Form of Application
for seeking information under the Right to Information Act
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| To |
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Public Information Officer (PIO)
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Name : Shri D.Majumdar
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Railway office complex
Tilak Bridge
New Delhi 110002 |
| Sir,
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| 1.
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You are requested to provide me the following information: |
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_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________ |
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| 2. |
I belong to Below Poverty Line Section of Society and as such no fee is payable
by me. |
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OR
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I do not belong to Below Poverty Line Section of Society and a fee
of Rs.________ has
been deposited in cash with the cashier vide receipt No.________ dated
_________ ,
copy enclosed. |
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OR
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I do not belong to Below Poverty Line Section of Society and a fee of
Rs.________ is
being rendered herewith vide DD No. _________ dated __________ drawn on
_____________. |
| 3. |
This to certify that I am a citizen of India. |
| Place :____________ |
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| Date :_____________
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Signature of Applicant :________________________ |
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Name of Applicant : __________________________ |
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Father / Husband Name: _______________________ |
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Tel. No. (Office) : ____________________________ |
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(Residence): ________________________________ |
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Postal Address : _____________________________ |
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_____________________________ |
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_____________________________ |
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e-mail: ____________________________________ |
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| (Strike out whichever is not applicable.) |
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APPLICATION FEE DETAILS
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| 1. |
Application fee : Rs. 10/-
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| 2. |
Further fee towards cost of providing information: |
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| (a) |
rupees two for each page (in A-4 or A-3 size paper) created or copied ; |
| (b) |
actual charge or cost price of a copy in larger size paper; |
| (c) |
for inspection of records, no fee for the first hour; and a fee of rupees five
for each fifteen minutes (or fraction thereof) thereafter. |
| (d) |
For information provided in diskette or floppy, rupees fifty per diskette or
floppy; and
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| (e) |
For information provided in printed form at the price fixed for such
publication or rupees two per page of photocopy for extracts from the
publication. |
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| 3. |
Mode of Payment |
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The total amount of fee payable while seeking information under the Right to
Information Act may be paid in cash with the COFMOW cashier or in the form of
demand draft or bankers cheque in favour of “COFMOW” payable at New
Delhi. |
