Application form for seeking information under the RTI Act 2005
(Use of this Application Form is Optional and Application on plain paper is acceptable)

Please fill in BLOCK LETTERS

PART I:

1. Name of applicant:

2. Date of Birth (optional):

3. Gender(optional):

Male/Female:

4. Address for correspondence with Pin Code
(Please ensure correct address for delivery of information/reply)

5. Whether belonging to below poverty line category:            Yes/No
(if yes, please attach proof).

6. Whether citizen of India:            Yes/No.

PART II:

i. Specify the particulars of the information sought for.

ii. Whether the information sought is required to be supplied:
(a) In Printed form
(b) In diskette or floppy
(c) Whether inspection of records also sought.

iii. Whether application fee2 of Rs. 10 (rupees ten) is paid? If yes, please specify whether by cash (please enclose copy of receipt) or demand draft or Banker’s cheque (drawn in favour of “Sr. AO (Cash), NCNGN, BSNL”, payable at New Delhi. No fee is required to be paid if the applicant belongs to below poverty line category and the proof of this fact has been attached.

Declaration of the Applicant:

The information given by me in this form is true and I am solely responsible for its accuracy.



(Signature of the Applicant)
Place:
Date:

Note:

1. The above form has been devised to facilitate supply of information to the applicant. However, it is open to the applicant to submit the application on plain paper.

2. Attention of the applicant is drawn to section 7(3) of the RTI Act; where under additional payment of fees may be required

Instructions and Procedure for Request of Information

1. Application Procedure for requesting information:
Applications seeking information can be submitted in English or Hindi or in the official language of the area, to the concern CPIOs. The Application can be made on a plain paper. The application for obtaining information shall be accompanied by an application fee of rupees ten by way of cash against proper receipt or by demand draft or bankers cheques payable to the “Sr AO (Cash), NCNGN, BSNL” at New Delhi”.

2. Time limit to get information:

i). 30 days from the date of application.
ii). 48 hours for information concerning the life and liberty of a person.
iii). 5 days shall be added to the above response time, in case the application for information is given to Assistant Public Information Officer.
iv). If the interests of a third party are involved then time limit will be 40 days (maximum period+ time given to the party to make representation).
v). Failure to provide information within the specified period is a deemed refusal.

A request for obtaining information under sub-section (1) of section 6 shall be accompanied by an application fee of rupees ten by way of cash against proper receipt or by demand draft or bankers cheque payable to the “Sr AO (Cash), NCNGN, BSNL” at New Delhi. For providing the information under sub-section (1) of section 7, the fee shall be charged by way of cash against proper receipt or by demand draft or bankers cheque payable to the “Sr AO (Cash), NCNGN, BSNL” at New Delhi at the following rates:- 1. rupees two for each page (in A-4 or A-3 size paper) created or copied; 2. actual charge or cost price of a copy in larger size paper; 3. actual cost or price for samples or models; and 4. for inspection of records, no fee for the first hour; and a fee of rupees five for each subsequent hour (or fraction thereof) thereafter. For providing the information under sub-section (5) of section 7, the fee shall be charged by way of cash against proper receipt or by demand draft or bankers cheque payable to the “Sr AO (Cash), NCNGN, BSNL”, at New Delhi at the following rates:- 1. for information provided in diskette or floppy rupees fifty per diskette or floppy; and 2. 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.

4. Grounds for rejection of the application seeking information: Request for supply of any information/document falling under the following categories can be rejected:

1. Exempted under the provisions of Section (8) of the Right to information Act, 2005.

2. Infringing upon the copy right of any person other than the State (section 9) of the Right to information Act, 2005