The statement shall include the particulars prescribed by 2° and 3° of Article 54 and by the third paragraph of Article 57. It shall designate the judgment appealed against, specify the heads of the judgment appealed against to which the appeal is limited, unless the appeal seeks to set aside the judgment or if the subject-matter of the dispute is indivisible, and mention, where applicable, the name and address of the appellant’s representative before the court. It is accompanied by a copy of the decision.