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Dated : ____/____/________

To,
Public Information Officer
____________________________
____________________________
____________________________
PIN: ________________________

Affix here court fee


stamp of Rs. 10 /-

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


I would like to know the details of required details for project mentioned below:
Project Name
___________________________________________________________________
Project Location/Address:
___________________________________________________________

Information Required as below:


____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
If requested information does not pertain to your department, then please follow
the provisions of Section 6(3) of the RTI Act 2005.
As per RTI Act, please provide details (name & Designation) of the first appellate
authority w.r.t. above request.

Attachments (If Any) :

I would like to receive this Information BY POST

IN PERSON

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


1. That I have deposited the requisite fee of Rs. 10 by Court fee stamp as pasted on top of
this form.
2. That I belong to Category of below Poverty Line (BPL): No/Yes
3. That I am Citizen of India and I am asking the information as Citizen.
4. I assure that I shall not allow/ cause to use/ pass/share/display/ or circulate the information
received in any manner which would be detrimental to the Unity and Sovereignty or
against the Interest of India.

Regards,
Name of Applicant:
Signature of applicant:
Date:
Communication Address
Mobile No.

Dated : ____/____/________
Email