FORM ā€˜Eā€™

 

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FORM ‘E’

Second Appeal under section 19 (3) of the Act

 

From

 

(Applicant’s Name & Address)

 

To,

 

The Mizoram Information Commission

 

  1. Full Name of the Appellant                            :
  2. Address with contact Nos.                             :
  3. Particulars of the First Appellate Authority   :
  4. Date of receipt of the order appealed against :
  5. Last date of filing the appeal                          :
  6. Particulars of information.

 

  1. Nature and subject matter of the        :

Information required

  1. Name of the Office or Department to            :

which the information relates

  1. The grounds for appeal

(Details if any to be enclosed in separate sheet)

 

Verification

 

                        I ………………………….. (Name of the appellant), son of/daughter of/ wife of ………............. hereby declare that the particulars furnished in the appeal are to the best of my knowledge and belief, true and correct and that I have not suppressed any material fact.

 

 

Place:                                                                           Signature of the appellant                                                                                                                              

Date:

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