11.01.05.08

.08 Forms and Content of Appeal Before the Board of Review.

Appeals shall be filed in the following form or in a form substantially similar to this form:

(FORM) BEFORE THE BOARD OF REVIEW OF THE DEPARTMENT OF TRANSPORTATION

(Name and Address) (Complainant)

Vs.

(Official or Administration appealed from See Rule 4.) (Respondent)

APPEAL NO.

1. (Name) , Complainant, appeals from: (Here set forth the decision made by the Administrator when requested by complainant to review a regulation promulgated by his Administration, or the failure of the Administrator to render a decision. Included also shall be a statement that the complainant has complied with the requirements of Regulation .04.)

2. The issue involved in this appeal is: (Here set forth, in sufficient detail, the grounds upon which the appeal is subject to review by the Board under Regulation .03 the grounds upon which the Regulation is challenged, and the alleged error of the respondent.)

3. Complainant also desires to state as follows: (Here set forth any other comments or matters complainant believes are proper, necessary, or desirable to include in this notation of appeal.)

4. List the name, address, and telephone number of each complainant.

Signed: (Complainant) Address and Telephone