Maternity Benefit Act,1961
FORM J: Appeal under Section 17
[Rule 11]
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.
Date _______ Signature of aggrieved person.
Full address ____________