authorized Signatory 2. 3. 4. ........... Date : Place :
For office use
Date of filing or Date of receipt by post Registration No.