Rti Application Form
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ANNEXURE “A” (See rule 3)
Format of Application for obtaining information under The Right to Information Act 2005
Affix Court fee stamp of Rs.10/-
To: The State Public Information Officer, (Name of the office with address)
1. FULL NAME OF APPLICANT :
2. ADDRESS :
3. PARTICULARS OF INFORMATION REQUIRED (i) Subject matter of information :
(ii) Period to which the information relates :
(iii) Description of information required : (Details may be attached on additional A4 size paper if required)
(iv) Whether information is required by post or in person : (v) In case by post (Ordinary, Registered or Speed) :
3. WHETHER THE APPLICANT IS BELOW POVERTY LINE : (If yes, attach a photocopy of the proof thereof)
Place : Date
:
Signature of the applicant
Format of Application for obtaining information under The Right to Information Act 2005
Affix Court fee stamp of Rs.10/-
To: The State Public Information Officer, (Name of the office with address)
1. FULL NAME OF APPLICANT :
2. ADDRESS :
3. PARTICULARS OF INFORMATION REQUIRED (i) Subject matter of information :
(ii) Period to which the information relates :
(iii) Description of information required : (Details may be attached on additional A4 size paper if required)
(iv) Whether information is required by post or in person : (v) In case by post (Ordinary, Registered or Speed) :
3. WHETHER THE APPLICANT IS BELOW POVERTY LINE : (If yes, attach a photocopy of the proof thereof)
Place : Date
:
Signature of the applicant
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