Sakshi Trust "RTI"

To

Public Information officer

Department

City

State

Form A requesting under section 6(1) of the

Right to Information Act 2005

A. Full Name of Applicant:                             

B. Address                                                        (fill any address from where you would like to correspond with Public Information officer [PIO])

C: Information required

1.  Please intimate the [name of agency] ward in which the following address falls:

 (give your address here)

 2.  Please provide a list of all the works awarded by Engineering Division (both maintenance and project divisions) of [name of agency] in this whole ward for the period _____________ to _______________.  The list should contain the following details:

1.  Name of the work

2. Work Order No

3. Name of contractor

4. Date of start

5. Date of completion

6. Rate at which work awarded

7. Sanctioned amount

8. Amount paid so far

9. Head of account

10. Status of work

11. Basis for decision to undertake this work

12. Sketch of each of these works

13. Copy of the Layout sketch of this ward

I would also like to inspect the work order registers for this division for the above period to ascertain that the list provided to me is correct. Please intimate the date, time and venue when I could come and inspect the same.

 Place: Bangalore                    

Date: 20-12-2005                                                          Signature of applicant

I have paid an application fee of Rs.XXX  vide IPO / Challan/ DD no: