THE SCHEDULE
Regulation 5(1)(a)
Form 1
INSURANCE ACT
(CHAPTER 142)
INSURANCE (APPEALS)
REGULATIONS
NOTICE OF APPEAL
Date of Service of Notice on Secretary:
Name of Appellant:
NRIC No./Company Registration No.:
Address(es):
Telephone Number(s):
This appeal is made under section _____________ of the Insurance Act.
The appeal is against the Authority’s decision of:
(state date and brief description of decision appealed against)
 
_______________________________
Signature of Appellant/
Advocate and Solicitor acting
for the Appellant
Regulation 5(1)(b)
INSURANCE ACT
(CHAPTER 142)
INSURANCE (APPEALS)
REGULATIONS
PETITION OF APPEAL
Date of Service of Petition on Secretary:
Name of Appellant:
NRIC No./Company Registration No.:
Address(es):
Telephone Number(s):
This appeal is made under section ____________ of the Insurance Act.
The appeal is against the Authority’s decision of:
(state date and brief description of decision appealed against, and any further circumstances out of which the appeal arises)
The issue/issues* arising in the appeal:
(state the issues)
The reason/reasons* for the appeal:
(state the substance of the decision appealed against and particulars of the grounds of appeal)
________________________________
Signature of Appellant/
Advocate and Solicitor acting
for the Appellant
* Delete whichever is inapplicable
[G.N. No. S 470/2002]