APPLICATION FOR ACCESS TO INFORMATION UNDER THE RIGHT TO INFORMATION ACT, 2019 (ACT 989)

1. *Type of Applicant
2. *Name of Applicant
3. Date

4. *Public Institution
5. *Date of Birth
6. Tax Identification Number
7. *Id. No.
7(a). *Type of Identification
7(b) Upload Id photo
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8. If Represented, Name of Person Being Represented
8(a). Capacity of Representative
9.
*Description of the Information being sought (specify the type and class of information including cover dates. Kindly fill multiple applications for multiple requests)
10. *Manner of Access
10(a). *Form of Access
11 *Contact Details

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12. Applicant’s signature/thumbprint

Please use your mouse to sign in the signature space provided

13.
Signature of Witness (where applicable)
“This request was read to the applicant in the language the applicant understands and the applicant appeared to have understood the content of the request.”