(Here mention the grounds on which the appeal is made):

2. 3. Relief sought:

2. 4. Prayer:

1. In the light of what is stated above, the appellant respectfully prays that the order/ decision of the respondent be quashed/set-aside.
2. The policy/guidelines/regulation framed by the respondent be quashed/ modified /annulled to the extent ...................................................
3. ..........................................................................................