Haryana Govt has amended RTI rules from 18-03-2016 and revised rules are as under:
[2005 rules replaced by 2009 on 21-12-2009 effective from 01-01-2010] [Again amended on 18-03-2016 –filing fee reduced to Rs.10/-, CD Rs.50 and inspection first hour free and thereafter Rs.5/- per hour or part thereof beyond first hour]
The rules provide for a format for application under RTI Act called Form-A, which is annexed herewith.
A. Application fee: Rs.10/- to be paid by bank’s demand draft or pay order or Indian Postal Order [IPO] or in cash against receipt or through treasury challan. Applicants holding BPL certificate need not pay any application fee.
Payment by IPO should be preferred being cheap and convenient. IPO should be in favour of “Accounts Officer, [mention name of public authority i.e. govt dept/organization etc]” and should be made payable at the place where application is sent.
B. Other charges: Information in A-3 or A-4 size paper….Rs.2/- per page, Large size: actual cost, publications: actual cost. CD Rs.50/- per CD. Inspection: Free for first hour and if exceeds one hour Rs.5/- for each hour or part thereof beyond first hour.
Rules do not provide for formats for first appeal, second appeal/complaint. No fees are charged for appeals. Suggested formats for appeals/complaint are annexed hereunder.
State Information Commission, Haryana, SCO No. 70-71, Sector 8-C, Chandigarh. Telephone No. 0172-2726568, Fax No. 0172-2783834 Website: http://cicharyana.gov.in/
The Right to Information Act, 2005
Form A [See rule 3 (1)]
To The State Public Information Officer/ State Assistant Public Information Officer, (Name of the office with address)
1. Full name of the applicant:
3. Particulars of information required:- (i) Subject matter of information* (ii) The period to which the information relates (iii) Description of the information required* (iv) Whether information is required by post or in person (the actual postal charges shall be included in addition to the fees.) (v) In case by post (Ordinary, Registered or Speed)
4. IPO No. for Rs.10/- is enclosed.
Signature of the Applicant
* Broad category of the subject to be indicated (such as Grant/Government land/ Service matters/Licenses etc.) Relevant period for which information is required to be indicated. * Specific details of the information are required to be indicated. 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 Right to Information Act, 2005 First Appeal
Date: To The Appellate Authority By regd AD post (Department/office)……………… Sir, As I have not received any decision/As I am aggrieved by the decision of the Public Information Officer…………, I hereby file this appeal. The particulars of my application are as under: Name of the appellant : Address of appellant : (A) Designation of the State Public Information Officer : Address of State Public Information Officer: (B) Department/office and address : (C) Particulars of the decision against which the appeal is preferred including the No. & Date of such decision. Date of application submitted in the Form A : Details of Information sought: as per enclosed form A 6. Reasons for Appeal: 7. Brief facts of the case. 8. Prayer/relief’s sought for : A] The information sought be ordered to be supplied immediately by registered post at my address. B] The information be now supplied to me free of cost. C] CPIO be advised to permit inspection of record, as requested by me. [if applicable] D] I should be fully compensated for not supplying information in prescribed time limit. E] Disciplinary action be initiated for not complying with the law against erring officers. 9. Enclosures: Self attested copies of RTI application, reply of SPIO [if received], postal proof of mailing RTI application. I hereby state that the information and particulars given above are true to the best of my knowledge and brief. Place Signature of Appellant _
SEOND APPEAL/COMPLAINT TO STATE INFORMATION COMMISSION, HARYANA
Date: By speed post AD
To, State Chief Information Commissioner, State Information Commission, Haryana, SCO No. 70-71, Sector 8-C, Chandigarh.
As I have not received any decision/As I am aggrieved by the decision of the PIO & First Appellate Authority, I here by file this second appeal/complaint for your kind consideration. The particulars are as under:
[1) Full name of the Applicant :
 Address of Applicant with phone No. and email ID if any :
(3) Name and address of StatePublic Information Officer:
No. and date of reply if received:
(4) Name and address of the First Appellate Authority:
No. and date of reply if received:
 Date of receipt of order of first appellate authority :
(6) Particulars of information sought- as per enclosed RTI application
(7) Brief facts and grounds for appeal:
A] The information sought be ordered to be supplied immediately by registered post at my address.
B] The information be now supplied to me free of cost.
C] CPIO be advised to permit inspection of record, as requested by me. [if applicable]
D] Penalty as per RTI Act be imposed on PIO.
E] I should be fully compensated for not supplying information in prescribed time limit and breach of my right.
F] Disciplinary action be ordered to be initiated for not complying with the law against PIO & FAA
G] Public Authority be ordered to reimburse traveling and lodging-boarding expenses incurred by me for attending hearing.
H] Hon’ble Commission may order making an entry in service book/annual appraisal report of the concerned PIO & FAA for defying act of the parliament.
I] The hon’ble Commission be pleased to pass such other orders as deemed fit in the interest of justice and spirit of RTI.
(9) Enclosures: Self attested photo copies of the following documents :
A. Application in form A dated with its enclosures if any, B. Reply dated of PIO if received, C. First Appeal dated D. Reply dated___ to first appeal, if received, E. Postal proof of posting of Form A and first appeal.
. Verification: I the undersigned hereby state that the information and particulars given here-in-above are true to the best of my knowledge and belief. Place : Signature of Appellant/Complainant [To be submitted in three copies to the Commission]