12.—(1) An appeal to the Secretary of State shall be made by serving (within the period referred to in paragraph 9(2)(a) of Schedule 3) a notice of appeal on the Secretary of State.
(2) A notice of appeal shall state—
(a)the name and address of the licensee;
(b)the disputed revocation of the licence, the date of the notice referred to in paragraph 9(1)(b) of Schedule 3 and the date when the period mentioned in paragraph 9(2)(a) of Schedule 3 ends;
(c)full particulars of the grounds of appeal; and
(d)whether or not the licensee requires a hearing to be held;
and shall be signed by or on behalf of the licensee.
(3) The Secretary of State shall send a copy of the notice of appeal to the Director General.