SCHEDULE �A�
(See RULE 6)
BEFORE THE LOKAYUKTA OF BIHAR AT PATNA
COMPLAINT NO _____________________________________ OF 20_________
A.B. (ADD description and residence) � Complainant
versus
C.D. (ADD description and residence) � Public Servant, complained against.
Herein the complainant complains as follows :
(Here give a brief substance of the action complained against and the grievance or allegation)
(Lengthy statement should be avoided)
If a complaint involving a grievance is made after the expiry of 12 months from the date of the order complained against, give the date on which the action complained against become known to the complainant and a statement of grounds showing sufficient cause for not making the complaint within the period specified section 8(4)(a) of the Act.
A duly sworn in affidavit supporting the averments in the complaint is filed herewith. This ______________________________ day of (month and year).
Signature or thumb impression of the complainant