ANNEXURE - A
RTI APPLICATION FORM
(RIGHT OT INFORMATION ACT – 2005)
To
The Public information Officer Affix
Court Fee
________________________ Stamp of
Rs.10
____________________________
____________________________
Respected Sir,
Subject: Request for Information under Right to Information Act 2005.
I Sri / Smt /Ms. ______________________________________________
Son/Daughter/wife of _________________________________________
resident of ___________________________________________________
_____________________________________________________________
wish to seek information as under
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Whether information is required by post or in person:
In case by post (Ordinary, Registered, Speed):
Whether applicant belong to Category of Poverty Line (BPL):
(If yes, attach a photo copy of certificate)
Signature of the Applicant
Date:
Place: