FORM-D

                                         [See Rule-7(1)]

Form of Memorandum  of Appeal to the first Appellate Authority under

                                     Section 19 (1) of the Act

 

From

            ______________________________________

                      (Applicant's  Name & address)

Before

           The First  Appellate Authority

 

1.  Full  name of the Appellant                       :

2.  Address                                                 :

 

 

3.   Particulars of Public Information  Officer    :

4. Date of recept of the order appealed against       :

5. Last date for filling the appeal                             :

6. Particulars of information :

  (a)  Nature and subject matter of the information required   :

  (b) Name of the office or department to which the

      information relates                                                    :

7.  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 tje best of my knowledge and belife, true and correct and that I

have not suppressed any material fact.

 

                                                                                                                                Signature of the Appellant                                                                                                                                    Place : 

                                                                                                                               Date :

 

To

    ________________________________________

      Name and address of  Appellate Authority