Format of a 'RTI Application'

                                                               Date :

To,

The Public Information Officer
(Name of the Organisation)
(Address)
Pincode

Sir/Mam

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

I Sri / Smt/ Ms.(Your Name) Son/Daughter/wife of Shri/Smt/Ms _________ resident of (Your Full Address), wish to seek information as under

Particulars of information

(a) Concerned Office/Department :
(b) Particulars of information required:
      (i) Details of information required :
      (ii) Period for which information asked for:
      (iii) Other details:

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

1. That I have deposited the requisite fee by way of Cash / banker /cheque / Draft / Postal Order/ others.

2. That I belong to Category of below Poverty Line (BPL): Yes / No. If yes, I am attaching the valid photocopy of the certificate. Yes / No

                            Declaration

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

b. I state that the information sought does not fall within the restriction contained in Section 8 & 9 of the RTI Act and to the best of my knowledge it pertains to your office.

c. Further, 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.

Place____________
Date_____________

(Name & Signature)

Postal Address:
E-mail address:
Contact Number: