Application Form under Right to Information Act, 2005

(To be filled in duplicate by the Applicant and submitted at the reception of the Delhi State ConsumerDisputes Redressal Commission, A-Block, 1st Floor, Vikas Bhawan, New Delhi)

(Separate form to be filled up for each query)

 1(a)††† Name and Address of the Applicant:

 

   

 

(b) †††† E-mail address:

(c) †††† Phone/Fax No.

 2. †††††† Date of Submission of Application:

 3. †††††† Subject Matter :

 

  

4. ††††††† Details of Information requested:

 

  

  

5. ††††††† Period to which the information relates:

 

 

6. ††††††† Fee enclosed (in cash/DD/Bankerís cheque)

†††

 

7. ††††††† Due dates by which information is to be furnished

††††††††††† (30 days from submission of application)

 

 8. †††††† How the applicant would like his information to be sent

(a)    By post

(b)   To be collected by hand

(c)    By e-mail

(d)   By Fax 

 

         (Signature of the Applicant)