RTI Application Form
Form-A
See Rule 3(1)
I. D. No: _____________
(For office use only)
Dated: ________
To,
Public Information Officer (PIO),
________
(Central Government)
________,
________,
Andaman and Nicobar Islands,
________, IN
Re: Request to furnish information under section 6(1) of the Right to Information Act, 2005 on the following questions/points.
Sir/Madam,
Through this letter, I request you to provide me with a certified copy of the following information:
________.
Please do limit your search of aforementioned items for the duration from ________ to ________.
The following details/documents have been attached along with this letter for your reference:
________
Please provide the aforementioned details through the following method: Postal (Speed Post) to the address mentioned at the end of this document.
I also request you to allow me a time slot with the details to inspect the aforementioned documents/information or samples as the case may be in-person.
I am willing to pay the required cost for getting the aforementioned information after deducting any reductions under the applicable laws.
Lorem ipsum dolor sit amet consectetur adipiscing elit sed do eiusmod tempor incididunt ut labore et dolore magna aliqua ut enim ad minim veniam quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat duis aute irure dolor in reprehenderit voluptate velit esse cillum dolore eu fugiat nulla.
I am a citizen of India and I am eligible to seek information under the Right to Information Act, 2005. I belong to the BPL category and a copy of the BPL card is attached along with this letter.
Lorem ipsum dolor sit amet consectetur adipiscing elit sed do eiusmod tempor incididunt ut labore et dolore magna aliqua ut enim ad minim veniam quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat duis aute irure dolor in reprehenderit voluptate velit esse cillum dolore eu fugiat nulla pariatur lorem ipsum dolor sit amet consectetur adipiscing elit sed do eiusmod tempor incididunt.
I assure that I shall not allow/cause to use/circulate the information received pursuant to this application in any case with any person which would be detrimental to the unity and sovereignty or against the interest of India.
Date: ________
Place: ________
Yours sincerely,
________________________
________
Permanent Address:
________
________
Andaman and Nicobar Islands
________, IN
Ph: ________