First Appeal under Right to Information Act

Format of First Appeal under section 19(1) of the Right to Information Act.

ID NO__________

(For Official Use)

_________________

(Name & address of the Senior Officer acting as First Appellate Authority)

1.	Name of the Applicant	__________________________
2.	Address of the Applicant
3.	Particulars of the Central/ State Public Information Officer: (a) Name : (b) Address:
4.	Date of submission of application for seeking information
5.	Date on which 30/35/40 days from submission of application are over
6.	Reasons for appeal: (Please indicate separately for each question) (a) No response received within the specified period: (b) Aggrieved by the response received within the specified period (c ) Grounds for appeal
7.	Last date for filing the appeal
8.	Particulars of Information (a) Information requested (b) Subject (c) Period
9.	A fee of ____for appeal has been deposited in______ vide Receipt No._____ Dated _________(only if applicable)

Signature of Appellant
E-mail address, if any
Tel. No. (office)________
` (Residence)____________

Place:_________

Date:_________

Please attach :
(a) Copy of RTI application.
(b) Copy of the response received from CPIO with which the appellant is aggrieved.