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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.
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.
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: ________
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