Sample Application Form for Seeking Information under RTI Act 2005

Application Form for Seeking Information under RTI Act 2005

To

Public Information Officer,

Address of Information Officer:

1. Name of Applicant

2. Address

3. Particulars of information sought

(a) Department concerned

(b) Particulars of information required

(i) Details of information required (specified):

(ii) Period for which information asked for :

(iii) Any other details

4. I state that the information sought does not fall within the restrictions contained in Section 8 of the Act and to the best of my knowledge it pertains to your office.

5. A fee of Rs. 10/- is enclosed herewith vide Demand Draft No.________ dated ______

favouring “abc” payable at xyz or the fee has been deposited in your office by cash on ____ (Cross out what is not applicable)

Date : ( Signature of Applicant)

E-mail address, if any:__________ Place______________

Telephone No (Office)____________ Residence __________

Mobile___________

Right To Information