FORM - A

Application form for obtaining information

To
The State Public Information Officer /
State Assistant Public Information Officer
Andhra Pradesh Legislature Secretariat
Velagapudi, Amaravathi, Guntur Dist .

1. Name of the applicant

2. Full Address

3. Brief particulars of information required

4. I hereby state that the information sought for us not covered under the categories which are exempted from disclosure of information under Section 8 or Section 9 of the Right to Information Act, 2005 to the best of my knowledge it pertains to your Secretariat.

5. I hereby state that the prescribed application fee of Rs. -------- has been paid vide Receipt No. -------------, date --------------- to Drawing and Disbursing Officer, Andhra Pradesh Legislature Secretariat towards fee payable.


Place:

Date:                                             Signature of the Applicant