For the purposes of section 145(1)(b) of the Act, the prescribed information is the following—
(a) the name and address of the claimant;
(b) the name and address of the licensee in respect of whom the claim is made;
(c) the grounds on which the claim is made;
(d) the amount of monetary loss suffered by the claimant;
(e) details of any action taken by the claimant to recover the loss from a source other than the Fund;
(f) details of any monetary or non-monetary amount recovered in relation to the loss by the claimant from a source other than the Fund.