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SAMPLE APPLICATION FORM (FILLED)

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ANNEXURE “A”
(See rule 3)


Format of Application for obtaining information under
The Right to Information Act 2005
To : The Assistant Police Commissioner,
Or The Public Information Officer,
Borivali Police Station, 1st Floor,
S.V.Road, Borivli – 400092

 

1. FULL NAME OF APPLICANT : Romesh Sadanand Bahari

2. ADDRESS : B-6/22, Jeevan Anand Building, Shanti Ashram, Borivali west, Mumbai 400103

3. PARTICULARS OF INFORMATION REQUIRED :

(i) Subject matter of information : Names of persons booked under the Noise Pollution (Regulation & Control) Rules 2000 and the Case numbers.

 

(ii) Period to which the information relates : January 2004 to May 2005

(iii) Description of information required : I require details of the persons against whom action has been taken for violating the norms prescribed under the Noise Pollution (Regulation & Control) Rules 2000, during any festival. Provide me the names of the persons, and the Case Numbers of the cases filed.

 

 

 

(iv) Whether information is required by post or in person : By Post

(v) In case by post (Ordinary, Registered or Speed) : By Speedpost only


4. WHETHER THE APPLICANT IS BELOW POVERTY LINE : No
(If yes, attach a photocopy of the proof thereof)

 

 

 

Place : Mumbai

Date : October 11, 2005

 

(Romesh S. Bahari)

Signature of the applicant