THE SCHEDULE
[See section 63(4)(c)]

CERTIFICATE 
PART A
(To be filled by the Party)
                       

I, _________  (Name), Son/daughter/spouse of  _______________       residing/employed at  _____________       do hereby solemnly affirm and sincerely state and submit as follows:—

I have produced electronic record/output of the digital record taken from the following device/digital record source (tick mark):—

 Computer / Storage Media 

     DVR

 Mobile 

     FlashDrive 


     CD/DVD    


       Server   


         Cloud   


            Other

                               
Other: __________________                             
Make & Model:__________         Color:_____________                        
Serial Number:___________________  
IMEI/UIN/UID/MAC/Cloud ID _____________                 (as applicable)
and any other relevant information, if any, about the device/digital record  _________________    (specify).
The digital device or the digital record source was under the lawful control for regularly creating, storing or processing information for the purposes of carrying out regular activities and during this period, the computer or the communication device was working properly and the relevant information was regularly fed into the computer during the ordinary course of business. If the computer/digital device at any point of time was not working properly or out of operation, then it has not affected the electronic/digital record or its accuracy. The digital device or the source of the digital record is:-

     Owned
     Maintained
     Managed
     Operated
    
                                  
by me (select as applicable).
I state that the HASH value/s of the electronic/digital record/s is _______________, obtained through the following algorithm:—

     SHA1:
     SHA256 :
     MD5:
     Other:_____________________ (Legally acceptable standard)
(Hash report to be enclosed with the certificate)


                                                                                                                                    (Name and signature)
Date (DD/MM/YYYY):      
Time (IST):___________hours (In 24 hours format) 
Place:  





PART B
(To be filled by the Expert)

I,____________  (Name), Son/daughter/spouse of_________     residing/employed at ______________   do hereby solemnly affirm and sincerely state and submit as follows:—

The produced electronic record/output of the digital record are obtained from the following device/digital record source (tick mark):

     Computer / Storage Media 
     DVR
     Mobile 
     FlashDrive
     CD/DVD
    
           Server
    
             Cloud
    
                Other
    
   
Other:________          
Make & Model:___________     Color:___________             Serial Number:______________             
IMEI/UIN/UID/MAC/Cloud ID______________________(as applicable)
and any other relevant information, if any, about the device/digital record_______________________________________________________________(specify).
I state that the HASH value/s of the electronic/digital record/s is                 , obtained through the following algorithm:—

     SHA1:
     SHA256 :
     MD5:
     Other:_____________________ (Legally acceptable standard)
(Hash report to be enclosed with the certificate)


                                                                                                                        (Name, designation and signature)
Date (DD/MM/YYYY):___________          
Time (IST):_____________hours (In 24 hours format) 
Place:______________________           



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Note: For Reference only.