The Central /State Public Information Officer
or Assistant Public Information Officer
(Name of the Office along with the Address)
Sub:-Application seeking Information under RTI Act, 2005.
It is requested to provide the following information under the RTI Act, 2005.
(1) Details of information required
(a) Subject matter and details of information required in the form of specific questions which should be specific.
Q. No. 1 – ……
Q. No. 2 – …….
Q. No. 3 – ……..
(b) Period for which information is sought.
(2) If inspection is being sought, a categorical mention should be made.
(3) If life and liberty is claimed, it should be specified.
(4) Any other relevant point
In case the information is held by or related to another public authority, the application or such part of it as may be appropriate may be transferred to that other public authority under intimation to the undersigned as per Section 6(3) of RTI Act. (It acts as a reminder for the PIO who is required to do it under the Act).
Evidence of payment of Application fee of Rs. 10/- and mode of payment.
(i) A fee of Rs. 10/- has been deposited in cash in the Accounts Office of the Public authority vide Receipt No.________ dated__________; or
(ii) A Postal Order/Bank Draft No. __________ dated _______ is enclosed; or
(iii) Exemption from payment of fees is claimed and evidence of the BPL status (example- Photocopy of BPL Ration Card) is attached.
Signature / Thumb Impression of the applicant
Full name and Postal Address of the Applicant
Contact Phone No. and e-mail (If any)