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Annexture A Format of application for obtaining information under the Right to Information Act 2005

To, The Executive Engineer, B-2 Division, M.B.R & R Board, B-Ward office, Babula Tank Road, Mumbai:- 400 009. 1. Full Name of Applicant 2 Address : Mrs. Parvin Alimiya Kazi : 136-138, Ayeshabai Supariwala Building, 1st Floor, A-Block, Hazrat Abbas A.S. Street, Mumbai. 400 009. : 1) Certified Copy of Estimate and Work order issued For repair. 2) Date on which repair work undertaken. : Property bearing Ward No. B- 2765, C.S.No. 1428 Of Mandvi Div, situated at 2, Dontad Street, B-Ward, Mumbai.

3. Particulars of information

(i) Subject matter of information

(ii) The Period of which information : from 21.3.2011 to till date (iii) Description of the information (iv) Whether information is Required by post or in person (v) In case by post (Ordinary, Registered or speed) : Work order and estimate issued for repair of the above said building with status of repair work. : In person contact no. 9322406174 : By Registered on above address.

4. Whether the applicant is below Poverty line Place Date: 18.6.2011

: NO : Mumbai

(Parvin Alimiya Kazi)

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