Information & Public Relations Department Page 6

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Received the application from ---------------------------------------------------------------
address---------------------------------------------------------------------------------------------------------
on-------------------------seeking information.
Place
Full name of Public Information Officer
Date
Designation
Seal
-6-
FORM B
[See Rule 4 (2) ]
Information for Payment
From
Name & Designation of the Public Information Officer
To
Name of the applicant -
Address
Sir,
Please refer to your application dated ---------------addressed to the undersigned
requesting information on --------------------------------------------------------------. I am to inform
you that the following amount towards cost for providing information may be deposited in cash,
to enable the undersigned to furnish information sought for.
Please make payment within a period of fifteen days from the date of receipt of this
intimation failing which the application shall be rejected.
Fee-------------------
Yours faithfully
Place:
Public Information Officer
Date:
Seal:

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