IN THE COURT OF APPEAL

Cr. App. No.................................. of 20...................................

STATE v

I hereby give you notice that a Judge of the Court of Appeal having considered your application for—

• (a)leave to appeal;
• (b)extension of time within which notice of appeal or of application for leave to appeal may be given;
• (c)legal aid to be assigned to you;
• (d)permission to you to be present at the hearing of your appeal .. has refused the applications marked .. (and has granted the applications marked.................).

If you desire to have the abovemarked applications which have been refused determined by the Court of Appeal, you are required to fill up the enclosed form and return it to me.

Dated this ................. day of ................. 20 ..

Registrar

To: the abovenamed .................................. the appellant.