a) name, surname and personal identification number of the applicant;
b) domicile address, contact data, family status, employment status of the applicant;
c) short description of the issue or case for which primary legal aid services have been requested;
ç) if applicable, length of the meeting or meetings;
d) short description of the delivery of primary legal aid services and outcome of this delivery.
dh) declaration that the applicant has not benefitted prior primary legal aid for the same problem or issue;
e) other data in accordance of the format approved by the Minister of Justice.