404 GUIARAT:COVERNMENT GAZETTE EX. 224052010 [PARTIV.A FORMA See rule 30) “Application orm for obtaining information Te abl tformation Officer (Rane of Publi Autocity / Department /Oice) ‘Ades: ‘uaptto obiain following information rons you under he Right o Information Act 2005. The Gens are ss onder 1, Appligan’s Name : A Adirest of theapplicant : au Ldetaline Spesiie dation formation esqulred (in betes ssuceds o 2 4. (1) have paid application fee Ra... ia word nupettion nnn ent vide essipt 0 inthe depart fe Of on (© (2) enclose herewith crossed Deenand DrafvPay Ocdecindian Postal Onde for seas under. (Ramprerienes [Bae] | dea! pay oxder {dian postal order Ti Gaverement al Gupeal” MR een sn (Glare of Pubic Authority - Other thas Gavt. Depart / Offices - ind 5) Nordic sta out fe tam Frevenue samp of Rs. fied on is application {B43} 1 tave pid appieation fe by chain. oro tmenton nase of ak, ‘rate place) wah ienchsed in og herewith (ns) Tee ade appicaton 00 R20 on jul trp pape dha amp pape bence na set fs paid, BGG) Uheaeby declare that I belong to LPL family as on dt... and enelae herewith eins oP 1 PETES condor crf copy / se copy of cztcae for TPL Therefore {kane sor pad sppiiaton fee. f Ehercby declare that Lama Citizen of India Etinreby declare mat above derails are tre the best of my Knowledge and bebe Due ‘Signature of applicant: Phe: ‘Teleptone No. (ftir) {Residenest Mobile No. (if any? —Siikeout whishever is notapptiable,