FORM II
Appeal to the First Appellate Authority under section 9(1) of the Maharashtra Right to Public Services Act, 2015

Before: Sub-Divisional Officer, [office address of the Sub-Divisional Officer]

Name and address of the eligible person: [your full name and address]
Name and address of the Designated Officer: Tahsildar, [office address]

1. Date of application: [date]
2. Date of acknowledgement: [date]  Application ID: [number]
3. Date of production of documents: [date]
4. Details of the public service required: Age, Nationality and Domicile Certificate
5. Decision of the Designated Officer: [no decision / rejected on date]
6. Stipulated time limit: 15 days
7. Date on which the rejection was received: [date, or "not applicable"]
8. Grounds of appeal:
   (i) The service was not provided within the stipulated time limit. [keep this line or delete it]
   (ii) The application was rejected. The reasons given are not correct because [your reasons]. [keep this line or delete it]
9. Relief sought: Issue the Age, Nationality and Domicile Certificate within the time you direct.
10. Any other information: [optional]

List of documents enclosed:
1. Copy of the acknowledgement of my application
2. [copy of the rejection order, if any]
3. [other documents]

Declaration: The particulars given above are true and correct to the best of my knowledge, information and belief.

Date: [date]
Place: [place]
Signature: [signature]