| Appendix 'A' |
APPLICATION FOR SEEKING INFORMATION
| I.D. No. .. | ||
| (For official use) | ||
| To, | ||||
| The Public Information Officer (Navy) | ||||
| . | ||||
| . | (Name and address of public authority concerned) | |||
| 1. |
Name of the Applicant: .......................................... |
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| 2. | Address: ............................................................. | |||
| 3. | Particulars of information- | |||
| (a) |
Concerned department: ....................................................... |
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| (b) |
Particulars of information required |
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| (i) |
Details of information required :....................................... |
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| (ii) |
Period for which information asked for :............................ |
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| (iii) |
Other details :............................................................. |
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4. I state that the information sought does not fall within the exemptions contained in section 8 of the Right to Information Act, 2005 and to the best of my knowledge it pertains to your office.
5. A fee of Rs .. has been deposited in the office of the Central Public Information Officer vide No. . Dated ..
OR
A Demand Draft/Bankers Cheque No. .. dated for Rs .. drawn on .. (name of bank) favoring Accounts Officer . (name of office), towards payment of fee is enclosed herewith.
| Place . | Signature of Applicant |
| Date . | E-mail address, if any . |
| Tel. No. (office) . | |
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(Residence) .. |
Note: (i) Reasonable assistance can be provided by the Central Public Information Officer in filling up the Form.
(ii) Please ensure that the Form is complete in all respect and there is no ambiguity in providing the details of information required.
ACKNOWLEDGEMENT OF APPLICATION FOR SEEKING INFORMATION
| I.D. No. | Dated .. |
1. Received an application from Shri/Ms .resident of .. under section 6(1) of the Right to Information Act, 2005.
2. The applicant is advised to contact the undersigned on .. between .. AM to PM.
3. In case the applicant fails to turn up on the scheduled date(s), the Public Information Officer shall not be responsible for delay, if any.
4. The applicant shall have to deposit the balance fee, if any, with the authorized person before collection of information.
5. The applicant may also consult Web-site of the department from time to time to ascertain the status of his application.
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Signature and stamp of the |
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Competent Authority |
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E-mail address: .. |
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Web-site . |
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| Dated | Tel No. .. |
DRAFT CERTIFICATE
1. I, , Occupation , S/o presently staying at a permanent resident of do hereby certify that I had sought for the info pertaining to (nature of info) from (details of the officer giving info) for under the provisions of the 'The Right to Information Act, 2005'.
2. I, further certify that in consequence of my request I was allowed to obtain the said information on and have been provided with the information in the form of on (date) and that I am fully satisfied and have no other information to obtain from (name of the office/organisation).
Or
*I further certify that in consequence of my request I was denied the said information on and have been informed of the appellate authority and the time period for an appeal vide (mention the reference of Appx 'B')
*Strike out whichever is not applicable.)
| (Signature of Applicant) |