Form ‘A’
Form of application for seeking information
(See rule 3)

I.D.No________
(For official use)

To

The Competent Authority,
........................................
........................................

1.         Name of the Applicant:                ............................................

2.         Address:                                        ............................................

1. Particulars of information.

(a) Concerned department:                      ............................................

(b) Particulars of information required:   ............................................

    i. Details of information required:        ............................................

   ii. Period for which information
   asked for :                                               ............................................

  iii. Other details:                                      ............................................

1. I state that the information sought does not fall within the restrictions contained in the Right to Information Act, 2005 and to the best of my knowledge it pertains to your office.

1. A fee of Rs._____ has been deposited in the office of the Competent authority

Vide No______ dated_________.

Place:  .........................
Date: .........................
Signature of Applicant
E-mail address, if any ................................
Tel. No.  (Office) .......................................

Note: - (i) Reasonable assistance can be provided by the competent authority in filling up     the Form A.
(ii) Please ensure that the Form A is complete in all respect and there is no ambiguity in providing the details of information required.