The grounds on which the respondent will rely are [the grounds relied upon by the employment tribunal/Certification Officer for making the decision or order appealed from] [and] [the following grounds]:-
[here set out grounds which differ from those relied upon by the employment tribunal or Certification Officer, as case may be]:
4 The respondent cross-appeals from [here give particulars of the decision appealed from]:-
5 The respondent’s grounds of appeal are [here state the grounds of appeal]:-
Date: ________ Signed: _________________
For other forms, see Atkin’s Court Forms, Vol 38, 1999.