REGISTER FOR APPLICATION FOR INFORMATION (Under the Provisions of the RTI Act, 2005) Name of the Public Authority : Name of the Office of SPIO : Name of the SPIO : Name of the ASPIO : Sl. No. Date of application Applicant's Name with Father / Mother / Husband Name and address of communication If citizen of India If living below the poverty line Card No. Nature of Information required 1 2 3 4 5 6 In what form the information is required Amount of fee paid Date on which the information is ready for delivery Actual date with mode of delivery Signature of SPIO / ASPIO receiving the application with mode Applica-tion fee Further fee Amount Date of application Date of deposit of further fee 7 8 9 10 11 12 13 14 Rejected date with reasons in brief and signature of SPIO / ASPIO Remarks 15 16 * To be maintained in the office of the SPIO / ASPIO by page marking and giving certificate thereof.
