Application Form For Information Under The Right Page 4

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Form ‘A’
[See rule-3 (1)]
APPLICATION FOR INFORMATION UNDER
THE RIGHT TO INFORMATION ACT 2005
To
The Public Information Officer
(Name of the Department from which the information is sought )
(a) Subject matter of the information
----------------------------------------------------------------------------------------------
(b) Period to which the information relates.
Month & year
_________________________________________________________
(c) Description of the information required
(d) File No. if available
------------------------------------------------------------------------------------------------
(e) Whether the applicant claims exemption
as below poverty line family, if yes, attach proof
__________________________________________________________
(f) Original Treasury Challan No
amount and date of depositing
application fee under rule 4 be attached.
Applicant
Name_________
Address_____________
Telephone
No.____________

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