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First Appeal For Central Govt:format



The Right to Information Act, 2005




First Appeal for Central Govt.



I.D. No_________ Date: _________ [For office use]





The First Appellate Authority under RTI Act

Dept/Office___________________ REGD AD










As I am aggrieved by decision/no decision of Central Public



Information Officer, I hereby file this appeal for your kind decision.


1. Details of appellant


1.1 Full Name :


1.2. Full Address :


1.3 Phone/Cell No. :


1.4 Email ID :


2. Details of CPIO:


2.1 Name/Designation:


2.2 Full Address :



2.3 Name of Public Authority:




3. Details of RTI application to CPIO:


Date of Application________


Mailed on: _________


by registered/speed post No.________/hand delivery.


Date of receipt by CPIO______________


4. Particulars of payment of filing fee:


Paid Rs.10/- by bank draft/pay slip/IPO No. _________

Dated_________of_______________Bank/Post office


OR deposited cash on ____________against receipt No________




5. Details of information sought:






6. Particulars of Decision of CPIO:


Letter reference No__________________


Date of CPIO’s Decision:_____________


Date of receipt of decision by the appellant:___________


7. Brief facts of the case:





8. Reasons/grounds for this appeal:




9 Any other information in support of appeal:




10. Prayer/relief sought for:





11. Grounds for prayer/relief sought for:




12. Personal Presence at hearing: YES / NO




13. Enclosures: Photocopies of original RTI application with its enclosures, postal proof of mailing, acknowledgement of CPIO, decision letter of CPIO.


14. Declaration:


I hereby state that the information and particulars given above are true to the best of my knowledge and belief. I also declare that this matter is not previously filed with any information commission nor is pending with any Court or tribunal or authority.





Place: Date: Signature of appellant


P.S. Please refer office memorandum dated 09-07-2007 issued by DoPT, Govt. of India.


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