Form No. EA-1
( see Rule 3)
Form of Appeal to the Commissioner (Appeals) under section 35 of the Act
Grounds of appeal
Representative, if any
Verification
I................... the appellant, ................. do hereby declare that what is stated above is true to the best of my information and belief.
verified today, the.............. day of ..................
Place ...............
Date ...................
Note.- (1) The grounds of appeal and the form of verification shall be signed by the appellant in accordance with the provisions of rule 3.
(2) The form of appeal including the statement of facts and the grounds of appeal shall be filed in duplicate and shall be accompanied by a copy of the decision or order appealed against.