|2.||Further Fee (Document charges)||Rs. 2/- for each page|
|3.||Information on Floppy/Diskette||Rs.15 per each Floppy/Diskette + Rs.2 per page scanned and stored in Floppy/diskette|
|4.||Information in printed form||Actual price fixed for such publication or Rs.2 per page or extract from publication|
|5.||Inspection of Records||No Fee for first hour. Rs.5/- for each subsequent hour or fraction thereof.|
|6.||Mode of payment||By way of cash against a proper receipt or by Bank Draft or Banker's Cheque or Indian Postal Order payable to the “District Judge”. If applicant so desires, Fee can be deposited in advance being adjusted at the time of supply of information.|
|7.||Time for remitting Further Fee||15 days from date of intimation (failing which the application shall be rejected)|
|8.||Below Poverty Line applicant||No Fee is chargeable from BPL applicant. He should submit some proof to establish that he belongs to BPL category.|
|9.||Applicant seeking information under Life or Liberty clause||No Fee is chargeable from applicant seeking information under Life or Liberty clause. He should submit purpose of the information with brief explanation of the same.|
|10.||Charges for Speed Post/Regd Post||Applicant should submit sufficiently pre-stamped envelopment for sending information by Speed Post / Registered post.|
|11.||Collection of information in person||Where the applicant fail to turn up for collection of information on the appointed day, it shall be kept pending for another 15 days, and thereafter information shall not be supplied unless he submits a fresh application with requisite fees. In the event applicant fail to put in fresh application or fail to pay the further charges, action shall be taken to recover the balance if any.|
|12.||Electronic submission||Digitally signed application can be submitted electronically to the designated email address of PIO and the fee shall be remitted within 7 days thereafter, else it will be treated as no application is submitted.|
|13.||Separate applications||For every information sought a separate application shall be made except where the information sought are consequential or related to one another.|
Application for information under Section-6(1) of the Act Rule 4 (a)
Application No. ………….. for official use
The Public Information Officer / Assistant Public Information Officer ……………………………………….. ………………………………….
1. Name of the applicant:
2. Father's/Husband's name:
3. Permanent address:
4. Address at which information is required to be sent :
5. Form in which the information is required : (State if the information is required in the form of copies of documents/ information is required in diskette or floppy / copies of the extracts from any publication.)
6. How would you like the information to be sent: (State if you will collect the information yourself or through any of your representative or would like it to be sent by Fax or E-mail, if so, give the Fax number or the e -mail address. If you want the information to be sent by registered post or speed post, file the self-addressed prepaid envelope.)
7. Do you belong to BPL category? (If yes, give the details of the proof being submitted and also self - attested copy of the same. It may be noted, if required, the applicant can be asked to produce the original of the same at any time considered necessary.)
8. E-mail address (if any):
9. Mobile number (if any):
10. Land line number (if any):
11. If the information required concerns life and liberty of a person, give details:
12. The purpose for which the information is required : (Although the furnishing of this information is not mandatory, the same may be furnished as it may be of use in retrieving the required information.)
13. The name and address of the third party : where the information relates to a third party.
14. Department from which the information is required:
15. Particulars of the information requested for : (The information(s) requested for should relate to only one subject matter, retrievable from one set of records. If the space found is not adequate a separate sheet may be used. The number of sheets, if any, being attached with this form, be mentioned here.)
16. Any other information which may be useful in the expeditious disposal of the application.
Signature with full name and address of the Applicant.
Created by Shrawan Pathak on 2015/08/24 00:29.