To,

Dated: XX/XX/20XX
The Public information Officer
Registrar office,
xxxxxxxxx University
State
PIN: xxxxxxxx
Sir,
Subject: Request for Information under Right to Information Act 2005.
(Request for results of Carry over papers given in May/June 2016)
Myself Mr XXXXX Son of Mr XXXXXXXX,
Resident of : xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx, Pin-xxxxxx
Mobile number
: xxxxxxxxxxxx and xxxxxxxxxxxx
Also,
I am student of XXXXXXXXXXX and my details with the university are as under:
Student name
: XXXXXXXXXXXXXX
Enrollment Number
: Xxxxxxxx (Admission year xxxxx)
Institute
: XXXXXXXXXXXXX
Branch
: (XX) XXXXX Engineering.
Roll Number
: XXXXXXXXXXX
I wish to seek information as under:

Exam results of my Carryover Papers of Fourth Semester for which the

details are as under:
Sub Code (Sub name), Exam date : XXXXXX
SUB code (Sub name): xxxxxxxx
Exam Centre
: xxxxxxxxxxx
Reason for pendency of declaration of the results
Date when the results will be declared and uploaded on the website.

I thus inform that following formalities have been completed by me:

1. That I have deposited the requisite fee of Rs. 10/- by way of Postal Order favoring
__________________________________ dated ________________.
2. I need the photocopy of the Declared results for the COP exams of 20XX and I
had deposited the cost of the photocopy of Rs. 20/- for (2 pages) or
3. That I am Citizen of India and I am asking the information as Citizen of India.
4. I assure that I shall not allow/ cause to use/ pass/share/display/ or circulate the
information received in any case and under any circumstances, with any person or in
any manner which would be detrimental to the Unity and Sovereignty or against the
Interest of India.

Signature of the Applicant: Mr XXXXXX

Dated: XX/XX/XXXX