Format of RTI Application for any Dept. (Govt. of Haryana)

Form-A
[See Rule 3(1)]

To
    The State Public Information Officer
    O/o ...................................................
    ..........................................................
    ..........................................................

Sub :-    Application under RTI Act. to get information.

 1.    Name of the applicant    :    ..................................................
 2.    Parmanent Address    :    ....................................................................                                                      .....................................................................
                                              .....................................................................
3.    Particulars of information required     :   
    (i)    Subject Matter of Information    : Information about ..............
    (ii)    The period to which the information relates        : w.e.f. ................
    (iii)    Description of the information required    :
 1. (Write your questions here)
 2. (Write your questions here)


vi)    Whether information is required by Post or in Person            :    By post
(v)    In case by Post (Ordinary/Registered/Speed)                       :    Registered Post
   
A  sum of Rs. 50/- on account of fee as mandatory under Right to information Act for the supply of information has been sent by applicant with this application vide Cash Receipt No/Postal Order No - ............ Dated ............................ So please provide above information as soon as possible.

Place : ................................
Date : ..................................                                                   Signature of Applicant

Note : I, State that the information sought does not fall within the restrictions contained in
           Section 8 of the Act and to the best of my knowledge it pertains to your office.

ACKNOWLEDGEMENT

    Received your application Dated ................ vide Diary No. .................Dated .................
                                   

(Signature)
                                    The State Public Information Officer
    O/o ................................................

 .......................................................
    .......................................................