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Bare acts > Punjab Maternity Benefit Rules, 1967 > Form J
 
  


 

FORM ‘J’
(See Rule 12)
To
_________________
_________________
Sir,
Shri,___________________, Inspector having directed under sub-section (2) of Section
17 to pay the maternity benefit or other amount, being _____________- (nature of
amount) to which ________________ (name of woman) is said to be entitled, I prefer
this appeal under sub-section (3) of Section 17, In view of the facts mentioned in the
memorandum attached hereto and other documents filed herewith it is submitted that the
woman is not entitled to the maternity benefit or the said amount and hence the decision
of the Inspector in this behalf, copy of which is enclosed, may be set aside.
Dated____________
Signature of the aggrieved person
Full Address_______________.
---------------------

 

 

 

 

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