APPLICATION UNDER SECTION-6 OF THE RIGHT

TO INFORMATION ACT, 2005

To
The Central Public Information Officer

.
Name & Address of Applicant:.
.
.
.
.
Sir,
I am a citien of India and I see! follo"in# information in
terms of Section$% of &i#ht to Information Act, '(()
Particular !" i#"!r$ati!# !u%&t'
(1) Kindly supply me certified copy of Dealership Agreement executed by
and between Ms !!!!!!!!!!!!!!!!!("ndane#$%$ &
Agency name)' for distribution of "ndane#$%$ ($) cylinders' including
*erms + ,onditions as well as -er.ices and facilities re/uired to be
pro.ided by the Dealer to the consumers ,ustomers0
(1) Kindly supply me (ist showing (a) ,onsumer 2o0' (b) Date of %oo3ing'
(c) Date of Deli.ery + (d) %ill,ash Memo number and date' of all
Domestic use "ndane#$%$ ($) ,ylinders boo3ed and deli.ered by
!!!!!!!!(Agency name)' from !!!!!!to
!!!!!!!!00 (this period is 1 days before your date of boo3ing and
one day after you recei.ed deli.ery or actual date of filing 4*" Application'
if refill is not recei.ed)
(5) Kindly supply me date&wise /uantity (in number of cylinders) of
"ndane#$%$ domestic use ($) cylinders supplied by "ndane#$%$ to
Ms !!!!!!!!!! (Agency name)' from !!!!!to !!!!!
(this period is 1 days before your date of boo3ing and one day after you
recei.ed deli.ery or actual date of filing 4*" Application' if refill is not
recei.ed)
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(6) Kindly supply me list showing date&wise #ome Deli.ery as well as ,ash
+ ,arry deli.ery of ($) 4efill in respect of ,onsumer
no0 000000000000000000000000000000 (your consumer no) with Ms 000000000000000000000 (2ame
and Address of Agency) from 111715 to !!!(date of filing 4*"
Application)0
I am enclosin# IPO no. . for &s.*(+$ in fa,our of
. -Indian Oil Corporation .td+ /harat Petroleum Corporation .td
+ 0industan Petroleum Corporation .td1 to"ards APP.ICATION 233.
4indl5 suppl5 the information to me b5 &e#istered Post or
Speed Post on m5 abo,e address in terms of Section$6 of &i#ht to
Information Act, '(().
3ncl: IPO No.
7ours faithfull5,
Place :..
8ate : ..++.. Si#nature
A((lica#t
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