Rti Application Form printable pdf download

RTI APPLICATION FORM

To,

The Central Public Information Officer

________________________

____________________________

PIN: _______________________

Sir,

Subject: Request for Information under Right to Information Act 2005.

I Sri / Smt /Ms.

__________________________________________________________

Son/Daughter/wife of Shri/Smt/Ms.

__________________________________________

resident of

______________________________________________________________,

telephone number (with STD Code) ____- _____________________ and/or mobile

number: ______________________________ wish to seek information as under

----------------------------------------------------------------------------------------------------------------

I hereby inform that following formalities have been completed by me:

1. That I have deposited the requisite fee of Rs. _____/- by way of Cash / banker

cheque / Draft / Postal Order/ others ___________________ ) favoring

__________________________________ dated ________________.

2. I need the photocopy of the documents and I had deposited the cost of the

photocopy of Rs. ____/- for _____ (Number of Pages)

3. I had deposited sum of Rs. _____/- for the charges of CD. (strike out which ever

is not applicable)

4. That I belong to Category of below Poverty Line (BPL): Yes / No

(Strike whichever is not applicable). If yes, I am attaching the valid photocopy of

the certificate. Yes / No

5. That I am ‘Citizen’ of India and I am asking the information as ‘Citizen’.

6. I assure that I shall not allow/ cause to use/ pass/share/display/ or circulate the

information received in any case and under any circumstances, with any person or

in any manner which would be detrimental to the Unity and Sovereignty or

against the Interest of India.

Signature of the Applicant

Dated:

Rti Application Form