Request Form

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Right to Information Act-2005

Application for Information


To,
Central/State Public Information Officer,
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(Name & Address of CPIO/SPIO)

Subject: Application under-Section 6(1) of Right to Information Act- 2005.


Particular of information required: --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Applicant Name: ---------------------------------------------------------------------------------------------Fathers/Spouse Name: -------------------------------------------------------------------------------------Category (SC/ST/OBC): ------------------------------------------------------------------------------------Below Poverty Line (BPL) (Write Yes or No) : --------------------------------------------------------Postal Address: -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Phone/Mobile No: -------------------------------------- (if available)
e-mail Id: ------------------------------------------------------------------------- (if available)
Date: -------------------------------------------Place: ------------------------------------------Signature of Applicant
List of enclosures:

Note: Strike out whichever not applicable


Select either CPIO (Central Public Information Officer) or SPIO (State Public Information Officer) in your application

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