FORM ‘B’

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FORM ‘B’

Information for Payment

From

Name & Designation of the State Public Information Officer / State Assistant Public Information Officer

To,

                        Name of the applicant

                        Address

Sir,

                        Please refer to your application dated ________________________ addressed to the undersigned requesting information on …………………………... I am to inform you that the following amount towards cost for providing information may be deposited in cash, to enable the undersigned to furnish information sought for.

 

                        Please make payment within a period of fifteen days from the date of receipt of this intimation failing which the application shall be rejected.

 

Fee …………….

                                                                                                Yours faithfully,

Place:

Date:

State Public Information Officer/ State Assistant Public Information Officer

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