14th January, 2021 li Item (1) K Reproduction of copy of the Commission Guide (2) Reproduction of copy of Information Manual... Standard reproduction fees... oe fi Reproduction over and above (3) (3) (4) (a) (6) 10,000. 00 10,000. 00 5,000. 00 for photocopying, per page .. zs where the record or part thereof is provided in an— (i) (ii) (ili) (iv) 30. 00 alternate format, a fee not to exceed per page of braille be: SECOND 00. 00 sv 100. 00 1,000. 00 i SCHEDULE FORM REQUEST 50. 00 By: per page of large print. . perCD .. re 5 t FOR ACCESS (reg. 11) 1 TO INFORMATION PART A—PARTICULARS OF INFORMATION HOLDER Name of the institution/ information holder....................-.cceeccceescees-. nner daeceemuarte sce Address of the institution/ information holder...........0000...ccccccccseseseeeceseecceeee. Reese se Location (District/Town/City/TA/Village.........0...0cccccccscecsseeccsseeeseeceveeeeeeec ecccecc. Date of birth. ..... 00. ....cccc ccc ccecccu seuss sasacssscstesvavsvesesesesesecevecesesee, Sex... National ID Number ......00.. .... 0.00 c0c0cee Postal Sn i Telephone number.................ccceesessessssscssnesssseestessessssssesesececesceseeeees Email address........... cc ccccesccecec.0... ceceuceseee PART C__PARTICULARS OF PERSON ON WHOSE BEHALF THE REQUEST IS MADE (To be completed if request is being made on behalf of another person) Particulars of person on whose behalf the request is made (Please attach any documentation that indicates that you are authorized to act for the other person) IN NAG eo essere ace so caiscewiait PFS xonenendanecue EiszEvegTwesto Stix oneanienenemenecence es