For the purposes of section 56A(1) of the Act, the prescribed information is—
(a) the name of the responsible authority that referred the application; and
(b) the application reference number given by the responsible authority; and
(c) the reference number given to the application by the referral authority (if any); and
(d) the date the referral authority received the application; and
(e) the address of the land affected by the application; and
(f) the proposed use, development or other matter for which the application is made; and
(g) the date and decision of the referral authority.