Home > Form A

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
    • Subject matter of information
    • The period to which the information relates
    • Description of the information required
    • Whether information is required by post or in person (the actual postal charges shall be included in addition to the fees).
    • In case by post (Ordinary, Registered or Speed)

Place:
Date:

Signature of the Applicant

Acknowledgement

Received your application dated vide Diary No dated


(Signature)
State Public Information Officer/
State Assistant Public Information Officer
Name of the Department/Office
*The information published here has been provided by the respective department.