Pio Application Form Page 2

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3. (a) Whether information sought relates to third party?
(b) If yes his/her name & address
Yes
No
_______________________________
_______________________________
_______________________________
4. Specify the particulars of information required
(i) ___________________________________
(ii) ___________________________________
(iii) ___________________________________
(iv) ___________________________________
(v) ____________________________________
5. Time period for which information is required
.............................................................
6. Whether applicant belongs to BPL category:
Proof of BPL attached
Yes
No
7. Details of fee paid
Rs.________________
Signature of the applicant
* Application may preferably be submitted directly to the Public Information Officer
concerned to avoid delay.
:::::

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