The Right to Information Act, 2005

First Appeal under section 19(1)

Annexure B [See Rule 5(1)]
To,
The First Appellate Authority,
Address:

Paste Court Fee Stamp

Here
Of following value:
Rs. 5/- X 4 Nos.
OR Rs. 10/- X 2 No.

Dear Sir/ Madam,

As I am aggrieved by decision/no decision of Public Information Officer, I hereby file this

appeal/complaint for your kind decision:
1. Full Name of the Appellant:
2. Address:
3. Particulars of PIO:
4. Date of Receipt of the order

appealed against:
5. Last date for filing the appeal:
6. The Grounds for Appeal:

6.1 The PIO has not provided a specific & separate response against each of the points of
my request for information.
6.2 The PIO has not provided information against point no. 3(c) X, Y . of the RTI
application.
6.3 Similarly ..
7. Particulars of information:
(i) Nature & subject matter of the information:
Subject: Please refer to the photocopy of the RTI application enclosed herewith.
(ii) Name of the Office or
Department to which the
information relates:
8. Prayer / Relief sought for:
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sunilahya@gmail.com

8.1 Kindly direct the PIO to provide a specific & separate response against each of the
points of request for information in the RTI Application (i.e. a point-wise response).
8.2 Kindly direct the PIO to provide all the requested information within a period clearly
specified in your first appeal order.
8.3 In-accordance with the letter & spirit of the provision of section 19(5) of the RTI Act,
2005 during the course of the first appeal proceedings kindly put the onus on the PIO
to prove that the denial of a request was justified.
8.4 Similarly ..
9. Personal Presence at hearing: YES / NO:

YES

10.Enclosed Herewith:
10.1
10.2
Place:
Date:
Signature of Appellant.
Mobile No.
e-mail address:

Page 2 of 2

sunilahya@gmail.com