Péter Legéndy: Notice of Appeal Form

Addressee:

Name of appellant:

Address:

Official in charge:

Please refer to this number in your response:

Reference number:

Notice of Appeal
/The bold boxes must be filled out in print in all capital letters using CARBON PAPER and a typewriter, ballpoint pen or ink./

Surname:

First name:

Maiden name:

Family status:

Place and time of birth …………… town ………… year …… month …… day

Citizenship:

Letter and number of ID:

Reason for appeal:

Short description of subject:

Date of origin:

Justification of the subject:

Consequence of the justification of the subject:

Proposal:

Comment:

With full knowledge of my legal responsibility and liability I affirm that the above information is correct. I also acknowledge that any decision or verdict shown to be based on false information and therefore overruled will be repealed by the competent authority and new proceedings will begin.

Signed ……………… town ………… year …… month …… day

Supplement:

……………………………………………………………………

Signature of the appellant

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