THE RIGHT TO INFORMATION ACT 2005 APPLICATION FOR OBTAINING INFORMATION
The Public Information Officer,
OFFICE ADDRESS, XXXXX District
CITY - XXXXXX
1. Name of the Applicant: XXXXXXXX
2. Address with Phone Number:
Address line 1
Address line 2
Phone Number: xxxxxxxxxxxx
3. Particulars of the Information Required:
I would like to receive the following information about XXXXXXX S/o YYYYY, who is serving as DESIGNATION, OFFICE ADDRESS with the relevant documents’ copy.
1. XXXXXXXX’s current pay scale details with monthly take home salary after deductions.
2. XXXXXXXX’s joining date to the service and promotion details if any.
3. Any misconduct, departmental enquiry or remarks on XXXXXXXX, so far.
4. Loans availed from the department so far, if any.
5. Details of other loans availed from banks and other financial institutions.
6. With reference to “THE TAMIL NADU GOVERNMENT SERVANTS' CONDUCT RULES, 1973” guidelines defined by government, following information and documents are required:
1. Rule No: 3 – Details of the gifts and articles from relatives and friends received on his daughter ZZZZZZZZZ’s marriage held on DATE & PLACE, as declared by XXXXXXXX to the government.
2. Rule No: 3A – Declaration given by XXXXXXXX that he has not given dowry for his daughter’s marriage and the signed declaration from the parties that the dowry was not involved in the marriage.
3. Copies of following declaration forms, as Listed under SCHEDULE I for the period from 1990 to 2008.
a. Form No. I (Statement of immovable property held by Government Servants)
b. Form No. II (Statement of liquid assets held by Government Servants)
c. Form No. III (Statement of movable property held by Government Servants)
d. Form No. IV (Statement of Provident Fund and Life Insurance Policy held by Government Servants)
e. Form No. V (Statement of debts and other liabilities of the Government Servants)
f. Form No. VI (Form of report/application for permission of the Government for the building of or addition to a house)
g. Form No. VI-A (Form of application for permission for acquisition of house)
h. Form No. VII (Form of report to the Government after completion of the building of a house/addition to the house)
i. SCHEDULE II (Register of immovable property and interests in immovable property held by Government servant)
4. Details of payment of application fee:
Non-judicial court fee stamp of Rs.10/- is affixed on the top herein above.