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RTI APPLICATION

UNDER THE RIGHT TO INFORMATION ACT-2005

Application ID No. :   (For official use)


 

 To   --Department name and address---

         The Public Information Officer


1. Name of the Applicant:                   ____________________

2. Address                                            _____________________

                                                                _____________________

3. Particulars of information:

         (a) Concerned Office/Department: 

          (b) Particulars of information required 

     (i) Details of information required: 

     (ii) Period for which information asked for: 

    (iii) Other details:

4. Format in which information is required:

5. Mode of delivery expected:

(ordinary post, speed post, by courier, by hand, through internet or e-mail, by fax etc.).Additional fee may be charged to cover the  cost of delivery.

6. The information can be furnished  (Please delete the inapplicable portion).

              a)            Within 30 days as prescribed under Section 6 (1)

b)            The information sought for concerns my life and liberty, therefore the information

               may be  furnished to me within 48 hours

7            I state that the information sought does not fall within the restrictions  

               contained in section 8 and 9 of the Act and to the   best of my     

               knowledge it pertains to your office.

 

8.            I also state that I am a citizen of India and I am eligible to seek information under the 

                Right to Information Act 2005.

9.              (i)           A Postal Order/Bank Draft No. _______ dated _____is enclosed, or 

                               (ii)          The applicant is not liable to pay any fee because he/she is below the

                  &nbs p;                           poverty line (proof is attached).

                                                    (Please tick one and delete the remaining two options)

Place:

Date :

(Name & Signature)

Postal Address   : 

Tel No              :  

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