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Second Appeal u/s 19(3) of the Right To Information Act 2005

before

President of Executives/Board of Directors

Feroz Shah Kotla Stadium
NEW DELHI 110002

Appeal Date: __________________

Appellant:
Address: _______________________________
________________________________________
________________________________________
Email: ______________________________;
Phone: ____________________________

Enclosed is the second appeal u/s 19(3) of the RTI Act 2005 by XXXXX, against Order dated
by First Appellate Authority vide Letter No. ____________________________dated
_________________OR No action by Appellate Authority for First Appeal filed dated
_______________against PIO reply vide letter No. ___________________dated __________________]
OR [No action by Appellate Authority for First Appeal filed dated
_____________________________against deemed refusal by PIO for RTI Application filed dated
____________________________RTI application dated ___________________________] Index of
enclosed second appeal is as follows:

INDEX OF SECOND APPEAL

of Mr. ______________________dated _______________________________

S. No. Title Pages

1 Index of Appeal 1

2 Original Second Appeal 2-

3 Chronological chart of events

4 Annexure – A: Copy of RTI Application

5 Annexure – B: Copy of PIO Response

6 Annexure – C: Copy of First Appeal

7 Annexure – D: Copy of FAA Orders

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Total number of pages including enclosures: ___________

1) Original Second Appeal & extra copy of Second Appeal is sent to President of
Executives/Board of Directors
2) Copy of Second Appeal is sent to PIO
3) Copy of Second Appeal is sent to FAA

Date : XXXXXXXXXX
Place: XXXXXX (Appellant)

Second Appeal u/s 19(3) of the Right To Information Act 2005

before

President of Executives/Board of Directors

Feroz Shah Kotla Stadium
NEW DELHI 110002
Appeal Date: _____________________________

Mr./Mrs.____________________________________________
Address: ___________________________________________________________
____________________________________________________________________
1 Appellant details
____________________________________________________________________
Email: ________________________ ;
Phone: _____________________

PIO Name,
Designation
2 PIO Details
PA Name
Address Line1, Address Line2

FAA Name,
Designation
PA Name
3 FAA Details
Address: _____________________________________________________________
______________________________________________________________________
______________________________________________________________________

FAA Order vide letter No. ________________________dated ______________

4 Appeal Against
[ NO ACTION BY FAA for First Appeal filed on _______________________]

Not Satisfied by the Orders of FAA

[NO ACTION by FAA]
5 Reason(s) for Appeal
[Information not received after orders of FAA to supply the information
]
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Application Sent on

Application sent by
Particulars of RTI Speed Post
6
application
Fee Details

Enclosed in Annexure A: Copy of RTI Application

PIO Order No.

Dated
7 Particulars of PIO Orders
Received on

Enclosed in Annexure B: A Copy of PIO Response

First Appeal Sent on

First Appeal sent by

Particulars of First Speed Post
8
Appeal
Fee Details

Enclosed in Annexure – C: Copy of First Appeal

FAA Order No.

Dated
Particulars of FAA
9
Orders
Received on

Enclosed in Annexure – D: Copy of FAA Orders

RTI Application Sent on ________________ Annexure – A

PIO Response received on Annexure – B

Chronological order of
7 First Appeal filed on Annexure – C
events
FAA Order received on Annexure – D

Second Appeal filed on

Brief facts leading to

8
appeal

9 Grounds for this Appeal

Orders passed by FAA are unsatisfactory OR [ No orders passed by FAA even after a reminder]
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Information Requested Information Supplied Remarks

10 Additional Information
in support of Appeal

1) Information as applied

2) Impose penalty as u/s 20(1) of the RTI Act 2005

11 Prayer/relief sought for
3) Initiate disciplinary action as u/s 20(2) of the RTI Act 2005

4) Recommend the PIO to Compensate reasonably

12 Presence for Hearing Audio conference / Video conference

13 Verification I hereby state that the information and particulars given above are true
to the best of my knowledge and belief.

14 Signature of Appellant
Date : __________________________________
Place: ___________________ ( Appellant )

1) Index of Appeal
2) Chronological chart of events
3) Annexure – A: Copy of RTI Application
15 Enclosures(s)
4) Annexure – B: Copy of PIO Response
5) Annexure – C: Copy of First Appeal
6) Annexure – D: Copy of FAA Orders

1) PIO Name,
Designation,
Address: ___________________________________________________
____________________________________________________________
____________________________________________________________
16 COPY TO
2) FAA Name
Designation,
Address: ____________________________________________________
_____________________________________________________________
_____________________________________________________________

Total number of pages including enclosures: ___________

1) Original Second Appeal & an extra copy of Second Appeal is sent to CIC
2) Copy of First Appeal is sent to PIO
3) Copy of First Appeal is sent to FAA
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Date : _____________________________________
Place: ___________________________ (Appellant)

CHRONOLOGICAL CHART OF EVENTS

of Mr./Mrs. __________________dated ___________________________

S. No. Event Date

1 RTI Application sent on

3 PIO Response received on

4 First Appeal filed on

5 FAA Order Received on

6 Second Appeal filed on