(See rule 4)
Application under Section 57 of the Information Technology Act, 2000
For use in Tribunal’s Office
Date of Filing_____________
Date of Receipt By post -
Registration No. ——————————————————-
Signature of Registrar
IN THE CYBER REGULATIONS APPELLATE TRIBUNAL
A B APPLICANT
C D RESPONDENT
Details of Application:
1. Particulars of the applicant:
- Name of the applicant
- Name of Father/Husband
- Designation and office in which employed
- Office Address
- Address for service of all notice
2. Particulars of the respondent:
- Name and/or designation of the respondent
- Office address of the respondent
- Address for service of all notices
3. Particulars of the Order against which application is made:
The application is against the following order:
- Order No.
- Passed by
- Subject in brief
4. Jurisdiction of the Tribunal:
The applicant declares that the subject matter of the order against which he wants re-dressal is within the jurisdiction of the Tribunal.
The applicant further declares that the application is within the limitation prescribed in section 57 of the Information Technology Act, 2000.
6. Fact of the case:
The facts of the case are given below:
(Give here a concise statement of facts in a chronological order, each paragraph containing as nearly as possible a separate issue, fact or otherwise).
7. Relief(s) sought:
In view of the facts mentioned in para 6 above, the applicant prays for the following relief(s):
[Specify below the relief(s) sought explaining the ground for the relief(s) and the legal provisions (if any) relied upon].
8. Interim order, if prayed for:
Pending final decision on the application, the applicant seeks issue of the following interim order :
(Give here the nature of the interim order prayed for with reasons).
9. Details of the remedies exhausted:
The applicant declares that he has availed of all the remedies available to him under the relevant service rules, etc.
(Give here chronologically the details of representations made and the outcome of such representation).
10. Matter not pending with any other court, etc.
The applicant further declares that the matter regarding which this application has been made is not pending before any court of law or any other authority or has not been rejected by any court of law or other authority.
11. Details of Index:
An index in duplicate containing the details of the documents to be relied upon is enclosed.
12. List of enclosures:
I, ________________________________________ (name of the applicant), S/o, D/o, W/o _______________________________ age working as _____________________ resident of _______________________
hereby verify that the contents from 1 to 13 are true to my personal knowledge and belief and that I have not suppressed any material facts.
Signature of applicant
Cyber Regulation Appellate Tribunal
Receipt of the application filed in the Cyber Regulation Appellate Tribunal by Shri/Smt. ____________________________ working as ______________________ in the Office of _______________________________________________ residing ______________________________________ acknowledged.