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Sample RTI Application Form Template

This document is a sample Right to Information (RTI) application form obtained from the Hyderabad City Police website. The form requests information from the Public Information Officer and includes spaces for the applicant's details, the information being requested, payment details for applicable fees, a statement that the applicant is a citizen of India and will not misuse the information, and the applicant's signature and date. The format of RTI forms may differ between states but typically collect these core details.

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2K views1 page

Sample RTI Application Form Template

This document is a sample Right to Information (RTI) application form obtained from the Hyderabad City Police website. The form requests information from the Public Information Officer and includes spaces for the applicant's details, the information being requested, payment details for applicable fees, a statement that the applicant is a citizen of India and will not misuse the information, and the applicant's signature and date. The format of RTI forms may differ between states but typically collect these core details.

Uploaded by

piccoloash
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
  • Sample RTI Application Form

SAMPLE RTI APPLICATION FORM

(This is a sample RTI application form obtained from the website of Hyderabad City
Police. The format can differ from state to state.)

To,
The Public information Officer
________________________
____________________________
____________________________
PIN: _______________________

Sir,

Subject: Request for Information under Right to Information Act 2005.


I Sri / Smt /Ms. __________________________________________________________
Son/Daughter/wife of Shri/Smt/Ms. __________________________________________
resident of ______________________________________________________________,
telephone number (with STD Code) ____- _____________________ and/or mobile
number: ______________________________ wish to seek information as under

--------------------------------------------------------------------------------------------------------------------------
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I hereby inform that following formalities have been completed by me:


1. That I have deposited the requisite fee of Rs. _____/- by way of Cash / banker
cheque / Draft / Postal Order/ others ___________________ ) favoring
__________________________________ dated ________________.
2. I need the photocopy of the documents and I had deposited the cost of the photocopy of
Rs. ____/- for _____ (Number of Pages) or
3. I had deposited sum of Rs. _____/- for the charges of CD. (strike out whichever is not
applicable)
4. That I belong to Category of below Poverty Line (BPL): Yes / No (Strike whichever is not
applicable). If yes, I am attaching the valid photocopy of the certificate. Yes / No
5. That I am ‘Citizen’ of India and I am asking the information as ‘Citizen’.
6. I assure that I shall not allow/ cause to use/ pass/share/display/ or circulate the
information received in any case and under any circumstances, with any person or in any
manner which would be detrimental to the Unity and Sovereignty or against the Interest of
India.

Signature of the Applicant

Dated:

SAMPLE RTI APPLICATION FORM (This is a sample RTI application form obtained from the website of Hyderabad City Police. The f

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