Application Form

To

The State Public Information Officer/

State Assistant Public Information Officer,

(Name of the office with address)

1. Full name of the applicant
2. Address
3. Particulars of information required:
   1. Subject matter of information
   2. The period to which the information relates
   3. Description of the information required
   4. Whether information is required by post or in person (the actual postal charges shall be included in addition to the fees).
   5. In case by post (Ordinary, Registered or Speed)

Acknowledgement

Received your application dated ………………… vide Diary No …………………… dated …………………