FORM ‘L’

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[See Rule 21(I)]

1. Name of the applicant             : 

2. Address                                   :

3. Father’s name (in case of firm name and address of the partners

   and persons holding power of attoney to act on behalf of the firm):

    4.  No. and date of order of  appellate/ Revisional authority against

          which application is filed :

5.    Ground of application :

      6.   Evidence of payment of fee for application :

7. No. and date of order by competent authority against which appeal/ revision was preferred  :

      8. Any addition information the applicant desires to furnish :

Signature of the applicant

Date :

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