Format of application for obtaining information under the

Right of Information Act, 2005

Application Form
,
To,
____________________________________________________________________________
____________________________________________________________________________
1. : ______________________________________________
Full Name of the applicant
2. : _____________________________________________________
Address ______________________________________________________________
3. : __________________________________
Particulars information required
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
: __________________________________
The period to which the information relates

Weather information is required by post or in person : _________________
( )
(The actual postal charges shall be included in additional fees)
: ___________________
In case by post
(, )
(Ordinary, Registered or Speed)
4. : / _______________________________
Whether the applicant is below poverty line : (Yes/No)
( )

Date

Place

Signature of the Applicant