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NÒT: DEKLARASYON KI ENDIKE ANBA LA A DWE FÈT POU RANPLI AK SOUMÈT AVÈK REPLIK OSWA NENPÒT LÒT PAPYE MOUN KI FÈ PETISYON AN, TANKOU DEKLARASYON SOU SÈMAN OSWA PYÈS, MOUN KI FÈ PETISYON AN SOUMÈT POU KORE KONTESTASYON AN
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NOTE: THE FOLLOWING STATEMENT MUST BE COMPLETED AND SUBMITTED WITH PETITIONER'S REPLY OR ANY OTHER PAPERS, SUCH AS AFFIDAVITS OR EXHIBITS, PETITIONER SUBMITS IN SUPPORT OF THE APPEAL