mIO_u>_u 99% [NBA UHm>m._.m_N AflmmHmAPPdOZ >20 UflonmmmHZm O.” 0;;va mnImZW Homm i THE BHOPAL GAS LEAK DISASTER (REGISTRATION AND PROCESSING ‘ ‘ OF CLAIMS) SCHEME, 1985. 1 In estercise of the pOWers conferred by SectiOn 9 of the Bhopal Gas Leak Disaster 1 (Processing of Claims) Act,1985 (21 of 1985), the Central Govt. hereby frame the i j followrng scheme, namely : ~ Short titie and i (1) This scheme may be called the Bhopal Gas Leak Disaster (Registration and Gmmencomonti Processing of claims) Scheme, 1985. 1‘ 3 .
(2) It shall come into force on the date of the publication in the {)flicial Gazette. Dcl’initon. 2. In this Scheme, unless the context otherwise requires:— *(a) “Act” means the Bhopal Gas Leak Disaster (Processing of Claims) Act, 1985 1 (21 of1985); *(aa) “Bhopal Gas thims Monthly Unit Scheme” means the i “Bhopal Gas Victims Monthly Unit Scheme, 1992” made by the Board of the i unitTcust of India in exercise of the powers com-"erred by the Section 21 of , i the unitTrustofIndia Act,1963,(53 of 1963);
(b) “Section” means a Section of the Act ;
(0) words and expressions used herein and not defined but defined in the Act, shall have the meanings respectively assigned. to them in the Act. Authorities for 3. The Deputy-Commissioners appointed under section (1 of the Act shall he registration of the authorities for registration of claims (including the receipt, scrutiny and proper clai Ill-“~- Gafiegol’iflafiion of such claims under paragraphs 5 of the Scheme) arising within the areas of their respectiijui‘isdiChions and they shall be assisted bysuch other officers as maybe appointed by the Central Government under section 6 of the Act for scrutifsny and verificasi on of the clai m5and other related matters- , ‘ I ‘ ; -~a‘.““°r 01f l
4. (1) An a‘pplication for claim shall be made to the Deputy Gommissimier iiiiilmg clalm‘g‘ cOncerned in Form No. 1 or,as the case may be, Form No. 2 or Form No. 3 or Form NO- 4 or Form No.5appended tothis Scheme within. a period ofsixty days from the date notified by the 00mmissioner inviting applications for claims:
Provided that if the Deputy CommissiOner is satisfied that the ciaimant was presen ted by Sufficient cause from filing the application for the claims W1 thin the sxad lperiod -i of sixty days, he may entertain the application for chaplains within afurther'period ofsixty days but not thereafter.
(2) Not W1 thstanding anything contained in sub-paragraph (J!) an application for a claim arising in future On account of the BhOpal gas leak disaster may be made to the Deputy Commissioner within such further period, after the expiry .of the period 3pacified in the provisiOn to the said sub-paragraph (l) as he may specify from time to time.
(3) The claim may be made by any person attested by the Bhopal Gas Leak Disastci' or,as the case may be, the spouse, children or other heirs of such deceased perspn or bya represen tativc duly authorised by such person in this behalf or. in the case or a. minor so affected, by his guardian.
(4) A separate claim form in respect of each category of claim specified in paragrape 5 of the Scheme shall be filed by each person havmga claim. Each person filinga claim shall be corisidcredto have a single claim regardless of the number of nategories of claim included therein. ‘
(5) The Deputy Commissioner shall provide the required forms for filing the ‘ applications free of cost. ‘ WWW!“ or I db4 A. (1) Notwithstanding anything cantained in paragraph 4, all applicaticms Application f0!i received for ”Claims whether before or after the commencement of the BhOpal Gas ”him” Leak Disaster (Registration and Processing ofClaims) Amendment Scheme, 1987, by the Director of Claims or by any other officer specified in the order of the Government ofMacLhya Pradesh No. 373/691/I-Four/Goord nation/85, dated 7th May, 1985, she. 11 stand transferred alOng with relevant records, to the olfice of Deputy Qommrssxmier cori corned as if such applications had been made to that Deputy Commissioner under tions in accordance wth the provisions of this Scheme. 3 1 haragraph 4 and such Deputy 333111 ssioner may further process the “aid applica-~ V i ‘ l i i ‘1 (2) The Commissioner and Deputy Commissioner may summon any claimant‘ Whose appl cati On for claim has been transferred under sub-paragraph. (l), for verificatiOn ofparticulars in the applicatiOn and mayalso call for such additional informa- Ii tion as may be required by the Gomniissroner or the Deputy Commissioner, as the case may be. -,.v Fiatcaorisation 5. (1) Or reca'pt ota chins under paragraph 4 of the Scheme. the Deputy Comm? - x. : ' .i a ,_ d - , fl" , and registration planer shallsuhyect to the provimons of subuparagiaph (3) and sub paragraph C.) 9 of claims, cac: the claim n the appropriate category under sub~paragraph (2) and thereofter rgnter the claim. Categories, namely ;
(a) death; . 'i1 (b) total disablement resulting in permanent disability to earn livelihood. ‘
(c) permanent partial dirablement aflecting the overall capacity to earn his livelihood ; 1
(d) temporary partial disablement resulting in reduced capacity to earn livelihood ‘ '3(da) injury of Utmost severity; i=(db) minory injury ;
(e) temporary dislocation of means of livelihood;
(5) claims ofthe Government, authorities under the control of the Government, local authoritiesand institutuitms for expenses incurred in providing relief aid and. rehabilitation to the II person airlected by the BhOpal Gas Leak Disaster ;
(g) administration expenses incurred by the Central Government, Government of MadhyaPradesh or local authorities to cope up with the Bhopal Gas Leak disaster, including all I local and administrativae expenses attributable or related the said disastr r;
(it) claims relating to loss of revenue to Government authorities under the control of Governl ment or local authori ties arising out of, or connected. wi th Bhopal Gas Leah Disaster;
(l) claims on account of damage to the fauna including mi lch and drought animals;
(j) claims arising from damage to flora including destruction of agricultural crops,vegetables, trees and orchards;
(it) claims on account of damage to environment including pollution of soil, flora, fauna and water systrms;
(1) claims relating to loss and distructicr cf prorri t}; (In) claims relating to loss of business of employment or both;
(in) clgims in respect ofinjuries that are likely to be suffered on account of the B11 _ a1 GasLeak isaster;
(0) any other claim. or claims which the Deputy Commissioner may determine for reasons to I, be recorded in writingas arising out of, or connected wi th5 ti (_ I l c; 2.] {as It a]: disaster.
(3) on the consideration of aclaim made under paragraph. 4 ol the SC] in; , if the Deputy Commi-ssiOner is of the opinion that the claim falls in a catergory difi'erentfrom the category mentionc d by the claimant, he may decide the appropriate category after giving an oppourtuni ty to the claimant to be heard and alsoafter takingin to comidera ti on an yfa cts made available tohi min this behalf by theGovemmentin this behalf. ‘
(4) Where the Deputy Commissioner is of the opinion that a claim made under paragraph 4 does notfallin any ofthe caterfories specifiedin sub-paragraph (2) he may refuse to register the claim;
Provided that before so refusing, he shall give a reasonable opportunity for a personalhearing to the clailnan t.
(5) If the claimantisnot satisfied with the order of the Deputy Commissioner under sub-paragaph(3) or sub-paragraph (4) he may prefer an appeal against such order to the Additional Commissmner who shall decide the same. ‘ ' l
(6) Every appeal under sub-paragraph (5) shall be filed in such Form as may be speCified by the- Commissioner within 60 days from the date-on which the order sought to be appealed againstls commu-nicated to the calimant preferring the appeal. L . , l (7) The AdditionalCommissioner shall give a rEaSOnable opr ortur-ity to t‘r( claimant of beingcard before passing an order and a copy of every order passed under this sub-paragraph shall be sent by the Additional Commissioner to the Deputy Comanissiomr and the damn: t. l 1:3,.........q...“ _. _ . . . , ‘ f, f ._ .
(2) The claims receivedfor registration anallbe plaCed unue. the following v : | by the Government or the authoities authrisrrd by the Government in H ' ‘ ’ .
(8) on categorisation and registration of the claim of aclaimant the Deputy Commrasioner shall make aVailable the information to the Commissioner who may transmit the same to the Central Gover nment for enabling it to discharge its function under section 3 of the Act. I
6. The Deputy Comm’ssicmer,while categorisingand registering rhe claims under Matters to be paragaph 5 of the Scheme shall :- ‘ teken in to con- . . . . . -. ' ' o
(a) give due consrderation and weightage to the data, collected andprovided :fizgii‘igti‘ohof . ‘ } this behalf, relatmg to cases arising out of, or connected with the Bhopalelolms,‘ Gas Leak Disaster; ‘
(b) obtain copies of claims filed in diflerent courts or before > other authorities,‘ whether within or outside India, to the extent feasible, for proper conside- ‘ - i ’ ratiOn of the claims made before him. '
7. (l) The Commissioner shall cause to be maintained a registerfor reg'stratiOn Maintenance of . ' of claims in serial order according to the receipt ofapplica ti 0ns for claims and a register for listing the claims, categOi-y-wise as laid dOWn in paragraph 5. record. i (2) The Commissioner may also cause to be maintained such other recored or register as he may deem necessary for the purpose of Carrying out the provisi- . ons of this Scheme. . 8. The CommissiOner shall have the pOWer to regulate his OWn procedure, and the Procedure. procedure to be followed by the Deputy Comm' ssi Oner and other officers and employees appointed under section 6,in all maters arising out of discharge ofhis or, as the case may be, their functions under this scheme, includfrigthe place or places where he shallhold his sittings. ‘ 9. There shall be created and maintained by the Central Government a Fund to be Processing of called the Processing of Claims Account Fund. . Claims of Acc0_ ‘ l (2) The Fund shall include the amount wich the Central Government may unt Fund. after due appropriation made by Parliament by lawin that behalf, credit to the said Fund and any other amounts which may be credited to such Fund. . ‘
(3) The amount or as the case may be, the amounts in the said Fund shall be applied by the Commissioner for meeting expenses in connectiOn with administration of this Scheme and of the provisions of the Act. ‘ 10. (1) There shall be created and maintained by the Central Governmenta Fund Claims and to be called the Claims and Relief Fund. ‘ Relief Fund | (2) The Fund shallinclude the amounts received in satisfaction of the claims and any other amounts made avaiable to the CommissiOner as donatiOn of relief purposes. tin (3) The amountsin the said Fund shall be applied by the Commissioner for the flowing purposes, namely :——- .
(a) disbursal of amounts in settlement of claims registered with the Deputy Commissioners ;
(b) disbursal of amounts as relief (including interim relief) to the persons afiec. ted by the Bhopal gas leak disaster ; and (C) apportionment of part of the fund for disbursal of amounts in settlement of claims arising in future or for disbursal of amounts to the Government of . i Madhya Pradesh for the social and economic rehabilitation of the persons ‘ afiected by the Bhopal gas leak disaster.
(4) Scperate accounts shall be maintained for receipt and disbursal of’ amounts in‘ settlement of claims and for relief purp0ses. l l. (l) The disbursal ofany amounts under this Scheme shall be made by the Deputy Disbursal appo- Commissioner to each claimant through credit in a bank or postal saving accounts rtionment. etc. ' Bhopal Gas Victims Mouthly Unit Scheme 1992. ofcertain a moun ts. OInserted by Notification No. G.S.R. 910 (E) dated 2nd Dec. 1992 Gazette of India extraordinary. i , - HI‘ Hi Audi t of Accounts; Function of the Commissionei & other officers etc. iappointed. under isectiOn 6 of the Act. ’ March 28, 1988. i i . l 8
(2) The Central Governmentmay determine the totalamcuntof compensatiOn to be apportioned for each category of claims and the quantum of compensation paya- ‘ble,in general, in relatiOn to each type of injury or loss.
(3) The Deputy Commissioner shall determine the quantum of compensation payable to each claimant within a category specifiedin paragraph 5 in accordance with the provisi ens ofsub-paragraph (4) subject to any Court order, settlement or award of damages in any specific case. -
(4) In determining the quantum of compensatiOn payable to the claimants. within different categories specified in paragraph 5, regard shall be had amOngstlother factors, to the following factors, namely :—
(a) the probable life span of the person aflected by the Bhopal gas leak disaster '
(b) the actual or projected earning capacity of the person so afflected ;
(c) the likely expenditure on immediate and anticipated medical treatment of the person so aflected ; i
(d) mentalanguish and physicalinjury suffered byapersOn in the Bhopal gas ‘ leak disaster; and ‘
(e) the type and severity of physical injury suflered by the persons so affected.
(5) In the event of a dispute as to disbursal of the amounts received in satisfacti an of claims, an appeal shall be against the order of the Deputy Commissioner to the *Add.‘ ti anal Comm ssi oner,who may decide the matter and make such disbursal as he may, for reasOns to be recorded in writing; thinkfi t.’
(6) The provisions of sub-paragraphs (6) and (7) of paragraph 5 of the Scheme shall apply to the appeal under sub-paragraph (5) as theyapply to the appeal under sub-paragraph (5) of that paragraph. ‘
12. The CommissiOner shall cause to be maintained all necessary books of accounts required for 3) rating the in 1d; created and mlintained under paragraphs 9 and 10 of this Scheme and the said books of accorrnts shall be audited by the auditors appointed by the Central Government. ‘
13. (1) The 33nnissioi 31' shall be incharge ofsupervising the work relating to receipt registration, processing and settlement of claims filed under this Scheme and all other matters cannected with the administration of the said Scheme. 110(2) Where an appeal has not been filed against the order ofi the Deputy CommissiOner passed under sub-paragraph (3) or sub-paragraph (4) of paragraph 5, the Additional CommissiOner may call for the record ofany claim filed under paragraph 4. If the Additional Commissioner after re-examinatiOn of record co .15 der itnecessary or expedient so to do, he may revise, for reas0ns to be recorded in " Writing, the order passed by the Deputy Commissioner; i ' ,_i i _ *Substituted by the amendment NotificatiOn No. GSR 394 (E) dated *Amanded andinserted by the Notification No. G.S.R. 449"(E)dated10thjune 1993, by the Gazette of India Extraordinary. , i? \ l 9' ‘ - ., V |
Provided that Whig the order in revision is likely to be ptejudz c‘al to the interest of the ciaiman t, no such order shall be passed Ln revision unless the claimanthas been given a reasonable opportunity of showing cause against the proposed order- The provisiomr of this sub-paragraph shall also apply to the orders of‘ the DCP‘I‘Y CommissiOner passed under paragraph 11 of this Scheme for which appeal is contemplated in sub-paragraph(5) thereof.
(3) The CommissiOner may,suo motu, call for the record of any claim filed under. this Scheme andif he censidersit necessary. or expedient so to do, revise, for reasons to be recorded in Writing, the order passed thereon; .
Provided that where the orders in revisiOn is likely to be prejmii Cial t0 theinterests of the claimant, no such order shall be passed in revisiOn unless the claimant has been given reasOnable opportunity of showing cause against the pr OPOSBd 0rd“- ‘1‘
(3) All ‘offitgra appointed under sectiOn 6 of the Act shall work under the suvaisiOn of tire Commission: and assist himin carrying out' the day-toad'ay administratiOn of the Scheme and the PIOVlSlOIlS of the Act. l l q , _.,_.__.__. mag;vgmthu—Kv-Gau : .1LV‘»U.’;5F:1‘ Ham 1.. w I ,, ml flame of Injured Perm : ' hi I \ Father's Name ‘ ”.m,‘ .... . 10, ”FORM No. l (5“ Paragraph 4) (In01“ In Mp0!!! 0fparlou- who Wereinjured in the Bhopal Gas Leak binder) I Form No; im‘II’IiII ’IIIII! I II I IIIIII II I .. IiIIIiIIlIIII ~IIII II‘IIIII __ "IIIII'IIIIIIIIII' élililliiiiIliii ” I 11 . ‘ 1 ' . my[3) Age (111 Years) . . CODE 3 : 1 l -
(4) Ex‘nployment History : . . . l! 1. Skilled, 3 ., a . . ... . A in: LIi-M =11 5i
2. Un-ski lled, '
3. Semi-Skilled, 3
4. Self employed, ‘ . . p. _.: .. .. ,. m m: 5, Un-employcd. a -
(5)" Incqme per man-ch - ’,_. - .. , fl. , , J ‘ (In Rupees) . ‘ . ll ‘ .- L _= i
(6) _ Identification :- ’ ‘ ’ (A) Ration Gatho. .. .. ». . “ -‘": est!) ! ' ‘ (B) Anyother Id, No‘. ‘ g. '(C) ReligiOn“ 1(7) Injury :-4 ‘ 1‘ (A) Eye . . ‘ . . I . . . ‘I .Yes/No z ‘ l-III} “5. "- V.‘ i. 1;“? : I (B) Respiratory (Ghent) ; . . , . .‘-' ,OYes/No ' " ll _ " (C) Mental Illness . . .. .— .. 'Yes/No \ é} ‘ " g (D) GIT l; ‘ .. .. .. 'Yes/No 'I . w—I:1 ~ -_ - r (E) Gynaecological .. .I “Yes/No I - " I ( ) Other than above . . _ . . . . 'Yes/No i ‘ ‘ . i 1'? Treatment: L‘ I ‘ ’ . I . ' ' I H V ’ h’ CODE _ : (A) Temporary and Cured ‘ .. .. Yes/No 'I 1| ' IH i ,' ' (£3) SuillreCeiving treatment .. ... Yes/No 'I ' ‘ i \ ‘ In 1 _ _ , . . A ., (C) Hospitalised and cured. . ... . . ' Yes/No 'I i? ‘ - - (D) Hospitalised butstill being treated .. I Yes/No- .l' » - .. ‘ I! IN ' ' ‘ eye Chest Menta m G I. T- Gyfiace’ 0th?“ . , ,(9) Treatment being taken for Yes/No , | » l _ . l . l . l l i \ ‘ 1 ' r
(10) Place of treatment being taken u. \ H: ‘ r . 1 1 -» a I) D‘sab’Ft -Gode : w .
1 .
1 .I 1!.) 1
1. Temporary ‘_ , , , n n I ‘ | ; 2 Permanent 1 1 .. .. . 1 ' ' ' A A I: 1 :1 1‘ 1 $12) Treatment after Gas—Tragedy : 1
1. Date . w 2- Plate 1" .. .. U ' —."a “‘7 ~' w
3. Tohddaya 1 ‘ , _ _, ' , _ ._._.___.__.___..___.__._._. __.._._’._._.__. 11 1 ,. j; ,3.)
(13) Hospitalisation : 1 v. :- j . ‘ I. Date 1 . M
2. Place 1 1 . . ‘ . . . . L ' ,
3. Total day/5 . l1 ‘"
(14) If pregnant at the time of Gasnleakage . 1 (Delivered Chi Id) ~ 1 . (A) Normal Child 3 .. Yer/No 4 . . .1 , I h ‘
(n) Abnormal Child Yes/N0 ‘ g I (G) Died Yes/No l I (D) Still—birth Yes/No ’ 1" ‘l (E) Aborted Yes/No _ I [ (l5) Totalcxpenditure incurred because of Gas-Tragedy ' for : I -— (A) Treatment (In Rupees) ——--« - (B) Displacement etc. (In Rupees) 4- " ‘- Datc 1 ____._.._._. .0“ ____.___ __.___._.__._..._ _. An y Relief from Government , , , ,1 ‘ ___.__._.-_..~d~.q 7- ...-.__._«__._.._4_~_-._4_. _._. . F‘ Yes/No 1 If yes; amOunt received as ex—gratia payment : 2 (In Rupees) . . .. . . . -— ‘ * (l7—A) Tota Compensation claimed :
(18) An y other information ,__.._.__._. _._....__.._-__. _...-.7.,_ ._. M _ ._ _ 1(19) Fami 1y Code No of SocimEconomic Survey A —"— 1(20) Code No. of ICMR __..fl._.___....‘. _—. V . 1 t 13 l l
(21) Gategory in which claim falls (see paragraph 5) . .. .. .. .. .. .. laacuouoou'lulloo .I‘OI
(22) Any other relevantinformatiOn. *I/We/Institution havenot made any other claim For compensation/haw made other claims for compensation , the particular of which are given below:——« Sl. No. Form No. Date Compensation sought 1 I *I/We/InstitutiOn havenotfiled a separate suit in a court of law for compensation/have filed suit as detailed below in court of law:-—— 3 .51. No. Court Where suit filed suit No. Compensation sought 1 1 Place : ' Signature (with date) ‘ i Name: 1 Designation : 1 ~ 1 (Seal ifany) Witness:
1. Signature:
2. Name:
3. Address: *Strike out whichever is not applicable. ll VERIFICATION I I. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .dohereby declare that tothe’ bestofmy knowledge and belief whatis stated above is correct, complete and is truly stated. 1 I i 1 i 4 Signature of the applican t/respondent Name: Designation : 1 , \ (Sealif any): Witn ss: 1 l Signature: 1 Name : Address: Warning : Any 'persmx making any misrepresentation is liable to be prosecuted. I j I 14 1 FORM NO. 2 \ I - (see paragraph 4) (for claims in respect of loss of livestock due to- Bhopal Gas Leak Disaster) FORM No. 02 1 1 I \ . LIVE-STOCK 11414111044441 1-1-1111:11:11]:::1::1::1::1::1:1"1‘1—1-- 1 11:11“:1.-I‘::1:_l::r1m1--m:\:._- _... -_-—-_-I_..._._
3. Age (in years):
4. Profession: I I* II " I—_I I—I—:_I;_I—_I—: w- m- — _ItI—WI— —I*_W —h _ 1]-“I“
5. Address : ‘ . __.__«_.__1L_ - House No. I _. _ _ _. Mohalla/Street- _ _ w _ _ Locality ._. _ L_ _ L_ _ _ _ ____ Place : - ‘. I 4 _.._._.._1__. __.1 _ ' _. _ .1 _._ 4 I ' 1 Code
6. Purpose for‘which Live-stock Was used: |—.~——. M— —. —_I I (Domestic/Business) _._. L..- _ _ ._. ‘ _. ._._. ._.-.-1' _...1. __._._.. _._..d -._.-..1__._..._1 _._.-‘
7. (A) Number and kind of animals dead: I I I I I4 4 l1 _._._ _._._. __1 _._._1 ___« __1_":_._._. ___. I Number (B) Date of death : ._.. _.~ ___._.___.._1_. -.__..._..4._._. _._. _. .1- _-.__. (C) Proof of death: . Code
(1) Post M01 tem _.._._..__.._. 1.. 1. __
(ii) Evidence of removal of dead . I ’ body _1_ ___..-.~_.| (D) Cause of death ——-—-.———.—- ———-——~—~—-v—« —- «1 ~ ~»—. —- ._. —.--- —- ———-———-—._
18. Market value of live-stock dead: - ' I _ I I I 4I‘ I (in Rupees) ' ————- —1— ~«—- ———-—-- —-———»—1—- ——- —_.—-—-
9. No. and kind ofLi ve-stock1n capacitated becasue ofGas-Leak Disaster I a1d n1a1. ket value there of: Poultry Ass ._Bufi— Gow— Goat Bull P1 g HorseI i4 , ___ _-___. ._.__.__ ._. ,_.|__._.__ ___. _._1.L. __L Number IRupees I 10 No. and kind of Livestock with reduced efi‘lcien cy and market Value thereof Numbe 1' ' -1.r..n._...1.....1.4, _Rupecs - ..... 87/1719 (11—4 I I 1 l} 15
11. Loss ofTotal‘Inco‘ne ' . ‘ ~_;_.4_'_ --.“-.- i..__..‘_.__ .;;Lw_; _.;._._ In Rupees ' i '1 l ‘ I I _ i it i ' _ . _
12. (A) If Live-stock Insured: ' ' ' ' ’ l ' > Code Yes/No ' ‘ I ‘ H2" (B) Name ofInsuiamceGompany..................... . (C) Type of Coverage . ... L l l l ( ) Amount received from Company: In Rupees ‘ 1—. I I “““ ’H— ‘ l H
13. Any relief received from Government: . ‘ Code ._.‘_..__.V-. -. .... ._.__......‘.<__. Yes/No ...—‘H._..d...____4_._..__._._..! ll If yes, amount received as ex-gratia L payment : In Rupees , ‘ ~ I | i — l . , _ - _._._ .4 i "all p ' p ’ l 13-A Total Compensation claimed:e-........ .. , -\_ _l :H , g _ , l
(14) Category in which claim falls . . .. . .. ‘ (See paragraph 5)
(15) Any other rclevantinformat‘on . . .. . l H l , i it LWc/Insbitution have not made any other claim for compensatior/have made. other claims for compensatiOn, the particulars of whi ch are given below—- __....__‘.__ _.._. _. ._.__.__......_‘_. .. _'. _. _. __.< _, ...._.._.. _...r_....-..._. __.V_. _.__._... —.. Sl. No. Form No. , . Date Compensation. sought $ ‘ i l {1‘ l} l i ‘ l l ‘ ‘ : ‘