PROROMA-IX FORM FOR APPEAL BEFORE THE APPELLATE AUTHORITY 1. Name & address of the Complainant 2. Subject in brief and order/decision against which complaint is made 3. Limitation 4. Facts of the case: i) ii) iii) 5. Relief(s) claimed 6. Interim relief if any claimed 7. Remedies exhausted 8. Whether consumer has filed complaint with Consumer Forum/Civil Courts. If so, status/result thereof 9. List of enclosures Signature of Complainant