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FORM A
See Rule 3(1)
APPLICATION FOR INFORMATION UNDER SECTION 6(1) OF THE ACT
TO
THE PUBLIC INFORMATION OFFICER
SELECT DEPARTMENT NAME
LOCATION
1. FULL NAME OF APPLICANT*
2. FATHER'S / SPOUSE NAME*
3. PARMANENT ADDRESS*
4. CORRESPONDENCE ADDRESS
5. PARTICULAR OF INFORMATION SOLICITED  
(i) SUBJECT MATTER OF INFORMATION
(ii) THE PERIOD TO WHICH THE INFORMATION RELATES.
(iii) SPECIFIC DETAILS OF THE INFORMATION REQUIRED.
(iv) Whether information IS REQUIRED BY POST OR IN PERSON (The actual postal charges shall be included in providing information)
(v) IN CASE BY POST,THEN INDICATE WHETHER BY ORDINARY,REGISTERED OR SPEED
6. IS THIS INFORMATION NOT MADE AVAILABLE BY THE PUBLIC AUTHORITY UNDER VOLUNTARY DISCLOSURE.
7. DO YOU AGREE TO PAY THE REQUIRED FEE.
8. HAVE YOU DEPOSITED THE APPLICATION FEE?? (If yes, details of such deposit)
9. WHETHER BELONGS TO BELOW POVERTY LINE?, IF YES, Have you furnished the proof of the same with the application
PLACE FULL SIGNATURE OF THE APPLICANT
DATE


Puda Bhawan Sector- 62,Sas Nagar Mohali, Punjab