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তথ্যের আবেদন ফরম

SAMPLE RTI APPLICATION FORM 

To, 

The Public information Officer ________________________ 

____________________________ 

____________________________

 PIN: _______________________ 

Sir, 

Subject: Request for Information under Right to Information Act 2005. 

I Sri / Smt /Ms. __________________________________________________________ 

Son/Daughter/wife of Shri/Smt/Ms. __________________________________________

 resident of ______________________________________________________________, 

telephone number (with STD Code) ____- _____________________ and/or mobile number: ______________________________ wish to seek information as under

 ---------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------

 I hereby inform that following formalities have been completed by me: 

1. That I have deposited the requisite fee of Rs. _____/- by way of Cash / banker cheque / Draft / Postal Order/ others ___________________ ) favoring __________________________________ dated ________________. 

2. I need the photocopy of the documents and I had deposited the cost of the photocopy of Rs. ____/- for _____ (Number of Pages) or 

3. I had deposited sum of Rs. _____/- for the charges of CD. (strike out which ever is not applicable)

 4. That I belong to Category of below Poverty Line (BPL): Yes / No (Strike whichever is not applicable). If yes, I am attaching the valid photocopy of the certificate. Yes / No 

5. That I am ‘Citizen’ of India and I am asking the information as ‘Citizen’.

6. I assure that I shall not allow/ cause to use/ pass/share/display/ or circulate the information received in any case and under any circumstances, with any person or in any manner which would be detrimental to the Unity and Sovereignty or against the Interest of India.

 Signature of the Applicant