Pio Application Form - India

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Form of Application
PIO from which information is required
________________________________
________________________________
________________________________
A. Contact Details
1. Name of the Applicant ____________________________________________
2. (a) Mailing Address _____________________________________________
(b) Tel. No.
_____________________________________________
(c) E-mail
______________________________________________
3. Whether a citizen of India
Yes
No
B. Details of information sought
1. Nature of information sought
(a) Life & liberty of the person *
(Please
mark)
(b) Other than (a)
2. Type of information required
(a) Copy of documents
Yes
No
(b) Inspection of records
Yes
No
(c ) Sample of material
Yes
No
(d) Other Information
Yes
No
Form of Application
PIO from which information is required
________________________________
________________________________
________________________________
A. Contact Details
1. Name of the Applicant ____________________________________________
2. (a) Mailing Address _____________________________________________
(b) Tel. No.
_____________________________________________
(c) E-mail
______________________________________________
3. Whether a citizen of India
Yes
No
B. Details of information sought
1. Nature of information sought
(a) Life & liberty of the person *
(Please
mark)
(b) Other than (a)
2. Type of information required
(a) Copy of documents
Yes
No
(b) Inspection of records
Yes
No
(c ) Sample of material
Yes
No
(d) Other Information
Yes
No
3. (a) Whether information sought relates to third party?
(b) If yes his/her name & address
Yes
No
_______________________________
_______________________________
_______________________________
4. Specify the particulars of information required
(i) ___________________________________
(ii) ___________________________________
(iii) ___________________________________
(iv) ___________________________________
(v) ____________________________________
5. Time period for which information is required
.............................................................
6. Whether applicant belongs to BPL category:
Proof of BPL attached
Yes
No
7. Details of fee paid
Rs.________________
Signature of the applicant
* Application may preferably be submitted directly to the Public Information Officer
concerned to avoid delay.
:::::

Download Pio Application Form - India

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