Appendix 'D'



Enter Life or Liberty cases in Red Ink for Identification

ID No. Name and address of the applicant Date and source through which application received Particulars of fee/further fee paid. Write BPL in case of BPL applicants
    Date of receipt Direct/APIO/other Public Authority Amount PO/DD/ Cash Receipt No. Dated
1 2 3 4 5 6 7
Type of information asked for. Give gist in respective column
Life or Liberty Inspection of documents Copies of documents Sample of material Information on other issues Third Party Question in Brief
8 9 10 11 12 13 14
Letter sent for deposit of further fee Date of deposit of further fee and intimation to PIO
Date Amount
15 16 17
Status of disposal of application
Information fully supplied Partly supplied Transferred to other public authority Rejected due to exemption under section 8/9/24 No. of days available for disposal Date of disposal No. of days in which disposed Gist of reply sent Remarks
    Name of Public Authority Date            
18 19 20 21 22 23 24 25 26 27