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8. Other facts relevant to this appeal: <br />9. Remedy requested with reasons and explanation of the legal basis by which remedy should be <br />granted: <br />10. I would like to have my appeal heard in a meeting: ❑ open to the public <br />❑ closed to the public <br />This is to certify that to the best of my knowledge, information, and belief, every statement contained <br />herein is true, and no statement is misleading nor interposed for delay. <br />Signature of appellant Date <br />If appellant has a representative: <br />Signature of appellant's representative Date <br />Submit original and eight (8) copies of this appeal form to: <br />Merit Appeals Board <br />101 Pauahi Street, Suite 2 <br />Hilo, Hawaii 96720-4224 <br />Rules of the Merit Appeals Board provide as follows: <br />§104-2 Filing an appeal. (a) Appeals shall be filed within twenty calendar days from <br />the action giving rise to the appeal, provided, if use of an internal complaint procedure, <br />pursuant to Hawaii Revised Statutes §76-42, is required prior to filing an appeal with the <br />Board, the appeal to the Board shall be filed within twenty calendar days from a decision <br />rendered at that step in the internal complaint procedure immediately preceding the filing <br />of the appeal to the Board. Appeals from an administrative review of the director under <br />Title I of the rules of the Department of Human Resources shall be filed within twenty <br />calendar days from the director's decision. <br />Page 2 <br />