Il give you a small example (dont copy paste my answer though)
In-game Name: RiverRunner600
Why you have been banned:Using hacks
Where were you banned: survival (you must state which server not location in the server)
Who banned you: Xavier3479
Why you should be unbanned:i am ashamed of what ive done, i will never use any hacks again. I am aware if i have repeated this offence again. I have the right to be judged (hopefully wont happen again)
Hope this helped you. Use the rxact template but with your information and write atleast more than 3 lines on why you should be unbanned.
Good luck!