Annexure A
(see Rule 3)

 Format of application for obtaining information under the Right to Information Act, 2005

To

The Public Information Officer,

(Designation and address of the concerned office)

1. Full name of Applicant:

2. Address:

3.       Particulars of Information required:

(i) Subject matter of information:

(ii) The period to which information relates: Current.

(iii) Description of Information required:

I had made an application for the following reason (copy of application is attached) but no satisfactory action has been taken on my application so far.

Please provide the following information with respect to the same:

a)       Please indicate the progress made on my application so far. i.e. when did my application reach which officer, for how long did it stay with that officer and what did he/she do during that period?

b)       Please give the names and designations of the officials who were supposed to take action on my application  and who have not done so?

     c) Please give me a list of applicants who have applied for the same in the last three/six months, and the dates on which they were given

. If you wish to you could blank out the names of the applicants.

(iv) Whether information is required by post or in person,

(v) In case by post: Ordinary, registered or Speed post):

(4.) Whether applicant is below poverty line:
      (if so attach photocopy of below poverty line card.

 Place:

Date:                                                                               Signature of applicant.