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
