APPLICATION FOR INFORMATION UNDER SECTION 6 (I) OF THE ACT

To
The Public Information Office
Bangalore University, Janana Bharati
Bangalore – 5600056
1. Full Name of the Applicant : Santosh Kumar Pattanaik
2. Father’s Name : Sadasiba Pattanaik
3. Permanent Address : At – Chhotaraypur Sasan
Po- Gangadharpur
PS- Banapur
Dist – Khurdha –752034 (Odisha)

4. Particulars in respect of : Aadhar Card

Identity of Applicant
5. Particulars of information solicited: -
(a) Subject Matter of Information: -
Information sought for certified copy of B.Ed. College Affiliated for the
section 2011-12 and 2012-13 and 2013-14 to Sri Venketeswar College of
Education, No.1/18, 8th Cross, Maruthinagar, Madiwala, Bangalore-560068 for
B.Ed. Course of Santosh Kumar Pattanaik, having Regd. No.: 11G4D11061.
(b) The period to which the information related: 2011 -12 and 2012-13 and 2013-14.
(c) Specific details of information: Separated Sheet attached Herewith.
(d) Where information is By Post
Required by post or person: -
(The actual postal charges shall be
included in providing information)
(e) Incase by post (Ordinary, registered or speed): - Registered
6. Address to which information
will be sent and which form: - Santosh Kumar Pattanaik
At – Chhotaraypur Sasan
Po- Gangadharpur
PS- Banapur
Dist – Khurdha –752034 (Odisha)
7. Whether you have applied earlier :- No
8. Has the information provided earlier :- No
9. Is this information not made available
By the public authority :- No
10. Do you agree to pay the required fee :- Yes
11. Have you deposited application fee :- Yes
(If Yes, details of such deposit)
12. Whether belongs to BPL Category, :- No, No
Have you furnished the proof of the same
Place:

Date: Full Signature of the Applicant

OFFICE OF THE PUBLIC INFORMATION OFFICER

Received the application form _______________________________________

________________________________________________________________

Address _________________________________________________________

________________________________________________ seeking

information.

Place:

Date: Full Name of Public Information Officer

Designation: -
Seal:-
 COLUMN 5 (C) OF APPLICATION
Information sought for: -

Information sought for certified copy of B.Ed. College Affiliated for the section
2011-12 and 2012-13 and 2013-14 to Sri Venketeswar College of Education,
No.1/18, 8th Cross, Maruthinagar, Madiwala, Bangalore-560068 for B.Ed. Course
of Santosh Kumar Pattanaik, having Regd. No.: 11G4D11061.