FORM -1
Form of application for seeking information under the Right to Information Act,2005.
I.D. No (For official use)
To The Public Information Officer, …………………………………… ……………………………………
Name of the Applicant :
Address : …………………………………………………….. : …………………………………………………….. Particulars of information. - : ……………………………………………………..
(a) Concerned department : ……………………………………………………..
(b) Particulars of information required : ……………………………………………
i. Details of information required : …………………………………………………
ii. Period for which information asked for : ……………………………………………
iii. Other details : ……………………………………………
4. A fee of Rs 10/- (Rupees ten only) has been deposited in the office of the Public Information Officer vide receipt No…………. dated………………..
Place : ……………………
Date : ……………………..
SignatureofApplicant.E-mail address, if any Tel. No. (Office) (Residence) --------------------------------------------------------------------------------------------------------------- Note :- (i) Reasonable assistance can be provided by the Public Information Officer in filling up the Form 1
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